100 days of BJP rule in Delhi: Ayushman Bharat off to a smooth start, Arogya Mandirs still await impact

With at least 550 patients availing services under the Ayushman Bharat scheme, 62 hospitals being empanelled under the state health authority, and 3.16 lakh beneficiaries being registered, the scheme appears to be off to a smooth start.

Sources say more than 30,000 beneficiaries — aged 70 and above — have registered under the insurance scheme that gives a total health cover of Rs 10 lakh.

Beneficiaries are selected based on National Food Security Act (NFSA) data, and Socio-Economic and Caste Census 2011. While Centre offers a cover of Rs 5 lakh, the Delhi government provides an additional top-up of Rs 5 lakh to those eligible, Chief Minister Rekha Gupta had said after the Delhi Cabinet’s first meeting.

The government has also provided Ayushman cards for senior citizens aged 70 and above, eligible to get their medical expenses covered at empanelled government and private hospitals in the city, under Pradhan Mantri Vaya Vandana Yojana (PMVVY). The Delhi government has planned to deploy mobile vans across the city for door-to-door registration for elderly citizens.

However, the challenge for the government is the empanelment of private hospitals, as major players such as Apollo and Max hospitals, are yet to get onboard.

The National Health Authority (NHA) dashboard says a total of 93 hospitals have been empanelled, which includes 82 private hospitals and 11 public hospitals. The list accessed by The Indian Express mentioned a total of 62 hospitals, including both private and public hospitals. Of the 62 private hospitals providing services under Ayushman Bharat, nine are dedicated eye care hospitals. Along with this, hospitals also had general medicine, general surgery, and obstetrics and gynecology and cardiology.

Representing the Association of Healthcare Providers, India (APHI), Dr Vipender Sabherwal, convenor for the Ayushman Bharat scheme, says, “It’s a very good scheme but we need to do a reality check”.

“We have been in touch with the Union Health Ministry and the government officials on pricing and rates, which do not match the requirements of any good hospitals with all facilities. The amount, which is being offered to the hospitals is meagre, and not practical. Even our payments were not being made on time under Ayushman Bharat. Even the big names,” he adds.

Dr Vipender Sabherwal says the doctors’ associations will get in touch with the government again to discuss things.

AHPI represents about 15,000 private hospitals, including Fortis, Max Healthcare, Manipal, Medanta, Narayana and Apollo.

How primary healthcare fared

With the shutting of mohalla clinics and the setting up of Ayushman Arogya Mandirs, not much has changed when it comes to primary healthcare in the city.

Soon after coming to power, the BJP government decided to establish Jan Arogya Mandirs in place of AAP’s flagship mohalla clinics and Delhi government dispensaries.

While the Jan Arogya Mandir is yet to be officially inaugurated, the BJP government has readied at least four such clinics — one each in Todapur, Bhanwar Singh Camp in Vasant Vihar, Mayapuri and Inderpuri. This is part of the Centre’s flagship Pradhan Mantri Ayushman Bharat Health Infrastructure Mission scheme (PM-ABHIM), which has been implemented in the Capital.

Officials have received instructions to complete the construction of 33 Ayushman Arogya Mandir by May 29.

The distribution of these 33 centres includes 20 facilities being established in Public Works Department (PWD) structures, including one at the Delhi Secretariat. Additionally, 11 centres will operate from Municipal Corporation of Delhi (MCD) locations, while two will be situated in New Delhi Municipal Council (NDMC) buildings.

Delhi Health Minister Pankaj Kumar Singh had said that the government will open 200 such centres in the next two months.

The Arogya Mandir provides 12 comprehensive service packages, including maternal and child healthcare, vaccinations, mental health services, elderly care, and treatment for communicable diseases.

When The Indian Express visited an Arogya mandir in Central Delhi’s Inderpuri, locals said the clinic is providing similar services as it was providing when it was a mohalla clinic.

The facility is supposed to maintain an essential drug list of 256 medicines. In-house tests will be made available for blood sugar, haemoglobin, blood group, urine, pregnancy, among others. Ninety other tests will be outsourced to Agilus Lab.

Free dialysis

CM Rekha Gupta had announced adding 300 dialysis machines across 16 government hospitals in the first 100 days of her rule, making free dialysis services available to the economically weaker sections and subsidised treatment available to all others.

Currently, 150 dialysis machines are operational at Bhagwan Mahavir Hospital (North West), Guru Gobind Singh Govt. Hospital (West), Indira Gandhi Hospital (South West), Pt. Madan Mohan Malaviya Hospital (South), Deep Chand Bandhu Hospital (North West), Deen Dayal Upadhyay Hospital (West), Maharishi Valmiki Hospital (North), Lok Nayak Hospital (Central), Rajiv Gandhi Super Speciality Hospital (Shahdara), and Dr. Hedgewar Aarogya Sansthan (Shahdara).

An additional 150 dialysis machines are now being installed at six more government facilities: Dr. Baba Sahib Ambedkar Hospital (North West), Jag Pravesh Chandra Hospital (North East), Burari Hospital (Central), Janakpuri Super Speciality Hospital (West), Ambedkar Nagar Hospital (South), and Sanjay Gandhi Memorial Hospital (North West). These additions will expand the capacity and geographic reach of free and subsidized dialysis services for Delhi’s citizens.

This initiative is being implemented under the Pradhan Mantri National Dialysis Program (PMNDP) and PPP Dialysis Project of the Delhi government. It includes 150 machines already operational under the Pradhan Mantri National Dialysis Programme (PMNDP) and PPP Dialysis Project. An additional 150 machines are now being added as part of improving public healthcare infrastructure.

Of the 300 dialysis units in Delhi government hospitals, many are yet to be installed.