Shortage of doctors, lack of diagnostic facilities: What’s been ailing Delhi’s polyclinics

At 12.30 pm, security guards and staff tell patients to leave or get their checkup done quickly as the clinic will shut by 12.40-12.45. By 1 pm, the clinic shuts for the day. Priyanka says she had come to the clinic the day before at 12.30 pm but it was shut. “But the board outside says it will remain functional from 8 am till 2 pm,” she adds.

Set up in 2016, the polyclinic has been catering to around 1,000 people a month. However, patients claim doctors are mostly unavailable — a major issue, among several others, that plagues several polyclinics in the capital.

When The Indian Express enquired from residents about when the clinic opens, they say doctors arrive only by 10 am.

Meanwhile, a crowd was seen outside an Ayurvedic and Unani centre that’s housed in the same building as the polyclinic. Around 20-30 patients are prescribed medicines in just an hour. “We just needed a few medicines. The allopathy doctor isn’t here today so we are taking Unani medicine,” says Iqra, a resident of Gali Qasim Jan.

Locals in the area say the building used to be a Hindustani Dawakhana established by freedom fighter and Unani medicine expert Hakim Ajmal Khan before it became an ‘Aam Aadmi Polyclinic’ a few years ago.

The concept

The first polyclinic was opened in Delhi in 2015 by the Aam Aadmi Party government, with the aim of introducing a three-tier structure to boost primary healthcare. The first tier would have 1,000 mohalla clinics to address common healthcare problems. Patients with specialised needs would be referred to the second tier — the polyclinics. The third tier comprises tertiary-care hospitals.

According to a statement by former health minister Satyendar Jain in March 2022, there are about 25 polyclinics in Delhi. As per the government’s plan, polyclinics are specialist OPDs where medicine, gynaecology and paediatrics specialists are available every day and orthopaedics, eye, ENT, surgery and skin specialists are available once a week.

The purpose of these clinics was to save patients the hassle of visiting crowded hospitals and reducing the outpatient burden on government hospitals. To this end, patients from mohalla clinics are to be referred to polyclinics, which are, in turn, associated with Delhi government hospitals and doctors from these hospitals were to conduct OPDs by turns.

In 2016, 22 dispensaries were converted into polyclinics and were to remain under the supervision of state government hospitals.

No doctors, no tests

The Ballimaran clinic and another in Madanpur Khadar, which are affiliated to Lok Nayak hospital, face a host of problems: Lack of staff, diagnostic facilities and even medicine.

As per data accessed by The Indian Express, three positions of medical officers are vacant at Ballimaran while five posts are vacant at Madanpur Khadar.

At the Madanpur Khadar polyclinic, a single medical officer caters to the around 500 patients that it sees in a month. Rooms of other medical officers, including the Dot Centre meant for TB patients, are shut. One staff member makes receipts for patients while two others distribute medicines.

Among the patients waiting for a consultation is a pregnant woman, Seema Kumari from UP’s Jaunpur. Accompanied by her sister-in-law, she has come to get an MCH card which has details of vaccines she needs to get during her pregnancy.

She visited the clinic earlier to see a gynaecologist but the doctor was not available then. “We are just here for the vaccine card. My treatment is going on in a nearby private clinic,” she adds.

When asked if she has ever got a blood test or ultrasound done, Seema says the clinic does not have these facilities.

According to a staff member, all those requiring a blood test, ultrasound, MRI or X-ray have to go to Lajpat Nagar Colony Hospital, PSMS Hospital in Kalkaji or the polyclinic in Badarpur where the tests are available.

At the Ballimaran polyclinic too, no diagnostic facility is available either. “We come here only for medicines. For other things we go to Irwin (Lok Nayak hospital),” says a patient at the clinic.

A staff member here says that earlier, if a patient needs an MRI or an ultrasound, the clinic would send them to higher centres through the Delhi Arogya Kosh facility — that provides financial aid to needy people to avail treatment and diagnostic facilities at state government-run hospitals — but this has not been done for a long time.

“Even simple items like plaster of paris are mostly unavailable. In case of a fracture, we directly send patients to Lok Nayak’s ortho trauma centre,” adds the staffer.

At Madanpur Khadar, a shortage of medicine is also forcing patients to turn to private pharmacies. Mamta Yadav, a resident of the area, came to the clinic to get eye drops but it was not available. “I will buy it from a nearby pharmacy,” she says.

The only silver lining, says Mamta, is that medicines at the clinic are free of cost: “Whenever we need medicines, we come here. They are not available most of the time, but when they are, we get them for free.”

Meanwhile, the two clinics barely see any referral cases from mohalla clinics. Said an official from the Delhi government on condition of anonymity: “Those who have been visiting these clinics are mostly new patients from nearby areas. Those referred from mohalla clinics go to hospitals directly or private clinics.”

When asked about the situation at the polyclinics, a Delhi government official laid the blame at the door of the L-G as well as the Centre. He said: “The health department is facing an acute shortage of specialist doctors across hospitals and polyclinics. Recruitment is under the domain of the L-G and the central government. Despite many communications, consecutive L-Gs have not been able to provide specialist doctors…”

Responding to the Delhi government’s claims, Raj Niwas officials said no such proposal had been received by the L-G Secretariat till date. “When it comes to posts at medical institutions, whether it be GTB Hospital or Indira Gandhi Super Speciality Hospital among others, all have been cleared successfully and at priority,” an L-G House official said.

The official further alleged that it suited the Delhi government to keep these vacancies unfilled so that it could “employ people of their choice on contract”.