What a day-long strike shows about the importance of Aam Aadmi Clinics for Punjab govt

Why the clinics matter

The network of Aam Aadmi Clinics has today expanded to 1,090 operational clinics, with more than 3,000 doctors, pharmacists and clinical assistants forming the core workforce.

Millions of people have availed themselves of these facilities, where patients can access consultations, medicines and diagnostic tests for free. That makes the clinics particularly significant in the run-up to the 2027 elections. Unlike a policy whose impact may be difficult for voters to see, these clinics are tangible and accessible points of contact between the government and citizens.

Any prolonged disruption, therefore, could have had consequences beyond the immediate labour dispute. Patients dependent on the clinics could have been forced to seek services elsewhere, while the Opposition could have questioned the government’s ability to keep its flagship healthcare programme functioning.

The government clearly did not want the strike to reach that stage. Its decision to immediately engage with the employees helped prevent the agitation from becoming a prolonged political issue.

What the employees are demanding

The employees who run this network say their own future remains uncertain. Their central demand is job security.

They say they are neither regular government employees nor on a conventional contractual arrangement. They work under an empanelment system, with their payments linked to the number of patients they attend. At present, they are hired through walking interviews at the Civil Surgeon offices.

Protesting staff have compared themselves to daily wagers, saying that they do not receive paid casual or medical leave and are not paid for Sundays and holidays when they do not attend to patients.

They have now sought a more defined employment structure. “If immediate regularisation is not possible, they have suggested a five-year renewable contractual arrangement similar to the National Health Mission model, which they believe would give them greater security while not immediately placing them on the regular government payroll,” said Dr Talwinder Singh, President of the Joint Morcha of Aam Aadmi Clinics Staff.

They have also sought higher patient-linked payments. Doctors receive Rs 50 per patient, pharmacists Rs 12 and clinical assistants Rs 11. They are demanding Rs 80 for doctors, Rs 30 for pharmacists and Rs 25 for clinical assistants.

“The government has already accepted some demands, including providing experience certificates for their service at the clinics, while seeking 15 days to consider the major demands requiring policy decisions,” said Punjab Health Minister Balbir Singh Sidhu.

Why is job security such a major concern now?

The employees are concerned about their jobs in case the political leadership changes post-election. The staff fears that a future government could alter the scheme, rename or restructure the clinics, or change the employment model under which they work.

Delhi’s case has added to this apprehension. After the BJP came to power there, the Mohalla Clinic network underwent a transition towards the Ayushman Arogya Mandir framework, creating uncertainty among sections of the existing workforce over their future.

There were protests and legal proceedings concerning the continuation of contractual staff, while the Delhi government maintained that existing employees would be given priority under the new system. The closure of 121 clinics in Delhi in 2025 further heightened concerns among employees.

Punjab’s employees argue that if the clinics have become a permanent part of the state’s healthcare infrastructure, the workforce running them should not remain dependent on the political government of the day.

Can the Punjab government realistically meet these demands?

Experts said that the most difficult question is regularisation.

Bringing more than 3,000 employees into the regular government workforce would have financial and administrative implications. The government would have to consider sanctioned posts, recruitment rules, eligibility criteria, salaries and the long-term impact on state finances.

The alternative suggested by the employees could provide greater job security without immediately imposing the full financial burden of regularisation. The government could also consider retaining the present empanelment system but improving it by increasing per-patient payments and introducing defined service benefits.

However, the employees want assurance that their employment will not lapse if the government changes.

The next 15 days will show whether the government can convert its assurances into a concrete policy response. It has to balance three competing considerations: the demand for job security, the demand for higher patient-linked payments, and the financial sustainability of a network providing free healthcare to millions of people.

A prolonged employee agitation would have risked undermining that narrative; a satisfactory settlement, on the other hand, could allow the government to present the episode as an example of its willingness to listen and negotiate.