AN ANALYSIS OF DELHI’S HEALTHCARE MODEL

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By Aditya Gupta

Today’s world contains more information than before, yet not everyone has access to it. Although there has been much improvement in health services, yet everyone is not able to use them. Globally, governments have made significant progress in extending better accessibility to health services to all its citizens because nowadays, the success of a nation is measured beyond the calculations of GDP numbers. Health is the foremost thing a nation should focus to become prosperous intrinsically. High-quality healthcare facilities are the bedrock of the long-term development of any country. This research paper comprehensively deals with the changes incorporated by the Government of Delhi. The Delhi Healthcare Model is an example nationally as well as internationally. The paper provides a detailed analysis of the healthcare model in Delhi while discussing in detail how these new policies and changes can provide an impetus to quality healthcare services and thus benefit the individual as well as the State fulfilling the legal duty of the State.

“No society can legitimately call itself civilised if a sick person is denied medical aide because of lack of means.”

– Aneurin Bevan

A healthy population is an asset for an individual himself/herself and for the nation too. Health is an essential component for a State to be considered a prospered and a developed nation in its true sense.

The Department of Health and Family Welfare which works under the Government of Delhi has played a significant role in the last 6 to 7 years in uplifting the dismal state of the health system in the Indian capital region, Delhi. Popularly known as the “Delhi Healthcare Model”, the Delhi Government has laid down several restructuring mechanisms, policies, effective implementation forces, strict measures and improved public health systems. The Constitution of India that says for access to better healthcare[1] and the Right to Health[2] to people are also strengthened with this model. And the common people of Delhi are now able to get better, promotive, preventive, curative and rehabilitative healthcare services because of the improved productivity of the State Health Department and the state-run medical institutions. Thus, improving Delhi’s overall healthcare system by reaching the unserved communities.[3]

The transformation that took place in Delhi’s health system after the implementation of the model was tremendous. It inspired several other programmes and models not even in other states but in other countries as well. The international recognition received by it from United Nations (UN) and World Health Organisation (WHO) sets out countless examples.

MODEL

The Delhi Government has been taking several extraordinary steps in upgrading every individual’s experience to quality health services especially making it within the reach of unserved communities and deprived sections of the society for whom good health care services are still a costly affair.[1] To achieve the same, several plans have been laid out to give free of cost medicines, tests and various medical procedures through a three-layered network of Mohalla Clinics, Polyclinics and Hospitals. Thus, making a positive step towards transforming Delhi’s overall healthcare system.[2]

  1. AAM AADMI MOHALLACLINICS (AAMCs)

Mohalla Clinics are neighborhood facilities set up by the Delhi Government in 158 areas across Delhi for an incredibly minimal price policy and are giving excellent essential medical services to the unserved networks. Diagnosis, medicines and tests are completely given without any cost in Mohalla Clinics. The establishment of Mohalla Clinics takes place in porta cabins or in rented properties whichever seems better looking at overall reachability and facility for the patients.

2. POLYCLINICS

To construct a strong three level general medical care framework in Delhi. During their launch, the government has sent off 23 Polyclinics that provided specific diagnosis, therapy and other secondary health care services in the form of Outpatients Department (OPD) consultation to patients free of charge. Thus, forestalling the issue to visit overcrowded hospitals in Delhi. Moreover, it will gradually diminish the out-patient burden on hospitals owned and managed by the government and even permits them to zero in on quality in-patient care services.

3. GOVERNMENT HOSPITALS

Delhi government runs more than 40 fully qualified hospitals across Delhi. During the past few years after the implementation of this restructuring government hospitals system, the Government of Delhi has altogether worked on the patient experience in government hospitals bringing about predominantly positive and happy feedback from patients. The Delhi government’s model has made all medicines, tests andmedical procedures at these hospitals totally free of cost. Moreover, assuming that patients who are residents of Delhi are waitlisted for a perilous or fatal medical surgery at a Delhi government hospital for over 30 days, the hospital transfers the patient to an empaneled or government cooperated private hospital which treats the patient without any cost. Interestingly, even costly tests like CT scan and MRI are being led free of charge for the patients.

Apart from this, 265 ambulances comprising different medical facilities were launched with a fast responsive 102 number call center support, delivery and post-delivery transport services, medical emergency support services, accident, and trauma services, etc.

ANALYSIS

The Delhi Government set the target to 1000 Mohalla Clinics, 125 Polyclinics and a total bed strength of 40,000 in the Government hospitals.[1]Recent years have witnessed Government of Delhi’s high and gradually increasing percentage of expenditure in public health services. However, the Government is reducing the allocation made to the development of Aam Aadmi Mohalla Clinics and Polyclinics. In the year 2018-2019 Rs. 403 crores were allocated and in the year 2019-2020 Rs. 375 crores were allocated, making serious concerns regarding the achievability of targets as set out by the government previously.

[1]Samarth Bansal, Report Card: Two years of AAP Government in Delhi, HINDUSTAN TIMES (March 21, 2017) https://www.hindustantimes.com/interactives/aap-government-two-years-report-card

These clinics are presently giving essential medical care to desperate unserved people and communities. Diagnosis, tests and medicines are generally free of charges in the Aam Aadmi Mohalla Clinics. Yet, achievement carries with it a few issues, for example, the huge number of patients visiting the center to get the benefit of the free treatment, numbers the clinics presumably never expected or were intended for. As per the accessible figures,

essentially more than 200 – 300 people visit these clinics every day.[1] According to official reports by the concerned Delhi Health Authorities, the clinics have taken special care of more than 2 crore OPD patients and led 25 lakh tests till March 2020. In a nation where around 62% of the population needs to bear their own medical services costs, Mohalla clinics play an imperative influence in lessening the expenses of common man for accessing good healthcare facilities. Polyclinics have played a significant role in reducing the burden of Government hospitals due to many services being available there, fast and efficient treatment of patients takes place in such polyclinics itself. Moreover, Government hospitals have been provided with better accessibility to medical resources for proper and high-level treatment of the general public at very minimal costs.[2]

Article 21 of the Constitution of Indiathat says about the Right to Life and Personal liberty of an individual also includes Right to Health.[3]Article 21 is a broad concept that also incorporates health as an eminent factor at various levels.Article 47 of the Directive Principles of the State Policy under the Constitution of India also says for improvement and access to better healthcare facilities as a state’s obligation.[4]Moreover, the State has been composed to give the most imperative health estimates towards the fulfillment of international standards.[5]

The World Health Organisation lays several policies and laws for the upgradation of health amenities in every nation. Even the Universal Declaration of Human Rights, 1948 also concern health as an important virtue for an individual and nation development.[6]

Former United Nations Secretary General Kofi Annan and Ban Ki-Moon and ex-Norwegian head Gro Harlem Brundtland, the former Director General of the World Health Organization, have additionally stacked appreciation on the Government for the Delhi Healthcare Model, after the visit of the clinics and hospitals. This has set an example to other states in India as well as abroad, making healthcare services affordable and accessible to every citizen in a very effective and efficient framework.

Structural Contribution of Hospitals owned in Delhi as of 2019-20

However, there is a lack of awareness about this drive and its advantages, there have been a few issues connected with delay in making payments and patient management between the private medical care players and the Government of Delhi.But such Public-Private Partnerships (PPP) models will undoubtedly fail if the Government and the private players have their own dreams and targets to satisfy. An unholy union will end in unfortunate ramifications for the government healthcare framework and furthermore speed up the general medical care expenditure of an individual and society.[7]

The Delhi Government’s endeavours to construct a three-level all-inclusive medical care framework in Delhi including Aam Aadmi Mohalla Clinics, Polyclinics and hospitals, has absolutely diminished the out-patient burden on Government medical institutions, allowing them the unprecedented chance to focus in on quality patient healthcare services.[8]

Note

[1] Article 47, Constitution of India, 1949

[1]Article 21, Constitution of India, 1949

[1] GOVERNMENT OF NATIONAL CAPITAL TERRITORY OF DELHI, http://health.delhigovt.nic.in/wps/wcm/connect/9cc748004b6f3a1a8a92cb788745c51a/HMIS.pdf?MOD=AJPERES&lmod=-382194844 (last visited March 21, 2020)

[1]Directorate of Economics & Statistics Government of National Capital Territory of Delhi, Delhi Statistical Handbook (2014) (last accessed Dec 12, 2015) www.des.delhigovt.nic.in

[1]Health and Healthcare: The Delhi Human Development Report, 106 (2016). http://delhi.gov.in/wps/wcm/connect/doit_planning/Planning/Misc./Index+Human+Development+Report+2013.

[1]Samarth Bansal, Report Card: Two years of AAP Government in Delhi, HINDUSTAN TIMES (March 21, 2017) https://www.hindustantimes.com/interactives/aap-government-two-years-report-card

[1]AAM AADMI PARTY, https://aamaadmiparty.org/aap-government-healthcare-facilities-guide, (last visited Oct 2, 2017)

[1]United Nations Development Programme, Ch. 4: Health and Healthcare, The Delhi Human Development Report, 94–5 (2018)

[1]State Of Punjab v. Mohinder Singh Chawla, AIR 1997 SC 1225

[1]Vincent Panikurlangara v. Union of India and Others, 1987 SCC (2) 165

[1] Paschim Banga Khet mazdoor Samity and Others v. The State of West Bengal and Others, 1996 SCC (4) 37

[1] Article 25(1), Universal Declaration of Human Rights, 1948

[1]Indian Ministry of Health, Government of India, Annual report of Department of Health and Family Welfare, (2015).

REFERENCES

[A] CASE LAWS

  1. State Of Punjab v. Mohinder Singh Chawla, AIR 1997 SC 12252.
  2. Vincent Panikurlangara v. Union of India and Others, 1987 SCC (2) 165
  3. Paschim Banga Khet mazdoor Samity and Others v. The State of West Bengal and Others, 1996 SCC (4) 37

[B] STATUTES

  1. The Constitution of India, 1949
  2. Universal Declaration of Human Rights, 1948

[C] BOOKS&REPORTS

  1. P. JAIN, THE CONSTITUTION OF INDIA, 2018 (16th ed. 2021)
  2. United Nations Development Programme, Ch. 4: Health and Healthcare, The Delhi Human Development Report, 94–5 (2018)
  3. Directorate of Economics & Statistics Government of National Capital Territory of Delhi, Delhi Statistical Handbook (2014) (last accessed Dec 12, 2015) www.des.delhigovt.nic.in
  4. Indian Ministry of Health, Government of India, Annual report of Department of Health and Family Welfare, (2015).
  5. Health and Healthcare: The Delhi Human Development Report, 106 (2016). http://delhi.gov.in/wps/wcm/connect/doit_planning/Planning/Misc./Index+Human+Development+Report+2013.
  6. GOVERNMENT OF NATIONAL CAPITAL TERRITORY OF DELHI, http://health.delhigovt.nic.in/wps/wcm/connect/9cc748004b6f3a1a8a92cb788745c51a/HMIS.pdf?MOD=AJPERES&lmod=-382194844 (last visited March 21, 2020)
  7. Samarth Bansal, Report Card: Two years of AAP Government in Delhi, HINDUSTAN TIMES (March 21, 2017) https://www.hindustantimes.com/interactives/aap-government-two-years-report-card
  8. AAM AADMI PARTY, https://aamaadmiparty.org/aap-government-healthcare-facilities-guide, (last visited Oct 2, 2017)
  9. Delhi Government to implement Health Management Information System, THE HINDU BUSINESS LINE (March 28, 2021) https://www.thehindubusinessline.com/news/delhi-govt-to-implement-health-information-management-system/article36152551.ece

[D] ONLINE DATABASES

  1. Government of Delhi (https://delhi.gov.in)
  2. All India Reporter (www.aironline.in)
  3. SCC OnLine (www.scconline.in)

[1]Delhi Government to implement Health Management Information