Punjab's rural dispensaries crumble amid urban health push, staff freeze

Chandigarh: Despite the Punjab government's push for urban healthcare reforms, rural healthcare in the state remains in crisis. Even as the Aam Aadmi Party (AAP) government announced new initiatives such as 1,000 additional MBBS posts in the Punjab Civil Medical Services (PCMS), hundreds of rural dispensaries continue to operate without medical staff or basic infrastructure, people familiar with the matter said.
A total of 1,186 rural dispensaries were set up in Punjab under the 73rd and 74th Constitutional Amendments in 2006 to provide healthcare through Panchayati Raj Institutions and bring basic medical services closer to villagers. However, a majority of these dispensaries are not functioning as intended. More than 600 dispensaries across the state do not have a single medical officer (MO) posted, leaving rural residents without access to essential healthcare, said an official privy to the matter.
Doctors reassigned, dispensaries neglected
In 2017, a total of 129 dispensaries were transferred from the rural development department to the health department in a bid to improve management. However, many of the medical officers were reassigned to primary health centres (PHCs) and urban health centres (UHCs), leaving the rural dispensaries understaffed and dysfunctional.
Currently, only 530 rural medical officers (RMOs) work under the zila parishads, insufficient to cover all the rural healthcare centres.
In areas like Mansa, Bathinda, Sangrur and Ferozepur, rural residents are forced to travel 30 to 40 kilometres to access basic medical treatment.
Amarjeet Kaur, a resident near Barnala, said: 'Our dispensary opens only occasionally and there is no doctor. We are given a few tablets, but for serious illness, we have to go to the city.'
No staff recruitment
Health workers and rural residents say there has been no recruitment for rural dispensaries in over a decade. Rajesh Sharma, secretary of the Rural Medical Services Association (RMSA), criticised the Punjab government for ignoring rural healthcare needs. 'While urban areas get more clinics and facilities, village dispensaries are being ignored,' Sharma said. 'Bureaucrats, backed by urban doctors with vested interests, have misinformed political leadership, stalling recruitment,' he added.
Sharma also raised concerns about the government's announcement of new medical officer posts, suggesting that doctors may not be posted to rural areas. 'In the past, doctors have been assigned to rural centres on paper but continue to work in urban hospitals,' he added.
Infrastructure in ruins
In addition to staffing shortages, many rural dispensaries lack basic infrastructure such as electricity, water and furniture. There are also issues with medicine supply, with stocks often running out for months at a time. According to a doctor working in rural Punjab, 'there is an erratic supply of medicines. Some dispensaries have medicine for only two or three months a year'.
Rural healthcare activists point out that while the SAD-BJP government had made improvements, things started to deteriorate under the Congress government from 2017 to 2022, and now, under the AAP government, the system seems to be in complete neglect.
While the rural development minister and secretary could not be reached for comment despite repeated attempts, an official from the department acknowledged the issue. 'We are aware of the shortage and have flagged it with higher authorities. We are working on how to fill vacancies and recruit doctors, particularly in remote areas where PCMS doctors are unwilling to work,' the official said, requesting anonymity.
The official also mentioned that the department has begun the process of procuring medicines for rural dispensaries and aims to resolve supply chain issues.

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