Chandigarh Pioneers Slot-Based Specialist Services at Urban Primary Health Centres to Boost Accessible Care

Spread the Message

Read Time:4 Minute, 58 Second

Chandigarh’s Health Department has launched a groundbreaking initiative to deliver specialist medical consultations at Urban Primary Health Centres (UPHCs), known locally as Urban Ayushman Arogya Mandirs (UAAMs). Announced in January 2026, the program hires specialists on a flexible slot basis to serve peripheral urban and semi-urban areas, aiming to decongest higher-level hospitals and enhance primary healthcare delivery.

Initiative Details

The program deploys specialists in key disciplines including general medicine, surgery, paediatrics, ophthalmology, ENT, psychiatry, and dermatology across 11 UAAMs in locations such as Badheri, Raipur Kalan, Manimajra, Sarangpur, Behlana, Kaimbwal, and Sectors 25, 33, 39, 52, and Palsora. Seven specialists have been empanelled so far, with two more in general surgery and medicine set to join after recent walk-in interviews; they operate on a rotational basis, providing two two-hour slots per day at Rs 2,000 per slot under a monthly roster. This slot-based model, part of the Pradhan Mantri Ayushman Bharat Health Infrastructure Mission (PM-ABHIM), addresses past recruitment challenges under the National Health Mission by offering flexible hours without administrative burdens.

Dr. Suman Singh, Director of Health Services in Chandigarh, highlighted the appeal of this approach: “The response has been positive because the roles are limited to specific slots and do not involve heavy paperwork, administrative responsibilities, or long duty hours.” She emphasized that UAAMs, as the first point of contact for comprehensive primary care, will now offer specialized consultations to reduce patient loads at civil hospitals and district facilities like GMSH-16 and GMCH-32.

National Context and Challenges

India’s primary healthcare system grapples with severe specialist shortages, with nearly 80% vacancy rates at Community Health Centres (CHCs)—rising from 44% in 2005 to current levels—affecting states like Punjab and Haryana neighboring Chandigarh. Rural CHCs require 5,491 specialists across surgeon, physician, gynaecologist, and paediatrician roles, but shortfalls exceed 80% in many areas; urban facilities fare slightly better at 56% availability but still face human resource gaps. Previous efforts, including salary hikes to match neighboring states, failed to retain talent due to workload and lack of incentives.

The Ayushman Bharat framework transforms PHCs and UPHCs into Health and Wellness Centres (HWCs), targeting comprehensive primary care for populations of 30,000 in plains or 20,000 in tribal areas, with PM-ABHIM funding specialist services at select urban sites. Chandigarh’s model aligns with guidelines for UPHCs with specialists (polyclinics), promoting decentralized care amid overburdened tertiary hospitals where bypassing lower facilities leads to long waits and inefficiencies.

Expert Perspectives

Public health experts praise the innovation for its practicality. Dr. Antony K.R., an independent National Health Mission monitor, noted similar shortages nationally: “These dismal statistics are a message to the government that it either needs to revise its strategy… or completely shut these centres.” A senior Punjab health official echoed flexibility’s role, stating that high patient volumes in urban clinics necessitate adaptable staffing.

Local voices, including those from PGIMER Chandigarh—which collaborated on prior UAAM health camps—see potential for integration. Dr. Vivek Lal, PGIMER Director, stressed community outreach during a September 2025 Sector 25 camp serving over 300 women with specialist consultations. However, Dr. Akhil Sarin, President of the Punjab Civil Medical Services Association, cautioned that while retiree or contract hires provide relief, long-term solutions demand regular recruitments.

Public Health Implications

This initiative could significantly ease urban healthcare burdens, where overcrowding at public tertiary facilities stems from direct specialist-seeking and poor referrals; studies show 53% of self-referrals cite congestion. By localizing care, it supports early detection, free drugs, and tests under Ayushman Bharat, potentially cutting hospital admissions by 15-20% as seen in similar models. For Chandigarh’s ~1.2 million residents, particularly in dense sectors, it means shorter travel, reduced costs, and timely interventions for common issues like skin conditions, eye problems, or mental health concerns.

Practical benefits include rotational coverage ensuring consistent access without full-time hires, fostering preventive care like screenings for hypertension, diabetes, and anaemia—as demonstrated in UAAM camps. Residents in Manimajra or Sector 52, previously traveling to PGIMER, can now consult locally, aligning with India’s push for universal primary care via 17,788 rural and 11,024 urban HWCs.

Limitations and Counterarguments

Challenges persist: Slot-based systems risk inconsistent availability if rosters falter, and high urban footfalls—seen in Punjab’s Aam Aadmi Clinics with 200+ patients daily—could strain brief consultations. Critics argue contract models may prioritize volume over quality, with past instances of inflated patient counts for pay. Scaling nationally requires infrastructure upgrades, as only 30% of PHCs meet IPHS standards.

Moreover, while flexible pay attracts talent, it may not sustain long-term amid competition from private sectors offering better benefits. Equity concerns arise if peripheral UAAMs lack transport links, potentially excluding vulnerable groups. Experts urge monitoring outcomes, like patient satisfaction and referral reductions, to refine the model.

Broader Impact and Future Outlook

Chandigarh’s approach exemplifies adaptive primary care amid India’s doctor-patient ratio of 0.7:1,000—below WHO norms—potentially inspiring states like Punjab facing similar vacancies. Success metrics, such as reduced GMSH-16 referrals, will guide expansion; early camps show community buy-in. As PM-ABHIM invests in critical care and labs, integrated specialist slots could transform UAAMs into robust hubs.

For health-conscious residents, this means empowered daily decisions: Seek local specialists for non-emergencies, prioritizing preventive check-ups to avoid tertiary rushes. Healthcare professionals gain a blueprint for workforce optimization.

Medical Disclaimer: This article is for informational purposes only and should not be considered medical advice. Always consult with qualified healthcare professionals before making any health-related decisions or changes to your treatment plan. The information presented here is based on current research and expert opinions, which may evolve as new evidence emerges.

References