In early September, a junior resident doctor at the Government Medical College and Hospital in Chandigarh’s Sector 32, spent three days trying to register with Digi Doctor—a registry of doctors that is part of the newly announced National Digital Health Mission 2020. The mission’s stated aim is to provide a backbone to support an integrated digital health infrastructure for the country. “By the end of it, I was so frustrated that I called up the helpline number listed on the NDHM website and asked if it was mandatory for me to register,” he said. “I was told that registering will be useful if I am a practicing clinician but is not mandatory. Then why was I forced to register when I am still a student?” At least five health workers from Chandigarh told me that they were compelled to enrol themselves in the doctor’s registry, and to register for national health IDs under the mission even though it is supposed to be voluntary. All five spoke to me on the condition of anonymity.
On 28 August, Jagat Ram, the director of the Post Graduate Institute of Medical Education and Research in the union territory, issued a circular, which stated that “registration for generating Health IDs is mandatory for all citizens of the country.” Chandigarh is one of seven union territories that the National Health Authority—the autonomous body attached to the union ministry of health and family welfare that is implementing the NDHM—had selected for a pilot project under the mission. The PGIMER order further said that the Chandigarh administration had directed the institute to get all its doctors and their family members to register for health IDs. Other government hospitals and medical education institutions in Chandigarh, like GMCH 32, also issued such directions. However, Indu Bhushan, the CEO of the NHA had repeatedly said since the NDHM was announced that it was “a purely voluntary scheme with the citizens’ rights at its core.”
The NHA distanced itself from PGIMER’s circular of 28 August in an emailed response to me on 4 September. Dr Praveen Gedam, the additional CEO of the NHA, who is in charge of implementing the NDHM, wrote that for the pilot project, “the generation of Health ID is purely a voluntary exercise i.e. it is a consent-based arrangement.” Gedam added that authorities had been advised “not to issue any such orders and withdraw/amend any such orders if already issued.”
In fact, the PGIMER backtracked and said that the term “mandatory” was an error that had been corrected. The institute issued a circular on 4 September stating that registering for health IDs was a completely voluntary exercise. “It is not mandatory per se, but it is just a good effort which will be successful if more and more people register, so we have only encouraged our staff to do so,” Ram said to me. In his email, Gedam also referred to this circular and said that it “now has been clarified that the registration for generating health IDs is purely a voluntary exercise.”