Medical mafia blocks ESI services in Khammam

Khammam district, known for its granite factories, hotels, cinemas, private companies, shops, and other industries, employs a significant number of daily wage workers and small employees, estimated at around 2.5 lakh. When including family members, nearly 10 lakh people are supposed to be covered under the Employees’ State Insurance (ESI) scheme. Despite this, proper ESI services remain largely unavailable, forcing workers and their families to depend on costly private medical care.

At present, the district is served by only a single dispensary near Sarapaka in Bhadrachalam. This small facility is insufficient to meet the healthcare needs of the vast workforce in the area. Even with three ministers in the district, including the Deputy Chief Minister, there appears to be little attention paid to establishing additional dispensaries. 

Workers and small employees have expressed frustration over the lack of action, noting that the state government has failed to set up dispensaries even after approvals from the central government.

The central government had previously approved three ESI dispensaries in Khammam more than a decade ago, recognizing the high number of workers in the district. However, state governments at the time did not take steps to operationalize them, and the approvals were eventually canceled. In 2018, as part of the establishment of 15 dispensaries across the state, the central government approved a dispensary in Mudigonda.

Despite this, the facility never became functional due to delays in land acquisition, construction, and staff appointments. Multiple reminders and ultimatums from the central government, including a warning in January this year to establish the dispensaries within 15 days, did not prompt any action from the state authorities. Consequently, all 15 approved dispensaries, including Mudigonda, were canceled, leading to anger among workers and the labor community.

Currently, aside from the Sarapaka dispensary, the only other facility in the district is a local branch office at Raparthinagar. This office offers no medicines or healthcare services. Doctors occasionally visit, but substantial treatment and care are unavailable, leaving workers to rely almost entirely on private hospitals.

Khammam is saturated with private medical facilities, which are reportedly thriving because more than 50 percent of their patients are workers, small employees, and their families—many of whom fall under ESI coverage. Workers allege that establishing ESI dispensaries would significantly reduce patient flow to private hospitals, affecting their revenue. They strongly suspect that pressure from these private medical providers has influenced state officials to delay or avoid setting up ESI facilities.

Workers and small employees argue that the inaction of state ministers, despite central approvals, reflects negligence and the undue influence of the “medical mafia.” Even with three ministers in the district, including the Deputy Chief Minister, there has been no progress in setting up dispensaries. <

The cancellation of the Mudigonda dispensary and the failure to operationalize other approved facilities have left Khammam’s labor community deeply dissatisfied. They insist that free healthcare services under ESI are essential for the welfare of workers and their families, and the continued delay and obstruction by both state authorities and private medical interests are a major source of frustration.