Healthcare in Karnataka: Is a Health Bill the Need of the Hour?

 

ವಿಜಯಪುರದಲ್ಲಿ ರಂಗೋಲಿಯ ಸುತ್ತ ಮಹಿಳೆಯರ ನೃತ್ಯ — PPP ವಿರುದ್ಧ ಘೋಷಣೆ

ನವೆಂಬರ್ 18, ಮಂಗಳವಾರ, ವಿಜಯಪುರದಲ್ಲಿ ಮಹಿಳೆಯರು ರಂಗೋಲಿಯ ಸುತ್ತ ನೃತ್ಯ ಮಾಡಿ
PPP ಮಾದರಿಯ ವೈದ್ಯಕೀಯ ಕಾಲೇಜು ಸ್ಥಾಪನೆಗೆ ವಿರೋಧದ ಗಟ್ಟಿಯಾದ ಸಂದೇಶ ನೀಡಿದರು.

ಜಿಲ್ಲೆಯ 30–35 ಪ್ರಮುಖ ವೃತ್ತಗಳಲ್ಲಿ ಮತ್ತು 9 ತಾಲೂಕು ಕೇಂದ್ರಗಳಲ್ಲಿ ಒಂದೇ ಸಮಯದಲ್ಲಿ ನಡೆದ ಈ ಸಾಂಸ್ಕೃತಿಕ ಪ್ರತಿಭಟನೆ - ಕೇವಲ ಕಲಾತ್ಮಕ ಕಾರ್ಯವಲ್ಲ—
ಜನರ ಹಕ್ಕು ರಕ್ಷಿಸುವ ಹೋರಾಟ.

ರಂಗೋಲಿಗಳಲ್ಲಿ ಮೂಡಿದ್ದ ಪದಗಳು:
“No PPP”, “Healthcare is our right”,
“ಸರ್ಕಾರಿ ವೈದ್ಯಕೀಯ ಕಾಲೇಜು ಬೇಕು”

ಜನರ ಸ್ಪಷ್ಟ ಧ್ವನಿ:

ಸಿದ್ದರಾಮಯ್ಯ ಸರ್ಕಾರವು PPP ಮಾದರಿಯನ್ನು ಕೈಬಿಟ್ಟು
ರಾಜ್ಯವೇ ವೈದ್ಯಕೀಯ ಕಾಲೇಜು ನಿರ್ಮಿಸಬೇಕು.

ಸಾರ್ವಜನಿಕ ಆರೋಗ್ಯ ಮಾರಾಟಕ್ಕೆ ಬೇಡ.
ಜನರ ಸಂಪತ್ತು ಖಾಸಗಿ ಲಾಭಕ್ಕೆ ಬೇಡ.

ವಿಜಯಪುರ ಮಾತನಾಡಿದೆ—ಇನ್ನು ಸರ್ಕಾರ ಕೇಳಬೇಕು.

 

Vijayapura Speaks: Women Lead a Powerful Protest Against PPP Medical College Plan

On Tuesday, the 18th of November, Vijayapura witnessed something extraordinary—not a rally with loud slogans, not a march led by political banners, but a silent, dignified, and deeply symbolic uprising led by the women of the district.

Across 30 to 35 major circles, and simultaneously in all nine taluk headquarters, groups of 20–25 women gathered at each location, kneeling on the ground to draw Rangoli—the traditional art form of celebration. But today, the Rangolis carried messages of resistance and anguish: “Healthcare is our right,” “No PPP,” “Our Medical College Must Belong to the People.”

This unique protest emerged in response to the Karnataka Government’s decision to establish the proposed Vijayapura District Medical College under a Public-Private Partnership (PPP) model. For the people of Vijayapura, this is not just an administrative decision—it is a question of dignity, equality, and survival.

The fear is simple and deeply rooted:
PPP means handing over public wealth and public health to private interests.
It means healthcare access defined by affordability, not need.
It means the poor being priced out of their own district hospital.

The message from the streets could not have been clearer:

“We will not allow our healthcare future to be privatized.”

This protest is also a heartfelt call to Chief Minister Siddaramaiah, a leader many still believe embodies the spirit of Kannada pride and socialist commitment.
People ask him to listen—not to political voices, but to the voices of ordinary citizens, farmers, workers, students, and especially women who occupied the streets today:

Establish the Medical College as a fully State-run institution.
Reject the PPP model.
Protect what belongs to the people.

What happened in Vijayapura today is not just a protest—it is a reminder that democracy lives only when citizens speak and governments listen.

The movement is growing.
And as the Rangoli patterns fade with the dusk, the message remains etched in the conscience of Karnataka:

Public health cannot be sold.

People’s voices cannot be ignored.

More actions are expected in the coming days. Vijayapura has spoken; now, the government must respond.

 Jana Vedike and Karnataka Jana Arogya Chaluvali will be holding protests in Bijapura town and other district headquarters of Bijapur on the 18th and 19th of November. We urge you to join and extend your support to the Vijayapura Government Medical College Establishment Committee (ವಿಜಯಪುರ ಸರಕಾರಿ ವೈದ್ಯಕೀಯ ಕಾಲೇಜು ಸ್ಥಾಪನಾ ಹೋರಾಟ ಸಮಿತಿ) in their demand for the establishment of a state-run medical college, not one developed through the PPP model.

 

https://thesouthfirst.com/health/interview-after-sridhar-vembus-claims-on-vaccines-and-autism-psychiatrist-dr-sugudev-sets-the-record-straight/   

                                                      Healthcare in India is being reduced to ‘free beds’ and ‘market beds’. 

Dr Akhila Vasan                         

  Dr Sylvia Karpagam

The private sector falls out of the ambit of the Right to Information (RTI) Act and fails to disclose basic morbidity and mortality statistics to the government. Synopsis: The latest PPP model being pushed by NITI Aayog requires private entities to build medical colleges in districts because it was “impossible for either the state or Union governments to bridge the gap in health and medical education infrastructure”. Adding a cherry on top, the government will also hand over district hospitals, including land, buildings, and staff, to private entities to serve as students’ clinical experience sites.

There is ample evidence that elected representatives and bureaucrats vested with the responsibility of ensuring healthcare to citizens are failing us in every way possible, handing over taxpayers’ money and public goods to an unregulated, unscrupulous and corrupt private sector.

Its proof includes last year’s announcements by the governments of Andhra Pradesh (AP) and Karnataka that they would set up new medical colleges under the Public Private Partnership (PPP) model.

It is a sobering thought that, under the guise of upgrading hospitals and increasing the number of medical colleges, public hospitals and public land worth crores of rupees are being handed over to private entities, with the NITI Aayog at the helm.

These violations occur despite the lack of evidence that these models benefit people. Further, the National Health Policy 2017 made PPP one of its key strategies, purportedly to strengthen the public health system, after consultations of the Union government and NITI Aayog with the World Bank in 2017.

Also Read: Privileged veganism vs othering of the marginalised

Why PPP model?

The latest PPP model being pushed by NITI Aayog requires private entities to build medical colleges in districts because it was “impossible for either the state or Union governments to bridge the gap in health and medical education infrastructure”.

Adding a cherry on top, the government will also hand over the district hospital, lock, stock and barrel, including land, buildings and staff, to the private entity to serve as students’ clinical experience sites.

In Karnataka, over 2,000 beds in nine district hospitals, worth more than ₹1,000 crore of public money, and hundreds of acres of public land, will be handed over. As if this was not enough, the Union and state would each provide 30-40 percent of the capital expenditure with a further 25 percent from each for operation and maintenance for the first five years.

Andhra Pradesh claims to have begun construction of 3,318 new buildings with ₹1,065 crore in central assistance in just one year and has also received a ₹100 crore performance incentive under the National Health Mission (NHM) and the Ayushman Arogya Mandir (AAM) initiative.

When the government is providing land, building, staff and equipment — bearing a substantial cost of capital expenditure — and also providing a part of the operational costs, it is only fair that citizens ask: Why isn’t the government investing in its own system? Why is it siphoning off taxpayers’ money into the coffers of the unregulated, unaccountable, predatory private sector?

Despite people’s resistance to this model, why is the government hell bent on going ahead? The answer lies in NITI Aayog’s policy documents, which are littered with references to business opportunities for global corporate cartels in India’s health care industry. It unapologetically refers to the Indian population as a ‘multi-billion-dollar health care market’.

The current PPP model is part of its effort to “penetrate the markets” in tier 2 and 3 towns and rural areas. If the intent and efforts of the apex policymaking body of the country is not to provide free universal health care to the suffering millions in this country but to afford access to “markets” for corporate cartels then it is no surprise that 80 percent of the households primarily depend on their “household income/savings” and 13 percent on “borrowings” to finance expenditure on hospitalisation.

Also Read: Dietary guidelines of ICMR-NIN exhibit food bias

PPP model to affect the poor

Despite the litany of PPP failures in Karnataka (Karuna trust, Mother and Child hospital Udupi, Arogya bandhu scheme, Apollo OPEC Hospital, Raichur), this model takes a step further and is set to dismantle the last remaining bastion of health care for the poor and also ensure that medical education remains beyond the reach of young people from marginalised communities.

The private entity in the model is expected to reserve 20 percent of beds for free patients and can charge “competitive market rates” for the remaining 80 percent for those who can pay.

As if this is not bad enough, those with Below Poverty Line (BPL) cards have to seek authorisation to avail the free bed. We have seen with the government health insurance scheme that they are, by design, meant to make healthcare less accessible, especially to those who need them most.

Sadly, these issues are already well known and documented. Yet the government is wilfully allowing a free government hospital to morph into a profit-seeking commercial enterprise.

Although the PPP model for medical colleges may increase the number of MBBS seats, it will be unaffordable for the majority, particularly those from vulnerable communities. Constitutional mandates related to labour laws, reservation, domicile in hiring etc., will be left in limbo, thus ensuring that the medical profession continues to be within the vice-like grip of the privileged caste and class groups.

Private medical colleges are already in disrepute for unethical practices, right from how they appoint faculty to violating National Medical Council (NMC) guidelines to the quality of students who graduate. Private medical colleges are now business entities churning out half-baked “doctors” who have little commitment to medical ethics or patient care and who then go on to practice in exploitative corporate hospitals.

The government has repeatedly demonstrated its failure to hold private institutions accountable, to push for laws that protect patient rights (Karnataka Private Medical Establishments (KPME) Act), enforce agreement clauses (audits, reports, data, etc.) or protect public institutions and public land.

On the other hand, the private sector falls out of the ambit of the Right to Information (RTI) Act and fails to disclose basic morbidity and mortality statistics to the government. In effect, the government will take on a major share of the responsibilities and liabilities, while the private entity will have all the rights and profits. Patients, citizens and communities, and even local elected representatives, will only fall by the wayside.

The plan to auction 103 district hospitals (in the first phase) with a total of 29,561 beds to private entities and allow the latter to set up medical colleges turns out to be by far the most brazen of additions by NITI Aayog to the playbook on how to destroy the public health system and endanger people’s health even more.

The chief minister of Karnataka belongs to one of the oppressed communities and has risen to the present position from the ranks of progressive people’s movements. One would expect him to see reason and stop this disastrous move. However, it looks as if he is all set to betray the trust of the people who returned him to power.

If he indeed has a sense of social justice and moral courage, he will stop his government’s disastrous move. Health is a state subject. And states have the choice and right to not implement a Centre’s policy proposal. Yet, the Karnataka government, which lays claim to the legacy of Buddha, Basavanna and Ambedkar, has shamefully chosen to go ahead and implement this policy.

Karnataka, for one, should be the first state to refrain from implementing this model given that the state has the dubious distinction of being the laboratory for testing out the PPP models, all of which now constitute a litany of miserable failures, whether at the primary or tertiary level.

(Dr. Akhila Vasan is a public health researcher affiliated with Karnataka Janaarogya Chaluvali. Dr. Sylvia Karpagam is a public health doctor and researcher. Views expressed are of the authors. Edited by Majnu Babu.)

https://thesouthfirst.com/opinion/profit-or-people-first-struggle-against-ppp-models-in-karnatakas-healthcare-sector/ 

Profit or people first? Struggle against PPP models in Karnataka’s healthcare sector

The public health infrastructure across Karnataka is inadequate, forcing families to seek care in private hospitals that charge exorbitant fees. This forces families to choose between losing a loved one or facing destitution.

Teena Xavier

Vijayakumar Seethappa

Synopsis: The Karnataka government is handing over government hospitals to private players to operate them on a PPP model. However, the state doesn’t seem to have learnt from its experience. Those at the receiving end are the poor.

The Congress came to power in Karnataka riding on the back of several promises. While some have been implemented wholeheartedly and others halfheartedly, some have yet to be rolled out.

When it comes to healthcare, the pro-people commitment lies in a shambles, with the government refusing to learn from several failed policies.

The public health infrastructure across Karnataka is inadequate, forcing families to seek care in private hospitals that charge exorbitant fees. This forces families to choose between losing a loved one or facing destitution.

Instead of strengthening public facilities, the administration continues to court the PPP (Public-Private Partnership) model that has only drained public resources and left people to the mercy of the private healthcare sector.

For the period 2018- 2023, ₹6,286 crore was reimbursed to empanelled private hospitals under the Ayushman Bharat Arogya Karnataka Insurance Scheme. Extending grants and subsidies, and handing over public lands and infrastructure sans accountability or responsibility seems to be the new ‘Karnataka model’.

District hospitals are earmarked for being handed over to corporate players in the name of efficiency. But where is efficiency? While Apollo abandoned the OPEC (Rajiv Gandhi Super Speciality) Hospital in Raichur, the one at Udupi was left to the mercy of BRS Shetty, who abandoned the idea midway, affecting patients and their families.

The state is not merely failing in its duty but has turned to be an agent of predatory private entities that monetise the suffering of its most vulnerable citizens. The chief minister and the health minister need to take a firm stand against the PPP  model instead of justifying it.

The PPP push and people’s resistance

Adding to its long list of failed PPPs, the government has now, inspired by NITI Aayog’s 2019 blueprint, decided to hand over public district hospitals to private players on 99-year leases.

Nine district hospitals, at Tumakuru, Davanagere, Chitradurga, Kolar, Dakshina Kannada, Udupi, Bengaluru Rural, Vijayapura, and Vijayanagara, are facing handover.

Ramanagara and Bagalkot were initially included, but excluded with the announcements of new government medical colleges.

People’s resistance to PPP models is neither new nor sporadic. It has been an ongoing struggle in the state against the commercialisation of healthcare. While not all actions have yielded the desired results, people are not giving up.

Save OPEC campaign in Raichur

When the Rajiv Gandhi Super Speciality Hospital (RGSSH) in Raichur was handed over to the Apollo Group, it was explicitly agreed that at least 70 percent of patients should be from the Below Poverty Line (BPL) families. But soon enough, irregularities emerged.

As early as 2007, the Karnataka Rajya Raitha Sangha had formally complained about how hospital services were being brokered for commissions and becoming inaccessible to BPL patients. Citing that their cards were found to have ‘irregularities’, patients were asked to deposit ₹25,000 each. They were promised reimbursement, but were later informed that their cards had been rejected.

On the one hand, the hospital agents collected money. On the other hand, the government reimbursed the medical expenses of the poor. This large-scale fraud was exposed by the local sanghatans. They complained to the principal secretary of health and family welfare, who instituted an enquiry.

This fraud was also picked up by the local audit circle. Apart from being directed to reimburse the deposit, Apollo Hospital faced no disciplinary action.

The simmering anger against the Apollo management exploded into the ‘Save OPEC’ campaign when the contract was due for renewal. The ‘Save OPEC’ struggle committee was formed under the leadership of a senior trade union leader.

Meanwhile, Apollo abandoned the hospital and decamped, leaving the staff in a lurch. The government refused to entertain the demands of the staff to be reinstated, claiming they were not government employees.

In desperation, the workers launched a 24×7 dharna in front of the hospital with the Save OPEC Committee’s support. Local MLAs and MPs were pressured to take a clear stance, and the matter reached the Cabinet and the Chief Minister’s Office.

The ‘Save OPEC’ Committee demanded that RGSSH should not be handed back to Apollo, and that it be made an autonomous institution with all the former staff reinstated.

In August 2013, the home minister agreed to the demands, but it took three years for the hospital to function again. Meanwhile, the toll on the infrastructure as well as on the protesting staff and patients was huge.

Campaign in Udupi

The Udupi district hospital and the maternal and child health hospital were handed over to a UAE-based businessman, BR Shetty’s company, BRS Ventures, for 30-60 years, with a commitment to renovate the MCH hospital and build a 400-bed super specialty hospital.

The land on which the hospital stood had been donated by Haji Abdullah Saheb, the founder of Corporation Bank and a philanthropist, with the explicit condition that the land would be used only for a government hospital serving the community, particularly the poor.

For the citizens of Udupi, who revered Haji Abdullah Saheb, the government’s move was an insult to his memory and a betrayal of people’s interests.

Local sanghatans, writers, progressive social movements, public intellectuals and ordinary citizens came together to oppose this move through online petitions, social media campaigns and large mobilisations on the ground. In October 2016, citizens marched in silence through the streets of Udupi carrying placards, saying, “Public hospitals belong to citizens”, “We want our health care rights, not charity”.

This march culminated in a public meeting where the same demands were again raised.

“It is cruel that the government can spend ₹1n700 crore for a mere 7-km steel flyover but claims to be a pauper when it comes to running a public hospital. If the government does not have money to run the hospital, each of us will contribute from our own pocket,” a senior citizen said.

The march and the public meeting were followed by a relay hunger strike. Yet the government decided to go ahead with the handover without even a tendering process.

Not surprisingly, midway through the project, BRS Ventures dropped out amid allegations of financial fraud. The construction of the 400-bed super specialty hospital stopped, leaving the building abandoned. The district hospital is awaiting construction, apparently due to a shortage of funds.

Davanagere and Bijapur

In 2022, there was a large-scale mobilisation that continues till date against the handing over of the popular Chitageri Government Hospital, which also caters to nearby districts of Haveri and Chitradurga, to a medical college under the PPP model.

Mobilisation against the PPP model in Bijapura began in January 2023 when the district hospital was shortlisted to be handed over to a private medical college under the PPP model.

On 25 January 2023, thousands of women, workers, students, and senior citizens participated in a massive protest in front of the District Hospital, which was followed by protests in the district’s all taluks. The struggle intensified over the past few months under the leadership of the “Sarkari Vaidyakeeya College Sthapana Horata Samiti”.

The Samiti began an indefinite protest on 18 September 2025. Every day, hundreds of people from women’s sangathans, slumdwellers’ collectives, progressive citizens’ forums and youth organisations from all parts of the district are gathering at the protest site.

The committee plans to launch a 24×7 protest as a run-up to the Cabinet meeting slated to be held in Bijapur at the end of this month.

People’s health or private profits?

The protests are poised to spread to other districts where such PPP models are planned. The people have made it clear that they will not mortgage their lives to predatory private interests.

The question is whether Siddaramaiah’s government will listen to the people who brought it back to power — or whether it will bulldoze ahead to represent and privilege profits over people.

(Views expressed are of the authors. Edited by Majnu Babu).

Protest against PPP model medical college and handing over of Bijapur district

 Protest against PPP model medical college and handing over of Bijapur district On October 23, 2025, a protest led by Teena Xavier of Karnataka Jana Arogya Chaluvali was held in Devara Hipparagi taluk, Bijapur, against a proposed PPP-model medical college and the privatization of district healthcare.