Tribals, patients agonise as Gujarat's Vyara Civil Hospital moves to PPP model
Bhuj, Dahod district hospitals, handed over to Adani and Zydus respectively, have been plagued by controversies over treatment, charges and medical college fees
The NITI Aayog in 2020 released a report suggesting that states hand over the management of government hospitals to private players. The BJP government in Gujarat went ahead with this a decade earlier, with the privatisation of a civil hospital at Bhuj, Kutch, in 2009.
Since then, successive BJP dispensations in Gujarat have handed over two more government hospitals to private players, and each time it has been mired in controversies.
Hospital deaths have raised concerns, and patients have complained about the charges. Moreover, these are teaching hospitals, and the medical colleges attached to them are accused of collecting exorbitant fees.
Adani, the pioneer
The Bhuj hospital, rebuilt at a cost of Rs 100 crore from the Prime Minister Relief Fund after the devastating 2001 earthquake, was handed over on a lease of 99 years to the Adani Foundation under a Private Public Partnership (PPP) deal.
Also read | Gujarat tribals up in arms as govt hospitals get privatised
It was renamed the 'GK General Hospital' and integrated with the Gujarat Adani Institute of Medical Sciences (GAIMS) that offers undergraduate and postgraduate course in medicine, making it a teaching hospital.
In 2013, Narendra Modi, as the then chief minister of Gujarat, touted the Adani-run hospital as a successful model to be emulated by other district hospitals.
Hospital makeover
The same year, then state health minister Nitin Patel said the government would undertake similar initiatives for six more districts — Tapi, Dahod, Panchamahal, Banaskantha, Bharuch, and Amreli. But there were no takers for the district hospitals.
In 2016 — by which time Modi had become the Prime Minister — the Gujarat government invited proposals to hand over five government hospitals to private parties under the PPP model.
In 2017, the Dahod Civil Hospital in the tribal dominated district in South Gujarat was given to the pharmaceutical giant Zydus Group.
In 2017, the Dahod Civil Hospital in the tribal-dominated district in South Gujarat was given to the pharmaceutical giant Zydus Group. The hospital is now called 'Zydus Medical College and Hospital' after being integrated with the Zydus Medical College, run by the Ramanbhai Foundation of Zydus Cadila.
More PPP hospitals
In 2022, the government again announced the privatisation of government district hospitals.
Health minister Rushikesh Patel said: “The government is going to emulate the PPP model of GK General in other districts to ensure premium healthcare in rural areas of the state. The model has been successful on all parameters. It has been affordable and efficient.”
Between 2019 and 2024, the Torrent Group purchased electoral bonds worth Rs 184 crore, of which Rs 134 crore went to the BJP. The Zydus Group gave bonds totalling Rs 29 crore to the BJP between 2022 and 2023.
He further said the government had decided to hand over the Vyara Civil Hospital in Tapi, a tribal majority district, to the Torrent Group, its third initiative under the PPP model.
The announcement was met with massive protests in the tribal belt ahead of Assembly elections in 2022, forcing the BJP government to halt the process.
Now again, Rushikesh Patel has announced the project will be set into motion, taken over by the UNM Foundation, a non-profit arm of the Torrent Group.
Treatment charges
Despite government claims, both the GK General in Bhuj and the Zydus Medical College and Hospital in Dahod have been plagued by controversies since their handover to private entities.
In 2010, residents of Bhuj protested against the outdoor patient department (OPD) fees being charged by GK General. However, it quickly died down with the police coming to the rescue of the hospital management.
Like in other government hospitals, OPD was earlier free in the Bhuj Civil Hospital. It changed under private management.
“The visiting charges for OPD in the hospital cost from Rs 100 to Rs 300 depending on the specialty. The only department that has a free OPD is general medicine. But most often the free OPD is assigned to the junior doctors,” a final year resident doctor of the GK General Hospital told The Federal.
Watch | How Urban Heat Islands are turning Indian cities into death traps
Infant and child deaths
The hospitals have been mired in other controversies, too. Between January and May 2018, over 110 newborn babies died at the GK General Hospital. The hospital management cited reasons like delayed admission or malnutrition for the deaths.
However, the deaths sparked protests across Gujarat. The government then formed a committee of doctors to conduct an inquiry. However, the panel gave a clean chit to the hospital.
A year later, Nitin Patel, then health minister of Gujarat, told the Assembly that more than 1,000 children had died in the Adani-run GK General Hospital between 2014 and 2019. The number stood at 188 in 2014, 187 in 2015, 208 in 2016, 276 in 2017 and 159 till May 2019.
“The treatment administered by the hospital was as per the set protocols and standard guidelines,” Patel said.
Lack of investigation
“The government conducted no inquiry despite a huge protest and outcry in Kutch,” Narain Gadhvi, an activist based out of Bhuj, told The Federal.
According to him, the Bhuj Civil Hospital is the only multispecialty government hospital in Kutch. Since Adani's takeover, it began charging fees for every OPD treatment that earlier used to be free.
Charges for in-patient treatment increased, too. Many people in that area now prefer to travel over 350 km to the Ahmedabad Civil Hospital or 400 km to the Rajkot Civil Hospital, Gadhvi said. This defeats the very purpose of running district hospitals.
Doctors upset
Despite the controversies, in May 2019, the Bhuj hospital was declared the second-best civil hospital in Gujarat, the first being the one in Ahmedabad. The performance was rated by the National Health Authority (NHA), a Central body formed to administer the PMJAY scheme.
Also read | With multiple lapses, HIV prevention and care pose big challenge in TN
In August 2019, the resident doctors of GK General went on strike demanding that the authorities clear their arrears of unpaid salaries and fill up faculty positions lying vacant for long.
In 2021, when the country was reeling under the pandemic, GK General medicos once again went on strike after the locals roughed up three doctors on COVID duty.
Bodies go missing
“Four bodies went missing from the hospital on April 26, 2021, creating an uproar. The families of the deceased, along with others, thrashed the three doctors on duty. An FIR was filed against the families that lost their kin but the missing bodies still remain a mystery,” Pankaj Gidwani, whose uncle’s body was among those that disappeared, told The Federal.
In August 2024, four children died at GK General after drinking contaminated water in the hospital.
In November 2024, the interns and resident doctors of the hospital went on strike, demanding the implementation of a stipend hike per Gujarat government rules effective from April that year.
Companies’ proximity to BJP
Between May 2019 and January 2024, the Torrent Group purchased electoral bonds worth Rs 184 crore, out of which Rs 134 crore went to the BJP. The Zydus Group gave bonds totaling Rs 29 crore to the BJP between 2022 and 2023.
In 2021, the Bihar drug regulator had declared a batch of remdesivir medicines manufactured by the Zydus Pharmaceuticals as substandard after several patients suffered adverse drug reactions from the medicines.
But the Gujarat government neither collected samples of the said batches for testing and nor did it initiate any action against company.Row over fees
“Admission fees for the undergraduate and post graduate courses of the Gujarat Adani Institute of Medical Sciences (GAIMS) are a lot higher than government medical colleges,” the final year resident doctor quoted earlier said.
Also read | Stripped of J-K quota, no infra at home, Ladakhi students on protest path
Adani GAIMS, which offers 21 courses at undergraduate and postgraduate levels, charges Rs 29-43 lakh for a five-year MBBS programme for the government and the NRI quota seats. A management quota seat costs Rs 80.5 lakh.
The fee structure for postgraduate programmes ranges from Rs 60 lakh to Rs 75 lakh for government quota seats. The hostel charges range from Rs 51,000 to Rs 1 lakh a month for male candidates and Rs 45,000 to Rs 1 lakh for females.
Private versus government
The Zydus Medical College and Hospital charges Rs 6.85 lakh per year for 132 government quota PG seats, Rs 15 lakh a year for management quota seats and Rs 19.5 lakh each for the 23 NRI seats.
In contrast, the annual fee for a three-year PG programme in the government-run medical colleges in Gujarat is Rs 25,000, and for a five-year undergraduate programme, Rs 15,000.
The annual fees in the 13 medical colleges under the Gujarat Medical Education and Research Society (GMERS) formed by the health department is Rs 3 lakh each for 147 government quota seats and Rs 14 lakh each for 23 NRI seats.
