KOCHI: The overwhelming presence of corporate representatives in the Kerala Holistic Model for Health, Wellness and Longevity Task Force has sparked worries that the panel tasked with shaping the state’s health policies could prioritise private-sector interests over strengthening public health institutions.
At a time when the UDF government is considering policy interventions in healthcare, the composition of the task force has come under scrutiny. The inclusion of former Uttar Pradesh chief secretary Deepak Singhal, who was removed from the post by the Akhilesh Yadav government in 2016, has also drawn criticism.
Former health minister K K Shailaja questioned the rationale behind bringing private-sector representatives into such a panel when Keralam has several qualified experts of its own. She alleged that a person who had faced corruption allegations in Uttar Pradesh had also been included, while clarifying that she was not suggesting that every member of the panel was unfit.
The concerns come against the backdrop of the state’s achievements in maternal and infant mortality and its relatively high life expectancy — 78.4 years for women and 71.9 for men — built on a strong public health system and sustained community-level interventions.
The task force has been asked to submit recommendations on policy interventions within two months. Public health experts, however, question whether a panel dominated by private healthcare interests can adequately address affordability without placing greater emphasis on public healthcare infrastructure, preventive medicine and primary care.
The stakes are considerable. While the average Indian household spends Rs 2,767 a year on healthcare, the corresponding expenditure in Kerala is Rs 8,388. The state’s annual out-of-pocket healthcare spending exceeds Rs 30,197 crore, while its budgetary allocation for health is less than half that amount.
The growing presence of private-equity investors in Keralam’s hospital sector has added to the debate. In 2024, US-based KKR acquired a controlling stake in Baby Memorial Hospital, a year after Blackstone picked up a stake in KIMS Healthcare. Aster DM Healthcare, too, has attracted private equity investment, reflecting growing commercial interest in the sector.
Public health expert Dr V Ramankutty said Keralam had seen several interventions funded by the World Bank and the Asian Development Bank, yet public health continued to suffer.
“There is lack of vigilance in the public health approach in the state, which has contributed to the increasing burden of non-communicable diseases,” he said.
M M Abbas, a public health activist and former president of Thrikkakara Municipal Cooperative Hospital, said the decline in public health vigilance over the past 25 years had contributed to the gradual weakening of the sector.
“Private hospitals, particularly with foreign corporate firms investing in the sector, function with a profit motive, though there are exceptions. Only government hospitals and institutions in cooperative sector can provide low-cost medical facilities.”
Writer and public health expert P K Sasidharan described public health as a neglected area in India. “Public health is a community-based, collaborative effort to reduce the disease burden and prevent illnesses. These aspects do not appear to be central to the task force’s area of study. What, then, is its purpose?” he asked.