A broad-based coalition of social organisations, BMC health worker unions and health groups while calling for an immediate halt to the ongoing privatisation of Mumbai’s public hospitals and health services under the Mumbai Brihanmumbai Municipal Corporation (BMC), has also demanded the urgent and regular recruitments to fill vacant posts, as well as systematic strengthening of public health facilities to ensure equitable, quality care for all residents of Mumbai.
A manufactured crisis to justify privatisation?
Six major BMC hospitals are currently being handed over to private companies through public–private partnership (PPP) arrangements. According to the views expressed by this coalition, this move will replace free public services with paid care, hitting Mumbai’s poor and marginalised the hardest. Simultaneously, the BMC has been steadily reducing regular health staff, replacing permanent positions with outsourced and contractual workers, eroding both service quality and workers’ security.
Despite mass retirements of BMC health staff, there has been no serious effort to fill and expand regular posts. This is a deliberate strategy: weaken the public system through neglect, then hand it over to private operators under long-term contracts. The result is restricting access to free care, worsening working conditions, and compromised service quality.
Problematic record of PPPs in BMC health services
Providing details to justify their accusations, in a press release issued Monday, October 7, citizens said that over 20 PPP projects already operate within Mumbai’s municipal health system, covering ICUs, diagnostic centres, dialysis units, and entire maternity homes and hospitals. Yet there is no independent evidence that these PPP arrangements have improved quality or accountability of health services. Many PPPs have been deeply problematic but despite such experiences, new moves for privatisation continue without any comprehensive evaluation of existing projects.
A recent study of healthcare PPPs in Mumbai and Pune has revealed alarming problems:
- Outsourced ICUs are staffed with underqualified doctors, even run by homeopathy practitioners, leading to compromised patient safety and preventable deaths. One ICU contract worth several crores was cancelled after 149 deaths were exposed.
- Diagnostic centres under PPPs frequently charge patients three to fifteen times higher than public hospitals, making them inaccessible to low-income communities.
- Monitoring mechanisms are very weak, allowing non-compliance with contracts, underqualified staff, and erratic service delivery. Some PPP hospitals remain grossly underutilised despite substantial infrastructure, due to lack of full-time doctors, essential equipment, or basic services.
- Political influence pervades the contracting process, with corporators or ex-corporators floating companies or favouring bidders to secure contracts, turning healthcare provisioning into a political-business venture.
Overall, rates charged to patients under various Municipal PPPs were found to be two to twenty-five times higher than comparable public hospital rates. The study concludes that PPPs have largely become vehicles for private profit rather than instruments of public good.
The real issue: Deliberate understaffing
The push for privatisation is justified by claims of inadequate capacity in public hospitals. In reality, the BMC has created an artificial shortage through chronic understaffing of its health services. According to Praja Foundation’s 2024 report, municipal hospitals face massive vacancy rates of 46% among doctors, 26% among nurses and paramedical staff, and 42% among labour staff, with an overall vacancy level of 36% in the health department. Rather than investing in recruitment and better working conditions, the BMC is diverting resources to PPPs—benefiting private operators while bypassing public accountability.
What needs to be emphasised is that there is no shortage of doctors and health workers in Mumbai, the available pool could be readily employed and all vacant posts in BMC could be promptly filled. For example, the number of vacant medical posts in BMC is around 975, while the annual output of MBBS doctors just from government medical colleges in Mumbai is around 1200, and number of graduating MD / MS doctors from these colleges is around 1000 per year. Enough doctors, nurses and health workers are available to fill all vacant posts.
Communities, Health workers and Public health experts raise their voices
Social movements and community organisations in various parts of Mumbai, especially in bastis and informal settlements are opposing user-fee-based PPPs which will deny them life-saving care. One major example of this resistance is the movement by “Aspatal Bachao, Nijikaran Hatao Kriti Samiti” active among residents of M-East ward (Mankhurd and Govandi areas). This is a coalition of over 25 organisations who have organised a series of major protests since July, demanding a halt to the privatisation of Shatabdi Hospital and Lallubhai Compound Super-Speciality Hospital. This mobilization is a powerful, grassroots rejection of BMC’s proposal to hand over key public hospitals to private players under the deeply problematic Public-Private Partnership (PPP) model.
Municipal health worker unions have also joined this movement, highlighting that outsourcing and PPPs cut down of secure employment for health workers. Contractual staff face much lower pay, total job insecurity and lack of social security. Privatisation also replaces teams of experienced regular health staff with precarious contract workers, thus affecting the quality of patient care. All unions belonging to this coalition, who represent thousands of health workers in Mumbai demand that all forms of privatisation under BMC must be halted, and that the huge number of vacancies must be filled promptly through regular recruitment, along with creation of additional posts to meet the city’s health needs. This will majorly reduce work overload on the existing BMC health staff. The vital role played by public health systems and their staff during the COVID pandemic underscores the urgency of this demand.
Public health professionals are also questioning handing over of public hospitals—built with public funds—to private players without robust evidence or accountability mechanisms. The entry of politically connected, non-medical operators undermines healthcare quality and ethics, especially in critical areas like ICUs and maternity care. What Mumbai urgently needs is a robust, publicly funded health system—not privatised services that exclude large numbers of people who are most in need.
Joint demands of the coalition
The coalition demands the BMC to retract its pernicious policy of privatisation and contractualisation, which only benefits contractors, corrupt officials and politicians. Instead BMC must now act decisively and promptly in public interest by taking the following steps:
- Immediately halt and cancel all PPP-based privatisation proposals for public hospitals and health services in Mumbai, and conduct an independent review of existing PPPs with a plan to return them to public management.
- Launch urgent recruitment drives to fill all staff vacancies—doctors, nurses, paramedics, sanitation, support staff—through regular appointments, while phasing out outsourcing.
- Develop a comprehensive plan to strengthen public health services through regular recruitment, increased budgets proportional to population needs, and improved management. This should be linked with assured, quality provision of various levels of health services and essential medicines.
- Ensure systems for transparency and social accountability, including community-based monitoring of BMC health services and participatory governance mechanisms involving communities, civil society groups as well as health workers.
Joint Plan of Action – Aspatal Bachao Neejikaran Hatao Kruti Samiti and Unions
– A more extensive public campaign will be launched to against privatisation of hospitals that have been tendered for PPP.
– A massive campaign will be launched in collaboration with health workers’ unions demanding full social security and rights of workers in public healthcare facilities and services. The right to health cannot be fulfilled without workers’ rights.”
– Jan sunvayi’s will be held across the city to address the current state of public health facilities and services.
– All political parties and their candidates will be asked to clarify their positions on these two issues: “transformation of public healthfavilties and services to serve people and opposition to any form of privatization of health services.” Those parties or candidates who unconditionally agree on this issue will be labeled “supporters of public health,” while those who do not will be labeled “enemies of public health,” and the public will teach them a lesson in upcoming elections.
– A massive state-level conference will be held by civil society organizations, unions and other organizations against privatisation and contractualisation of health services in Mumbai on November 30th.
We call upon every Mumbaikar to stand up and speak out today against ongoing privatisation of health services, which is a betrayal of public trust. It is surprising that existing BMC officials, who do not have any democratic mandate to take major policy decisions in the absence of an elected corporation, are trying to push through large scale privatisation of health services. Finally, the coalition stated in a press conference held today that Mumbai deserves a public health system that is equitable, transparent, accountable, and ensures that healthcare is strengthened as a public right, not being turned into a commodity for private profit.
Related:
Citizens and experts rally to save Mumbai’s BEST buses from privatisation pitfalls
BEST strike over Diwali bonus shakes Mumbai’s Bus Service, reveals growing transit strain
Samsung workers end strike but the core issue of recognition of unions’ remains