Anusha Paul
The New Indian Express reported on February 10, 2025, that Kerala has seen the closure of 99 private hospitals since 2011, citing the data from the Kerala Private Hospital Association (KPHA). The association believes this number is a conservative estimate, with the actual figure likely much higher.
Hussain Koya Thangal, President of the Kerala Private Hospital Association (KPHA), emphasized that while the cost of treatment has remained relatively stable, the financial burden of maintaining infrastructure and running hospitals has increased significantly. According to Thangal and the KPHA, the nursing strikes of the 2010s, along with the implementation of minimum wage laws, have further contributed to the shutting down of several hospitals, deepening the crisis within Kerala’s private healthcare sector.
The news also highlighted concerns raised by the CEO of BR Life Sree Uthradam Thirunal (SUT) Super Speciality Hospital, but this concern comes from a corporate giant whose vast investments and business ventures are spread across the globe, from financial groups to healthcare providers to manufacturers. It is rather rich to hear warnings about healthcare becoming a profit-driven industry from a network of companies that thrive on turning essential services into commodities for the wealthy. BR Life, has established its multi-speciality healthcare facilities in India, Nepal, Africa, and the Middle East.
At the heart of this corporate empire is the New Medical Centre (NMC), a very first private facility in the UAE that is part of a global financial machine, listed on the London Stock Exchange and included in the FTSE 100 and MSCI Global Index. BR Life SUT Super Speciality Hospital, with its international reach, is emblematic of the inherent contradictions of privatised healthcare—where profits are harvested by multinational corporations while the vast majority of the population is left to suffer. The idea that such entities are concerned about the consequences of their own greed-driven model of healthcare is almost laughable.
When the private healthcare sector in Kerala is described as “collapsing,” it’s crucial to understand the reality behind this narrative. At first glance, one might think that the health sector is in crisis, but this is a deliberate distortion of the facts. The so-called “collapse” of private hospitals is not the result of a financial downturn, but a direct consequence of the growing strength and accessibility of the public healthcare system.
What’s happening is not a collapse, but a fundamental restructuring. The private sector is struggling because it cannot compete with a public healthcare system that provides quality care at a fraction of the cost, without the greed-driven motives of capitalism.
Kerala’s healthcare system has undergone remarkable advancements in recent years, ensuring broader access to essential medical care and life-saving treatments. One of the state’s notable achievements is its drive toward oxygen self-sufficiency, with a total storage capacity of 2,095.63 MT of liquid oxygen now available, ensuring timely and effective treatment for patients in need.
The government has also made significant strides in primary healthcare with the establishment of 709 Family Health Centres. Out of the 885 Primary Health Centres in the state, 709 have been upgraded, broadening the reach of essential health services to communities across Kerala. In the last three and a half years, 25.17 lakh people have benefited from free treatment, with the total value of services amounting to Rs. 6,788 crore.
In terms of infrastructure, Kerala has made impressive strides in expanding its healthcare network. A total of 5,415 Community Health Centres are now operational, alongside 380 Urban Public Health Centres spread across 93 urban areas. Additionally, the Thiruvananthapuram Medical College has set a national benchmark by becoming the first in the country to establish a comprehensive stroke unit with a neuro-cath lab, significantly enhancing the care available for stroke patients. Moreover, all urban primary health centres have been transformed into health and wellness centres, promoting holistic well-being across Kerala.
In the area of cancer care, Kerala has not only matched but surpassed the offerings of private hospitals. The government’s proactive approach in cancer treatment, through the Aardram lifestyle diagnosis campaign, makes early detection and care more accessible to the public.
Through these initiatives, Kerala is actively challenging the profit-driven motives of the private healthcare sector. The state’s focus on providing cancer drugs at the lowest possible price and building the infrastructure necessary to offer world-class treatment at public hospitals is a radical step away from the commercialisation of healthcare.
A cancer speciality block, worth Rs. 25 crore, is being developed at Ernakulam General Hospital, and a 14-storey hospital building at Regional Cancer Centre (RCC), valued at Rs. 169.23 crore, is nearing completion. Additionally, mammogram, biopsy, and Pap smear services are being set up in district and taluk hospitals across Kerala to detect breast cancer in its earliest stages.
For the first time in India’s public sector, robotic surgery for cancer has been introduced at Regional Cancer Centre (RCC) and Malabar Cancer Centre (MCC), ensuring cutting-edge treatment for patients. Special cancer detection camps have been organized, and in addition to the main hospitals, 25 other facilities have been equipped to provide cancer care.
The MCC has also seen substantial growth, with an upgrade to a Postgraduate Institute of Oncology Science and Research, supported by Rs. 562.25 crore from Kerala Infrastructure Investment Fund Board (KIIFB) funds. The state has taken proactive steps to make cancer screening more accessible, with clinics being set up in all hospitals, offering one day a week dedicated to cancer screening. Moreover, innovative treatments for cancers, including eye cancer in children and retinoblastoma, have been introduced for the first time at MCC.
Other groundbreaking achievements include the introduction of Cervi Scan at RCC, a cutting-edge technology for detecting cervical cancer, and the roll out of the HPV vaccination program to protect young girls from cervical cancer. Kerala is also introducing a digital pathology system of excellence at both RCC and MCC, with state-of-the-art 3 Tesla MRI units and 3D digital mammography equipment installed at RCC.
Addressing rare diseases has also been a key focus for Kerala’s health initiatives. Diagnosing and treating rare diseases is often a challenge, with private hospital either unable to provide the necessary care or doing so at the a steep price. To address this, the Kerala government launched the ‘Kerala United Against Rare Diseases’ KARE project. This initiative connects government-run district hospitals to offer diagnosis, treatment, and ongoing care for people with rare diseases, making healthcare more inclusive and affordable for those with conditions that are otherwise difficult to treat.
In another leap forward for healthcare accessibility, Thiruvananthapuram General Hospital has become the first district-level hospital in India to install the G-Gaiter, an advanced AI-guided technology. This marks a major milestone in ensuring that innovative technologies typically seen in corporate-owned multi specialty hospitals are now available in district-level facilities.
These transformative initiatives in cancer care, healthcare infrastructure, rare disease care, and the adoption of advanced technologies are reshaping Kerala’s health sector, making it more inclusive, innovative, and accessible for all its residents.
The collapse of the private sector should not be viewed as a tragedy—it should be viewed as a victory for the people. Private hospitals, with their unending pursuit of profits, have always been fundamentally incompatible with the needs of the working class. The fact that so many private institutions are failing is an inevitable consequence of the capitalist model that seeks to commodify healthcare for personal gain. The dominance of the public healthcare system in Kerala, where healthcare is treated as a right and not a privilege, is the only way forward for any equitable society.
The failure of the private healthcare sector in Kerala is not just about economic inefficiency—it is a symptom of a deeper moral and political failure of capitalism itself. Private healthcare institutions complain that wages and inflated operational expenses are responsible for their downfall. This claim is nothing more than a smokescreen to disguise the true cause of their failure: greed. Their refusal to provide fair wages to workers, to invest in quality care, and their relentless pursuit of profit over people, is what has driven them into crisis.
The people of Kerala, through their government-run healthcare system, have demonstrated that the solution lies in expanding and investing in the public sector. Only through collective, state-controlled healthcare can we ensure that the needs of all people are met, regardless of their ability to pay. The rise of public healthcare in Kerala marks the triumph of people’s health over corporate greed, and it should serve as a model for the rest of the world to follow.