Cancer infra in India ‘highly inadequate’, needs a hub-spoke model: Panel
Parliament’s science and technology panel — in the first report of all the panels of the current Lok Sabha — has also recommended that the government should have a “robust mechanism to check the prices” of cancer medicinesUpdated: Nov 12, 2019 05:51 IST
A parliamentary panel, in a crucial report on the state of cancer treatment in India, has described the cancer-care infrastructure in the country as “highly inadequate”, and asked the government to throw its weight behind a pan-India “hub and spoke” model on the lines of the one used by the country’s premier cancer hospital and research facility, Tata Memorial Centre (TMC).
Parliament’s science and technology panel — in the first report of all the panels of the current Lok Sabha — has also recommended that the government should have a “robust mechanism to check the prices” of cancer medicines, and “tie up with various firms for CSR funding” for knowledge sharing and technology transfer. HT has accessed the report that panel chairman Jairam Ramesh submitted to Rajya Sabha chairman Venkaiah Naidu on Monday.
The panel has observed that the “existing cancer care infrastructure in India is highly inadequate” because a majority of patients have to travel from far-off locations to get adequate treatment.
India reports about 1.6 million new cancer cases annually, with an estimated mortality rate of 800,000 every year, according to the health ministry’s presentation to the Parliamentary standing committee on October 11. Out of this, 140,000 breast cancer and 100,000 cervical cancer cases are reported among women, while about 200,000 gastrointenstinal-tract cancer cases are reported among men.
TMC, considered the country’s premier cancer hospital and research centre, has said in its proposal to the panel that it wants to create cancer hospitals that will serve as around “30 hubs and between 100 and 130 spokes in various parts of the country”. Each “hub” (a large hospital with advanced facilities) should cover approximate population of 40 million, and a “spoke” (a smaller hospital connected to the hub) should cover a population of between 5-10 million. The hubs and spokes will see an estimated intake of 40,000 and spokes of 8,000 new patients annually, TMC said. This, it said, would reduce costs and the trouble of transporting and treating patients from parts of the country where cancer-care facilities are inadequate.
The Punjab government has signed an MoU with TMC for a hub in Mullanpur and a spoke in Sangrur. The Sangrur hospital has been operational since 2015 and treats about 4000 patients annually.
Punjab’s health minister Balbir Sidhu said the TMC’s hub and spoke is “a perfect model to follow for other private business giants in helping the state government in providing crucial health treatments.”
T Anbumani, project consultant for TMC in Punjab, said: “Hub and spoke is an ideal model. Oncology management, especially in government medical colleges, requires a lot of improvement. In our model, we share knowledge, skill, and resources. Three state government medical colleges are associated with us, and we even take patients from them. All we need from government is financial support, with less bureaucratic intervention.”
The Parliamentary committee, led by Congress leader Jairam Ramesh, has prepared the report in less than two months after being constituted on September 13.
“My objective is to submit a report every month. We will soon be submitting a report on environment and public health looking at what more needs to be done to check air, chemical and other forms of pollution,” Ramesh said on Monday.
The report also points out that Mortality to Incidence Ratio — calculated by dividing the mortality count by the incidence count annually — is 0.68 in India, which is higher than countries with very high and high human development index.
“The committee also finds a correlation between inadequate cancer care facilities and cancer deaths in the country,” said the report.
The report also emphasises the urgent requirement of cancer centres in “especially under-served parts of the country”, and notes that the incidence of cancer is “very high in all north-eastern states -- higher than the national average for several types of cancer, and showing a consistently rising trend over the past few years”.
The panel has described TMC, under the Department of Atomic Energy, as a “uniquely ideal organisation” and recommended that it set up a nationwide, government-funded hub-and-spoke model in cancer treatment.
Experts said a big problem in India is that patients are often diagnosed when the disease is at an advanced stage.
“Sadly, because of grossly inadequate infrastructure and lack of awareness, many patients are diagnosed at a later stage in India. It not only increases their expenses for treatment but also leads to higher mortality. We are also not conscious of air we are breathing and food we are eating to prevent cancer,” said Dr Prantar Chakrabarti, a specialist in blood cancer with Fortis hospitals.