The Madhya Pradesh government has approved a pilot project to hand over the management of 18 Community Health Centres (CHCs) in three districts to private operators, a move it says is aimed at improving healthcare access in underserved rural regions. However, the decision has triggered criticism from health activists, civil society groups, and opposition leaders, who argue that the plan amounts to the gradual privatization of public healthcare.
The proposal was approved by the state Cabinet chaired by Chief Minister Mohan Yadav on June 16. Under the pilot, 18 CHCs located in Rewa, Dewas, and Guna districts will be operated by private entities, trusts, or organizations for an initial period of five years. The government has indicated that the model could be expanded to other facilities if the pilot is deemed successful.
According to data presented before the Cabinet, Madhya Pradesh faces a major shortage of specialist doctors in its rural healthcare network. Of the 1,320 sanctioned specialist posts across the state's operational Community Health Centres, only 113 are currently filled, leaving nearly 85% of positions vacant.
Officials said the shortage has made it difficult for many CHCs to provide specialist services such as surgery, medicine, paediatrics, and obstetrics and gynaecology. Reports indicate that five of the 18 selected centres do not have a single specialist doctor.
Community Health Centres serve as an important component of India's rural healthcare system. They function as referral centres for Primary Health Centres (PHCs) and are expected to provide specialist care, inpatient services, emergency treatment, laboratory facilities, and maternal healthcare closer to rural populations.
Under the new arrangement, ownership of the healthcare facilities will remain with the state government. The government will continue to provide medicines, buildings, and basic infrastructure. Private operators, meanwhile, will be responsible for recruiting specialist doctors and healthcare personnel, managing daily operations, and delivering services at the centres.
The Public Health and Medical Education Department has been tasked with preparing and finalising the tender process for selecting private partners. Officials have described the initiative as a public-private partnership (PPP) aimed at filling longstanding workforce gaps in rural healthcare.
According to the state government, the objective is to ensure better access to healthcare services in regions where vacancies have significantly affected patient care. The project will undergo evaluation over five years before any decision is taken on wider implementation.
The outsourcing initiative comes shortly after the state unveiled the Madhya Pradesh Health Sector Investment Promotion Policy 2025. The policy seeks to increase private sector participation in healthcare infrastructure and service delivery by encouraging investments and partnerships.
Government documents associated with the policy highlight the need to strengthen healthcare infrastructure and workforce availability, particularly in underserved regions. Officials argue that private participation can help bridge existing gaps while improving service quality and accessibility.
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Health Department officials said several Community Health Centres had been identified where the delivery of specialist healthcare services had become challenging because of persistent workforce shortages. They noted that these staffing gaps prompted the state Cabinet to consider the pilot project.
Officials further stated that the Public Health and Medical Education Department has been assigned the responsibility of preparing and finalising the tender documents for operating the selected facilities.
“The Council of Ministers has approved the pilot project to outsource the management of Community Health Centres in Rewa, Dewas and Guna. It has been approved to outsource the management of identified community health centres in three districts of Rewa, Dewas and Guna, where most of the posts of doctors are vacant,” the department said in a statement.
Health rights groups and activists have opposed the move, arguing that it represents a step towards privatization of the public healthcare system. Jan Swasthya Abhiyan and other civil society organisations have reportedly described the decision as a "backdoor privatisation" of public health facilities and demanded that the government instead strengthen the public health workforce.
Former Chief Minister and Congress leader Kamal Nath criticised the decision, alleging that the state government was shifting its responsibility to private players instead of addressing staff shortages through recruitment.
According to reports, health activists have pointed out that the state has nearly 40,000 vacancies in the health department and argued that filling these posts would be a more sustainable solution than outsourcing facilities. They have also questioned the government's increasing reliance on private participation in healthcare after the announcement of the Health Sector Investment Promotion Policy 2025.
State officials, however, have maintained that the ownership of the centres and supply of medicines and infrastructure will remain with the government, and that the initiative is intended only to address the acute shortage of specialists in underserved regions.
(Rh/ARC/MSM)
