Lok Sabha Question No. 2120 (UNSTARRED), answered on 2022-07-29
Subject: National Programme for Prevention and Control of Cancer, Diabetes, Heart Disease and Stroke
Ministry: HEALTH AND FAMILY WELFARE
Asked by: Jugal Kishore Sharma, Locket Chatterjee, Dileshwar Kamait, Chandan Singh, Rama Devi, Riti Pathak

## GOVERNMENT OF INDIA MINISTRY OF HEALTH AND FAMILY WELFARE DEPARTMENT OF HEALTH AND FAMILY WELFARE

## LOK SABHA UNSTARRED QUESTION NO. 2120

TO BE ANSWERED ON 29 th July, 2022

## NATIONAL PROGRAMME FOR PREVENTION AND CONTROL OFCANCER, DIABETES, HEART DISEASE AND STROKE

## 2120.    SHRI JUGAL KISHORE SHARMA:

MS. LOCKET CHATTERJEE:

SHRI DILESHWAR KAMAIT:

SHRI CHANDAN SINGH:

SHRIMATI RAMA DEVI:

SHRIMATI RITI PATHAK:

Will the MINISTER OF HEALTH AND FAMILY WELFARE be pleased to state:

- (a)  the details of the progress made under thenational programme for prevention and control of cancer, diabetes, heart disease and stroke in the country;
- (b) whether doctors, other health workers, clinics and medical equipments are available in sufficient numberfor investigation, diagnosis and management of thesediseases, if so, the details hereof;
- (c)  whether  the  patients  are  not  being  treated  ontime  and  many  patients  die  due  to  lack  of  timely treatment,if so, the details thereof;
- (d) whether due to costly treatment of chronicdisease like cancer and others even in Governmenthospitals, patients belonging to Economically WeakerSection and middle class are unable to get treatment;
- (e) if so, whether the Government proposes to makearrangements for complete free of cost treatment ofthese diseases; and
- (f) if so, the details thereof and if not, the reasonstherefor?

## ANSWER THE MINISTER OF STATE IN THE MINISTRY OF HEALTH AND FAMILY WELFARE (DR. BHARATI PRAVIN PAWAR)

(a) to (f): The Department of Health & Family Welfare, Government of India, provides technical and financial  support  to  the  States/UTs  under  the  National  Programme  for  Prevention  and  Control  of Cancer, Diabetes, Cardiovascular Diseases and Stroke (NPCDCS), as part of National Health Mission (NHM), based on the proposals received from the States/UTs and subject to the resource envelope. The  programme  focusses  on  strengthening  infrastructure,  human  resource  development,  health promotion  &  awareness  generation  for  prevention,  early  diagnosis,  management  and  referral  to  an appropriate  level  of  healthcare  facility  for  treatment  of  the  Non-Communicable  Diseases  (NCDs). Under NPCDCS, 685 District NCD Clinics, 266 District Day Care Centres, 192 District Cardiac Care Units and 5451 Community Health Center NCD Clinics has been set up.

Under NHM, the support is also provided to State/UTs for hard area allowance to specialist doctors for serving  specially  in  rural  and  remote  areas  and  for  their  residential  quarters  so  that  they  find  it attractive  to  serve  in  public  health  facilities  in  such  areas.  Following  types  of  incentives  and honorarium  are  provided  to  staff  for  ensuring  service  delivery  in  the  country  including  rural  and remote areas.

-  Hard area allowance to specialist doctors are provided for serving in rural and remote areas and for their residential quarters so that they find it attractive to serve in public health facilities in such areas.
-  Incentives  like  special  incentives  for  doctors,  incentive  for  ANM  for  ensuring  timely  ANC checkup  and  recording,  incentives  for  conducting  adolescent  reproductive  and  sexual  health activities are provided.
-  States  are  allowed  to  offer  negotiable  salary  to  attract  specialist  including  flexibility  in strategies such as 'You Quote We Pay'.
-  Non-monetary  incentives  such  as  preferential  admission  in  post  graduate  courses  for  staff serving in difficult areas and improving accommodation arrangement in rural areas have also been introduced under NHM.
-  Multi-skilling of doctors is supported under NHM to overcome the shortage of specialists. Skill upgradation of existing HR is another major strategy under NRHM for achieving improvement in health outcomes.

A population-based initiative for prevention, control and screening for common NCDs i.e. diabetes, hypertension and common cancers (oral cancer, breast cancer and cervical cancer) has been rolled out in  the  country  under  NHM  and  also  as  a  part  of  Comprehensive  Primary  Health  Care.  Under  the initiative,  persons  more  than  30  years  of  age  are  targeted  for  their  screening.  Screening  of  these common NCDs is an integral part of service delivery under Ayushman Bharat - Health and Wellness Centres.

Preventive  aspect  of  NCDs  is  strengthened  under  Comprehensive  Primary  Health  Care  through Ayushman Bharat Health Wellness Centre scheme, by promotion of wellness activities and targeted communication at the community level. Other initiatives for increasing public awareness about NCDs and for promotion of healthy lifestyle includes observation of National & International Health Day and use  of  print,  electronic  and  social  media  for  continued  community  awareness.  Furthermore,  healthy eating  is  also  promoted  through  FSSAI.  Fit  India  movement  is  implemented  by  Ministry  of  Youth Affairs  and  Sports,  and  various  Yoga  related  activities  are  carried  out  by  Ministry  of  AYUSH.  In addition, NPCDCS gives financial support under NHM for awareness generation (IEC) activities for NCDs to be taken by the States/UTs as per their Programme Implementation Plans (PIPs).

The Central Government implements Strengthening of Tertiary Care Cancer Facilities Scheme in order to enhance the facilities for tertiary care of cancer. 19 State Cancer Institutes (SCIs)  and 20 Tertiary Care Cancer Centres (TCCCs) have been approved under the said scheme.Seven of these SCIs/TCCCs have been completed.

There is also focus on Cancer and other NCDs in its various aspects in case of new AIIMS and many upgraded  institutions  under  Pradhan  Mantri  Swasthya  Suraksha  Yojna  (PMSSY).  National  Cancer Institute at Jhajjar (Haryana) and Chittaranjan National Cancer Institute, Kolkata have also been set up for tertiary care of cancer.

Cancer  and  other  NCDs  is  diagnosed  and  treated  at  various  levels  in  the  health  care  facilities.  The treatment  in  Government  Hospitals  is  either  free  or  highly  subsidized  for  the  poor  and  needy. Treatment of Cancer and other NCDs is also available under Ayushman Bharat - Pradhan Mantri Jan Arogya Yojana (PMJAY). Health insurance cover of Rs. 5 lakhs per family per year for secondary or tertiary  care  hospitalisation  to  over  Rs.10.74cr.  poor  and  vulnerable  families,  identified  from  SECC 2011 database is provided. Besides, quality generic medicines are made available at affordable prices to all, under Pradhan Mantri Bhartiya Janaushadhi Pariyojana (PMBJP) in collaboration with the State

Governments. Affordable Medicines and Reliable Implants for Treatment (AMRIT) Pharmacy stores have  been  set  up  in  some  hospitals/institutions,  with  an  objective  to  make  available  drugs  at  a substantial  discount  vis-à-vis  the  Maximum  Retail  Price.  Under  the  umbrella  scheme  of  Rashtriya Arogya Nidhi (RAN), financial assistance is provided to families living below threshold poverty line for their treatment, including treatment of Cancer and other NCDs in Government hospitals.