Lok Sabha Question No. 557 (UNSTARRED), answered on 2022-12-09
Subject: Health Expenditure on Cancer Care
Ministry: HEALTH AND FAMILY WELFARE
Asked by: Dushyant Singh

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

## LOK SABHA UNSTARRED QUESTION NO. 557 TO BE ANSWERED ON 9 th December, 2022

## HEALTH EXPENDITURE ON CANCER CARE

## 557. SHRI DUSHYANT SINGH

Will the Minister of HEALTH AND FAMILY WELFARE be pleased to state:

- (a) whether  about  six  crore  Indian  citizens  are  pushed  below  the  poverty  line  every  year because of treatment costs associated with cancer in their families and if so, the details thereof;
- (b) the  details  regarding  the  per  capita  public  expenditure  on  cancer  care,  State/UT-wise along  with  the  steps  taken/proposed  to  be  taken  by  the  Government  to  reduce  out  of pocket expenditure and increase the affordability of cancer care;
- (c) the  number  of  Intensive  Care  Unit  (ICU)  and  chemotherapy  beds  available  in  the country, State/ UT-wise;
- (d) the number and list of public health institutions, Government hospitals, district hospitals and  medical  colleges  offering  external  and  internal  radiotherapy  facilities  categorized based on Tier-1, Tier-2 and Tier-3 cities; and
- (e) the necessary steps taken/proposed to be taken by the Government to increase hospital capacity and accessibility in the country?

## ANSWER

## THE MINISTER OF STATE IN THE MINISTRY OF HEALTH AND FAMILY WELFARE

## (DR. BHARATI PRAVIN PAWAR)

(a)  to  (e):  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 focuses 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,  268

District Day Care Centres has been set up to ensure continuum of chemotherapy of patients already put on treatment. The State/UT wise details of funds provided in NPCDCS Program under Flexible Pool for Non-Communicable Diseases programme (NCD) under NHM during the last three years i.e. from the FY 20l9-20 to 2021-22 is given at Annexure1. Treatment of Cancers is also available under Ayushman Bharat - Pradhan Mantri Jan Arogya Yojana (PMJAY). Besides, quality generic medicines are made available at affordable prices to all, under Pradhan Mantri Bhartiya JanaushadhiPariyojana (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 Cancer drugs at a substantial discount vis-à-vis the Maximum Retail Price. The Central Government implements Strengthening of Tertiary Cancer Care Centre Facilities Scheme in order to enhance the facilities for tertiary care of cancer. 19 State Cancer Institutes (SCIs)  and  20  Tertiary  Cancer  Care  Centres  (TCCCs)  have  been  approved  under  the  said scheme. Seven of these SCIs/TCCCs have been completed. There  is  also  focus  on  Oncology  in  its  various  aspects  in  case  of  new  AIIMS  and  many upgraded institutions under Pradhan Mantri Swasthya Suraksha Yojna (PMSSY). Setting up of National Cancer Institute at Jhajjar (Haryana) and second campus of Chittaranjan National Cancer Institute, Kolkata are also steps in this direction. All these enhance the capacity for treatment of cancer in the country. The  Department  of  Atomic  Energy  has  established  cancer  centres  in  Kharghar,  Varanasi (two),  Guwahati,  Sangrur,  Visakhapatnam,  New  Chandigarh  and  Muzaffarpur.  The  Tata Memorial Hospital in Mumbai is also providing services for cancer care. The details of radiotherapy facilities available States/UTs wise is given at Annexure 2.

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## Annexure 1

| State/UT wise details of Approvals of NPCDCS under NCD Flexible Pool underNHM during the period of F.Y. 2019-20 to 2021-22   | State/UT wise details of Approvals of NPCDCS under NCD Flexible Pool underNHM during the period of F.Y. 2019-20 to 2021-22   | State/UT wise details of Approvals of NPCDCS under NCD Flexible Pool underNHM during the period of F.Y. 2019-20 to 2021-22   | State/UT wise details of Approvals of NPCDCS under NCD Flexible Pool underNHM during the period of F.Y. 2019-20 to 2021-22   | State/UT wise details of Approvals of NPCDCS under NCD Flexible Pool underNHM during the period of F.Y. 2019-20 to 2021-22   |
|------------------------------------------------------------------------------------------------------------------------------|------------------------------------------------------------------------------------------------------------------------------|------------------------------------------------------------------------------------------------------------------------------|------------------------------------------------------------------------------------------------------------------------------|------------------------------------------------------------------------------------------------------------------------------|
| S.No.                                                                                                                        | State/UT                                                                                                                     | 2019-20                                                                                                                      | (Rs. In lakhs) 2020-21                                                                                                       | 2021-22                                                                                                                      |
| 1                                                                                                                            | Andaman &Nicobar Islands                                                                                                     | 52.00                                                                                                                        | 13.89                                                                                                                        | 56.96                                                                                                                        |
| 2                                                                                                                            | Andhra Pradesh                                                                                                               | 359.83                                                                                                                       | 1616.18                                                                                                                      | 4672.54                                                                                                                      |
| 3                                                                                                                            | Arunachal Pradesh                                                                                                            | 347.51                                                                                                                       | 381.58                                                                                                                       | 146.45                                                                                                                       |
| 4                                                                                                                            | Assam                                                                                                                        | 2067.53                                                                                                                      | 568.87                                                                                                                       | 1258.57                                                                                                                      |
| 5                                                                                                                            | Bihar                                                                                                                        | 792.39                                                                                                                       | 1977.74                                                                                                                      | 956.30                                                                                                                       |
| 6                                                                                                                            | Chandigarh                                                                                                                   | 2.80                                                                                                                         | 1.30                                                                                                                         | 12.84                                                                                                                        |
| 7                                                                                                                            | Chhattisgarh                                                                                                                 | 606.34                                                                                                                       | 433.45                                                                                                                       | 1619.06                                                                                                                      |
| 8                                                                                                                            | Dadra &Nagar Haveli                                                                                                          | 45.32                                                                                                                        |                                                                                                                              |                                                                                                                              |
| 9                                                                                                                            | Daman &Diu                                                                                                                   | 5.86                                                                                                                         | 14.18                                                                                                                        | 7.05                                                                                                                         |
| 10                                                                                                                           | Delhi                                                                                                                        | 145.88                                                                                                                       | 128.10                                                                                                                       | 191.15                                                                                                                       |
| 11                                                                                                                           | Goa                                                                                                                          | 85.33                                                                                                                        | 50.53                                                                                                                        | 168.97                                                                                                                       |
| 12                                                                                                                           | Gujarat                                                                                                                      | 518.38                                                                                                                       | 709.39                                                                                                                       | 2076.80                                                                                                                      |
| 13                                                                                                                           | Haryana                                                                                                                      | 320.86                                                                                                                       | 226.42                                                                                                                       | 476.86                                                                                                                       |
| 14                                                                                                                           | Himachal Pradesh                                                                                                             | 158.00                                                                                                                       | 45.00                                                                                                                        | 286.28                                                                                                                       |
| 15                                                                                                                           | Jammu &Kashmir                                                                                                               | 595.67                                                                                                                       | 1253.80                                                                                                                      | 805.68                                                                                                                       |
| 16                                                                                                                           | Jharkhand                                                                                                                    | 593.78                                                                                                                       | 535.24                                                                                                                       | 2620.26                                                                                                                      |
| 17                                                                                                                           | Karnataka                                                                                                                    | 1148.79                                                                                                                      | 675.94                                                                                                                       | 4097.12                                                                                                                      |
| 18                                                                                                                           | Kerala                                                                                                                       | 1508.70                                                                                                                      | 1092.82                                                                                                                      | 4250.92                                                                                                                      |
| 19                                                                                                                           | Ladakh                                                                                                                       | -                                                                                                                            | 0.00                                                                                                                         | 104.45                                                                                                                       |
| 20                                                                                                                           | Lakshadweep                                                                                                                  | 3.48                                                                                                                         | 15.55                                                                                                                        | 24.72                                                                                                                        |
| 21                                                                                                                           | Madhya Pradesh                                                                                                               | 530.77                                                                                                                       | 937.98                                                                                                                       | 1402.09                                                                                                                      |
| 22                                                                                                                           | Maharashtra                                                                                                                  | 3062.36                                                                                                                      | 747.47                                                                                                                       | 976.63                                                                                                                       |
| 23                                                                                                                           | Manipur                                                                                                                      | 199.92                                                                                                                       | 293.66                                                                                                                       | 623.31                                                                                                                       |
| 24                                                                                                                           | Meghalaya                                                                                                                    | 52.48                                                                                                                        | 46.55                                                                                                                        | 416.03                                                                                                                       |
| 25                                                                                                                           | Mizoram                                                                                                                      | 54.48                                                                                                                        | 58.88                                                                                                                        | 332.26                                                                                                                       |
| 26                                                                                                                           | Nagaland                                                                                                                     | 206.04                                                                                                                       | 137.10                                                                                                                       | 305.43                                                                                                                       |
| 27                                                                                                                           | Odisha                                                                                                                       | 661.80                                                                                                                       | 881.79                                                                                                                       | 2158.89                                                                                                                      |
| 28                                                                                                                           | Puducherry                                                                                                                   | 24.15                                                                                                                        | 23.72                                                                                                                        | 126.82                                                                                                                       |
| 29                                                                                                                           | Punjab                                                                                                                       | 184.45                                                                                                                       | 169.79                                                                                                                       | 705.42                                                                                                                       |
| 30                                                                                                                           | Rajasthan                                                                                                                    | 2903.20                                                                                                                      | 1227.09                                                                                                                      | 4603.49                                                                                                                      |
| 31                                                                                                                           | Sikkim                                                                                                                       | 72.31                                                                                                                        | 53.06                                                                                                                        | 156.78                                                                                                                       |
| 32                                                                                                                           | Tamil Nadu                                                                                                                   | 2006.42                                                                                                                      | 798.77                                                                                                                       | 4004.70                                                                                                                      |
| 33                                                                                                                           | Telangana                                                                                                                    | 766.04                                                                                                                       | 490.70                                                                                                                       | 3139.44                                                                                                                      |
| 34                                                                                                                           | Tripura                                                                                                                      | 215.13                                                                                                                       | 131.33                                                                                                                       | 383.86                                                                                                                       |
| 35                                                                                                                           | Uttar Pradesh                                                                                                                | 7602.17                                                                                                                      | 6654.70                                                                                                                      | 13196.18                                                                                                                     |
| 36                                                                                                                           | Uttarakhand                                                                                                                  | 331.74                                                                                                                       | 144.80                                                                                                                       | 597.75                                                                                                                       |
| 37                                                                                                                           | West Bengal                                                                                                                  | 892.09                                                                                                                       | 1399.34                                                                                                                      | 3697.33                                                                                                                      |

## Note:

1. The above data comprises of Non Recurring : Renovation and furnishing, District NCD Clinic, NCD Clinic at CHC, etc. Recurring grant: Miscellaneous & Contingencies, Education & Communication & Training, Public Private Partnership, Research & Surveillance, etc.
2. The above data is as per the available Financial Management Reports (FMRs) reported by the States/UTs.

## Details of Radiotherapy facilities available States/UTs wise:

|   S. No. | State             |   Existing RT equipment |
|----------|-------------------|-------------------------|
|        1 | Andhra Pradesh    |                      41 |
|        2 | Arunachal Pradesh |                       1 |
|        3 | Assam             |                      14 |
|        4 | Bihar             |                       7 |
|        5 | Chandigarh        |                       7 |
|        6 | Chhattisgarh      |                      10 |
|        7 | Delhi             |                      40 |
|        8 | Goa               |                       2 |
|        9 | Gujarat           |                      54 |
|       10 | Haryana           |                      26 |
|       11 | Himachal Pradesh  |                       3 |
|       12 | Jammu and Kashmir |                       8 |
|       13 | Jharkhand         |                       6 |
|       14 | Karnataka         |                      58 |
|       15 | Kerala            |                      46 |
|       16 | Madhya Pradesh    |                      25 |
|       17 | Maharashtra       |                     107 |
|       18 | Manipur           |                       2 |
|       19 | Meghalaya         |                       1 |
|       20 | Nagaland          |                       2 |
|       21 | Odisha            |                      13 |
|       22 | Puducherry        |                       3 |
|       23 | Punjab            |                      25 |
|       24 | Rajasthan         |                      27 |
|       25 | Sikkim            |                       1 |
|       26 | Tamil Nadu        |                      66 |
|       27 | Telangana         |                      43 |
|       28 | Tripura           |                       3 |
|       29 | Uttar Pradesh     |                      54 |
|       30 | Uttarakhand       |                       7 |
|       31 | West Bengal       |                      37 |
|       13 | Ladakh            |                       0 |
|       33 | DD&DNH            |                       0 |
|       34 | Mizoram           |                       1 |
|       35 | Andaman &Nicobar  |                       0 |
|       36 | Lakshadweep       |                       0 |