Cancer burden rising, all hands on the deck

A rising cancer burden - more than 15 lakh new cases annually - combined with a constrained specialist workforce, underscores a severe structural weakness in India's oncology care system. With only about 2,100 medical oncologists, 3,500 radiation oncologists and 4,000 onco-surgeons, it's unsurprising that late detection and delayed treatment are key problems. The situation has now been further complicated by a new PMJAY provision, which excludes trained and experienced cancer specialists from empanelment because they do not possess National Medical Commission (NMC)-approved super-specialty degrees. This is bureaucratese as an obstacle to common sense and public good.

Until a few decades ago, formal oncology courses were absent in the country, and fellowships were accepted pathways for acquiring specialised clinical expertise. Many MBBS and MD practitioners went down that route. But now these practitioners are ineligible under PMJAY norms. Only around 70 onco specialists with NMC- recognised 'super-specialty degrees' are added to the workforce annually. In such a scenario, a rigid framework appears counterproductive. This is especially paradoxical given GoI's parallel efforts: investments in infra for early cancer detection and treatment, and reductions in duties on cancer drugs.

'First, do no harm' is a foundational principle of modern medicine. In a complex and weak healthcare ecosystem, this principle must extend beyond clinicians to include policymakers and administrators. Regulations are essential. But they must remain responsive to ground realities. When they produce adverse outcomes, they warrant reassessment. Here, revisiting PMJAY eligibility criteria for oncology specialists is something the authorities must consider.