ANSWER
THE MINISTER OF STATE IN THE MINISTRY OF HEALTH AND
FAMILY WELFARE
(SMT. ANUPRIYA PATEL)
(a) to (e): The Government of India is implementing a National Programme for Prevention and Control of Cancer, Diabetes, Cardiovascular Diseases and Stroke (NPCDCS) under National Health Mission (NHM) in all the States/UTs including Uttar Pradesh, Bihar, Jharkhand, Uttarakhand & Hilly States for intervention upto district level. The objectives include awareness generation for prevention, screening, early detection and referral to an appropriate level institution for treatment. For Cancer, the focus of the programme is on Breast, Cervical and Oral Cancer. Operational guidelines have been recently released for prevention, control and population level screening of Diabetes, Hypertension and common Cancer (Cervix, Breast and Oral) to all the States for implementation including Uttar Pradesh, Bihar, Jharkhand, Uttarakhand and all Himalayan States.
Regional Cancer Centres (RCCs) were recognized and supported under the erstwhile National Cancer Control Programme (NCCP) for treatment of cancer patients. The scheme is no longer being implemented and there is no proposal to open regional cancer centres in collaboration with any private sector hospitals. The list of RCCs in the country including in Uttar Pradesh, Bihar, Jharkhand, Uttarakhand and all Himalayan States, recognized under erstwhile NCCP is at Annexure-I.
Under current Five Year Plan, a Tertiary Care for Cancer scheme is being implemented under which support is being provided to set up/establish State Cancer Institutes and Tertiary Care Cancer Centres in different parts of the country. These institutions will mentor all Cancer related activities including prevention, awareness generation, research and treatment in their respective jurisdiction.
Provisioning of drugs is supported under NHM and NPCDCS. The list of medicines specified in the National List of Essential Medicines (NLEM) which are included in the First Schedule of Drug Pricing Control Order (DPCO), 2013 also contain drugs used for the treatment of Cancer for which ceiling prices have been fixed. Most of the states are providing essential drugs, including certain cancer drugs free of cost to patients who come to public health facilities.
Affordable Medicines and Reliable Implants for Treatment (AMRIT) outlet has been opened at All India Institute of Medical Sciences, New Delhi and 6 other Institutions with an objective to make available Cancer and Cardiovascular drugs and implants at reasonable prices to the patients. M/s HLL Lifecare Ltd, which is a 100% Government of India owned PSU under this Ministry, has been directed to contact all States which may like to open AMRIT outlets in major State Government hospitals/institutions. As per the approval accorded for setting up AMRIT, the prices of the products are to be reasonable and significantly lower than the market price.
The treatment for cancer in Government Hospitals is either free or subsidized. In addition to Cancer diagnosis and treatment by the State Governments Health Institutes, the Central Government Institutions such as All India Institute of Medical Sciences, Safdurjung Hospital, Dr Ram Manohar Lohia Hospital, PGIMER Chandigarh, JIPMER Puducherry, Chittaranjan National Cancer Institute, Kolkata, etc. provide facilities for diagnosis and treatment of Cancer.
The Government is providing financial assistance to patients living below poverty line for life threatening diseases under the schemes Rashtriya Arogya Nidhi (RAN), Health Minister’s Cancer Patient Fund (HMCPF), State Illness Assistance Fund (SIAF) and Health Minister’s Discretionary Grant (HMDG). The details are given as under:
I. Rashtriya Arogya Nidhi has been set up to provide
financial assistance to patients, living below poverty line who are suffering from major life threatening diseases, to
receive medical treatment at any of the super specialty
Government hospital/ institute. Revolving Funds have been
set up in 13 Central Government Hospitals/Institutes and funds
upto Rs. 50 lakhs are placed at their disposal for providing
treatment upto Rs. 2 lakh in each case. Cases involving
treatment beyond 2 lakh are referred to Ministry of Health & Family Welfare, Government of India for providing funds. The details of funds utilized during 2015-16 under the scheme is at Annexure-II.
II. All State Governments/UT Administrations have been advised to set up an Illness Assistance Fund in respective States/UTs. It has been decided that grant-in-aid from Central Government would be released to each of these States/UTs (with Legislature) where such Funds are set up. The Grant-in-aid to States/UTs would be to the extent of 50% of the contributions made by the State Governments/UTs to the State Fund/Society subject to a maximum of Rs. 5 crore to States with higher percentage of population below poverty line and Rs. 2 crore for smaller States. The Illness Assistance Fund at the State/UT level can release financial assistance to patients living in their respective States/UT up to Rs. 1.50 lakh in an individual case and forward all such cases to Rashtriya Arogya Nidhi Headquarters, where the quantum of financial assistance is likely to exceed Rs. 1.50 lakh. The details of funds utilized under the scheme is at Annexure-III.
III. Health Minister’s Cancer Patient Fund (HMCPF) has been set up to provide financial assistance to the poor patients suffering from cancer. A Corpus Fund of Rs. 100 crore has been set up, which has been placed in fixed deposit. Interest accrued thereon is utilized to provide the financial assistance.
IV. Financial assistance towards treatment for cancer is provided to the patients having treatment in 27 Regional Cancer Centres (RCC), as per guidelines. Revolving Funds have been set up in 27 RCCs and funds upto 50 lakhs are placed at their disposal for providing treatment upto Rs. 2 lakh in each case. Cases involving treatment beyond 2 lakh are referred to Ministry of Health & Family Welfare, Government of India. The details of funds utilized under the scheme by the RCCs is at Annexure-IV. Release of assistance directly to hospitals for treatment of cancer patients is at Annexure-V.
V. Under the scheme Health Minister’s Discretionary Grant (HMDG), patients having annual family income of less than Rs. 1,25,000/- are provided financial assistance upto Rs. 1,25,000/- as per guidelines of the scheme to defray a part of expenditure on hospitalization/treatment. The details of funds utilized under above schemes State/UT wise is at Annexure-VI.
The accounts of Rashtriya Arogya Nidhi are audited by Chartered Accountants as well as by the CAG. The utilization certificates in the form of GFR 19-A are received from the hospitals are scrutinised before release of further funds from the RAN/HMCPF/SIAF schemes.
There are multiple monitoring mechanisms including performance audit by CAG and statutory audit through which the programmes under NHM including NPCDCS are monitored. In addition, regional review meetings are also held under NPCDCS. Regular coordination with the States/UTs is maintained for effective implementation of scheme and programme.
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