India’s push towards universal healthcare will remain incomplete if patients in smaller cities have to travel to metros for specialised treatment or struggle to afford private hospital care. Private hospitals need to expand into tier-2 and tier-3 cities and make treatment more affordable to reduce this imbalance, Prof Dr. M. Srinivas, Member, NITI Aayog, said at a healthcare industry conference in the national capital on October 27.
The challenge is not merely to build more hospitals but to ensure that patients can access safe, quality treatment closer to home without facing an overwhelming financial burden. Dr. Srinivas also called for minimum standards of patient safety and quality of care across hospitals, arguing that common benchmarks were essential to build public confidence in India’s healthcare system.
Speaking at the 20th edition of FICCI HEAL 2026, organised by FICCI, the Union Ministry of Health and Family Welfare, and NITI Aayog, he urged private hospitals to participate in universal health coverage and widen their reach beyond major urban centres.
“There is a need for the private hospitals to adopt the universal health scheme,” he said, calling for affordable services in smaller cities to avoid an unequal distribution of healthcare.
In fact, the concentration of private healthcare infrastructure in large cities has been a longstanding concern. A 2019 report by an expert sub-group of the Economic Advisory Council to the Prime Minister found that 48% of private hospitals in the million-plus cities covered by its analysis were located in eight large cities — Mumbai, Kolkata, Delhi, Chennai, Bengaluru, Hyderabad, Pune and Ahmedabad. Mumbai alone accounted for 16% of the hospitals in the analysis, while around 67% of corporate hospitals were located in these large cities.
A NITI Aayog report published in 2021 also highlighted the urban concentration of hospital beds. It estimated that 80% of private hospital beds were in urban areas, compared with 20% in rural areas. Across public and private facilities combined, 72% of beds were urban and 28% rural. These figures relate to the datasets and period covered by the reports and should not be read as a current census.
When asked to comment on Dr. Prof Srinivas’ suggestions on affordable care in smaller cities, Dr. Suchin Bajaj of Cygnus Ujala Healthcare, who was not at the event, was of the view that "the challenge is not just to make the treatment affordable, but focus should also be on creating a sustainable model that brings essential and specialised services within the reach of people outside large cities.”
With healthcare facilities expanded to 26 centres across smaller cities in the northern region in states such as Uttar Pradesh and Uttarakhand, he said the aim is to reach out to the poor people, providing health services at very low cost.
Needless to say, for patients from smaller towns, the gap can mean more than a long journey. Travel, accommodation and lost wages can add to the cost of treatment, while repeated trips for consultations and follow-up can strain household finances. Patients who need regular dialysis, cancer care or specialist reviews may find continuity of treatment particularly difficult when services are far from home, said Dr. Bajaj.
Dr. Srinivas also stressed that expansion must go hand in hand with minimum standards of safety and quality.
“The country should have a basic minimum standard of quality and safety at every hospital. As a country, we must come to a level where the world should recognise that Indian hospitals have a minimum standard of patient care,” he said.
The statement, however, did not specify what these standards would cover, whether they would be mandatory or how compliance would be monitored.
Dr. Srinivas, former director of AIIMS, Delhi, also emphasised that healthcare should put people at the centre by ensuring timely treatment and protecting them from additional financial hardship. He linked this goal to the Pradhan Mantri Jan Arogya Yojana (PM-JAY), which provides hospitalisation cover to eligible beneficiaries.
Greater participation by private hospitals in publicly funded schemes could help widen access, provided the terms of participation make it feasible for hospitals to provide the covered services and patients can obtain treatment without unexpected expenses. The specific universal health scheme Dr. Srinivas referred to was not identified in the conference statement.
Digital infrastructure could support continuity of care as patients move between hospitals. Referring to the Ayushman Bharat Digital Mission, Dr. Srinivas said India had developed a digital health ecosystem and that structured, interoperable data could help improve healthcare delivery and the use of artificial intelligence.
“Through the National Health Authority, we are coming out with structured data with interoperability, like one nation, one election. We will have one platform for ABHA ID and electronic health records which will be interoperable. That's something which we are pushing for,” he added.
At the conference, Dr. Ashutosh Raghuvanshi, Chair, FICCI Health Services Committee and MD & CEO, Fortis Healthcare, said India’s healthcare system needed to balance advanced capabilities with affordability, access and trust as the country worked towards Viksit Bharat 2047.
“As we look towards Viksit Bharat 2047, the healthcare sector must work towards a system that combines world-class capabilities with affordability, access, and trust. This will require sustained investment, stronger prevention and early diagnosis, a skilled healthcare workforce, and closer collaboration across the public and private sectors,” he said.
Dr. Kenji Shibuya, CEO, Medical Excellence JAPAN (MEJ), spoke about the scope for India and Japan to collaborate in healthcare.
“India and Japan have a unique opportunity to lead the healthcare transformation together. India's vision of 'Heal in India' is truly inspiring. By integrating advanced medical care, Ayurveda, and wellness awareness, India is positioning itself as a global healing destination,” he said.
Anuj Pasrija, Country Lead, J&J MedTech India & VP-Surgery, Johnson & Johnson, said future hospitals would need to remain connected with patients throughout their care.
"The hospital of the future will not be defined merely by its buildings, beds, or operating rooms. It will be defined by its ability to stay connected with the patient across the entire journey of patient care.”
