Activists flag concern over Karnataka’s proposed Right to Health Bill

Opposition to the proposed draft Karnataka Right to Health and Emergency Medical Services Bill, 2025, is gathering momentum, with public health experts and civil society groups warning that the proposed legislation could entrench privatisation rather than strengthen public healthcare.

At a public consultation convened by the Karnataka Janaarogya Chaluvali and Dhwani Legal Trust, participants questioned whether the Bill meaningfully advances the right to health or dilutes the State’s responsibility as the primary provider of care.

Lagging health indicators

Despite being one of India’s wealthier States, Karnataka continues to lag behind Kerala and Tamil Nadu on key indicators such as maternal mortality, infant mortality, neonatal mortality and under-five mortality. The National Family Health Survey (NFHS-5) data also points to high levels of anaemia among women and children, persistent child undernutrition and uneven insurance coverage.

Public health doctor and researcher Sylvia Karpagam said the conversation around a right to health law cannot be divorced from these structural gaps. “If the State does not commit to universal, free diagnostics, medicines and treatment through strengthened government facilities, the promise of a right to health will remain rhetorical,” she said.

Karnataka has often been projected as a model of reform because of its early adoption of privatisation, public-private partnerships and insurance-based care, in line with policy prescriptions promoted by institutions such as the International Monetary Fund and the World Bank. However, speakers argued that these approaches have not resolved inequities in access.

Akhila Vasan of the Karnataka Janaarogya Chaluvali said, “The draft Bill appears to legitimise these trends.”

“In the Bill that is circulating, the definitions of ‘public health’ and ‘healthcare’ are vague and do not clearly establish the State as the primary provider,” she said. “When the focus shifts to ‘eligible patients’ and empanelled private institutions, it opens the door to further outsourcing instead of strengthening public provisioning,” Ms. Vasan said.

The proposed State Health Authority (SHA) would empanel private hospitals, oversee ambulance services and ensure access to medical services. Critics at the consultation raised concerns about potential conflicts of interest and the absence of strong accountability safeguards.

Emergency medical services

The Bill’s emphasis on emergency medical services also drew scrutiny. In the landmark judgment in Pt. Parmanand Katara vs Union of India, the Supreme Court held that preservation of life is paramount and that every doctor, whether in a government or private institution, must provide immediate medical aid. Participants argued that restating this obligation without strengthening enforcement mechanisms risks diluting existing legal standards.

“Emergency care is already a legal and ethical obligation,” Dr. Karpagam said. “What we need are clear penalties for violations and accessible grievance redressal systems, not provisions that may introduce new layers of eligibility or reimbursement barriers,” she said.

Development economist Jean Dreze, who attended the consultation, emphasised that health must be viewed as a public good rather than a market commodity and underscored the importance of participatory governance in shaping any new legislation.

Legal loopholes

The draft proposes a multi-tier grievance redressal system but caps penalties at modest fines. Lawyers associated with Dhwani Legal Trust said they had identified several legal loopholes and would examine the Bill more closely in the coming weeks.

Ms. Vasan said, “If this law does not reaffirm the State’s responsibility to provide comprehensive, free and accountable healthcare, it risks becoming a framework that normalises privatisation rather than guaranteeing rights.”