As the Brihanmumbai Municipal Corporation (BMC) moves to partially privatize Borivali’s Bhagwati Hospital under the Public-Private Partnership (PPP) model, its own hospitals are struggling with an acute staff shortage, with 40% of essential Class IV positions lying vacant, alleged the Municipal Mazdoor Union.
Employees of civic-run hospitals have strongly opposed the decision, warning that vacancies in crucial roles such as ayahs, ward boys, sweepers, sanitation workers, and lab attendants are severely compromising patient care.
“Instead of strengthening public healthcare infrastructure and filling these critical vacancies, the BMC is prioritizing privatization. This could significantly impact the quality and affordability of healthcare services,” said Pradeep Narkar, secretary of the Municipal Mazdoor Union, in a statement to Hindustan Times.
According to internal data, KEM Hospital has 1,991 sanctioned Class IV posts, of which only 1,110 are filled, leaving 881 positions vacant (44%). LTMG (Sion) Hospital faces a similar shortfall, with 1,725 sanctioned posts and 719 vacancies (42%). BYL Nair Hospital has the highest deficit, with only 679 of its 1,454 positions occupied, leaving 775 posts vacant (53%).
These shortages, the union says, directly impact patient care. “We are often forced to work overtime to compensate for the staff shortage. Basic cleaning, patient support, and other essential duties are suffering,” said a sweeper from KEM Hospital on condition of anonymity.
The BMC has already spent Rs 500 crore on constructing the new Bhagwati Hospital. According to a recently issued government resolution (GR), the facility will house 480 beds, of which 148 will be managed by the BMC at civic hospital rates. The remaining beds will be operated by private entities. Patients admitted to these private beds will be eligible for treatment under the Ayushman Bharat Scheme and other government health programs.
The Privatization Increase Costs and Disparities, says Union
However, the union warns that partial privatization could increase treatment costs for patients not covered under these schemes and create disparities in care. “The BMC is handing over newly constructed hospitals to private operators under the PPP model, even as our 16 peripheral hospitals and four major civic hospitals struggle with severe staff shortages,” said a union member. “Rather than outsourcing, the corporation should focus on recruiting staff and ensuring that existing hospitals function efficiently.”
In the BMC budget announced in February, municipal commissioner Bhushan Gagrani proposed adopting the PPP model in hospitals to reduce operational costs and ease patient expenses. However, healthcare workers argue that unless chronic staffing shortages—especially in Class IV roles—are addressed, such models risk failure on the ground. They urge the civic body to prioritize hiring before involving private players in public healthcare.
“PPP models may work in theory, but in practice, hospitals without adequate nurses, ward staff, and sanitation workers will struggle to provide quality care,” said public health expert Dr. Amar Jesani. Healthcare is not just about infrastructure or technology—it’s about people. Without investing in human resources, even the best partnerships will fall short of delivering equitable healthcare.
