MUMBAI, Oct. 11 -- Unmoved by allegations of betrayal and public outrage, the civic administration is pressing ahead with its controversial plan to privatise key health services in Mumbai's municipal hospitals, a move many see as an abdication of its public duty. Calling it "Civic Health Collaboration", a more benign rebranding of the Public-Private Partnership (PPP) model, the Brihanmumbai Municipal Corporation's (BMC) has floated tenders for the privatisation of services in nine of its 16 peripheral hospitals, for a period of up to 30 years. For lakhs of families, civic hospitals are the only lifeline for medical treatment. But with privatisation looming, they are being priced out by a civic administration turning its back on the very people it was meant to serve. And it's not only key services that will be handed to private players. According to tenders floated in March, the 581-bed Shatabdi Hospital and Medical College in Govandi will allot 70% of its beds for paying patients and only 30% for civic referrals at "concessional rates". There were three bidders in the fray and the BMC has all but approved the final bid. Similarly, in Mankhurd, the 410-bed Lallubhai Compound Hospital will reserve 260 beds for patients holding orange or yellow ration cards, while only 150 beds will be set aside for civic patients. Full privatisation of Bhagwati Hospital was scrapped only after MP Piyush Goyal's intervention in April. As the BMC rolls out its controversial plan, 38-year-old Panvel resident, Rahul Kamat, is tending to his 55-year-old mother, admitted to Bhabha Hospital in Bandra, as her platelet count fell dangerously low ten days ago. "We needed two pouches of platelets. The hospital didn't have any because the component lab is still being set up, so I had to pay as much as Rs.11,000 per pouch at a private blood bank," said Kamat. "Inside the hospital, an ECG costs just Rs.20 and an echo test Rs.100. If these rates are hiked under the private system, how will we afford it? People don't come to civic hospitals for luxury, we come here for basic facilities at minimal cost," he said. Protests had erupted earlier this year in Govandi, where hundreds of residents marched against the privatisation plan, demanding that the BMC strengthen facilities instead of outsourcing them. "This locality is inhabited by poor, marginalised migrants earning barely Rs.200-300 a day. How will they afford Rs.500 dialysis sessions or more complicated procedures? Most don't even have ration cards or know of schemes. If privatisation comes here, it will hit this ward hardest," said advocate Faiyaz Shaikh, convenor of the Govandi Citizens' Healthcare Forum. Privatisation at some civic hospitals has been underway for a while now and the staff at a BMC-run hospital admitted that private players rarely follow government rules. "For example, despite the rules mandating that blood for thalassemia patients must be provided free, PPP-run blood banks at Shatabdi, HBT Trauma Centre and Cooper Hospital have not consistently observed this," said a doctor. Beyond the outsourcing itself, anger is mounting over the BMC's new definition of who qualifies as a "BMC patient". This category largely comprises citizens with yellow or orange ration cards issued by the Maharashtra government, BMC's own employees and corporators and their families, and those referred by BMC or state hospitals. For them, charges will remain nominal and in line with state-determined rates. For others, services will be billed at "reasonable rates" determined by the private service provider. In December last year, the BMC had floated a tender seeking consultants to prepare policies for implementing PPP projects. The consultants were tasked with preparing frameworks for different PPP models. A few months later, in his address while announcing the BMC's budget for 2025-26, municipal commissioner Bhushan Gagrani unveiled plans to expand the PPP model. According to him, the move will make healthcare more accessible, reduce operational costs, and ensure that hospitals and health centres can operate sustainably. However, a senior health official in a BMC-run hospital claimed the entire exercise was aimed at solving the severe manpower crunch, especially doctors and technicians, at civic peripheral hospitals. Health economist Ravi Duggal calls it a feeble excuse for handing public hospitals to private players. "You are essentially selling public assets to private entities under the guise of collaboration. Poor patients will be left at the mercy of the market, even though they pay taxes. The government underspends on health every year, sanctioned posts remain vacant, and then they claim they have no capacity. Instead of providing universal access, they are erecting barriers for the most vulnerable," he said. The BMC has trotted out another excuse in support of its PPP model. It claims non-BMC patients will get access to private health care through the Integrated Patient Health Service Access (IPHSA) scheme, and state schemes like MJPJAY and PMJAY....