Dialysis in India: Lifesaving Service or Systemic Struggle?

The gap between policy promises and patient experience

Government Vision versus Ground Reality

The Government of India has attempted to expand access to healthcare through initiatives such as One Nation, One Service and Aapke Dwar Ayushman. Under the Ayushman Bharat scheme, also called PM JAY, and the National Dialysis Program, also called PM NDP, the objective is to provide free dialysis services to patients who cannot otherwise afford treatment.

The reality on the ground often differs. Patients in several parts of the country face challenges that range from non availability of sessions to irregularities in service delivery. While policies exist on paper, gaps in execution continue to affect the dignity and safety of people who rely on dialysis to survive.

The Legal and Policy Framework

Issues in dialysis service delivery fall under multiple laws and policies, including:

• Bharatiya Nyaya Sanhita 2023, Sections 316, 318, 336, and 62 for fraud, trust violations, and document falsification
• Prevention of Corruption Act 1988
• Consumer Protection Act 2019
• Clinical Establishments Act 2010
• Indian Medical Council Regulations 2002
• PM JAY guidelines that allow audits, penalties, and blacklisting
• Digital Personal Data Protection Act 2023
• Right to Information Act 2005
• Whistleblower Protection Act 2014
• Maharashtra Patients’ Rights Bill, Draft 2022
• Constitution of India, Articles 14 and 21 for equality before law and the right to life
• UN ICESCR recognition stating that health is a human right

This framework exists not only to regulate providers but also to protect patients and to ensure accountability in healthcare delivery.

Concerns Around Urgent Dialysis Sessions

For a patient in urgent need, dialysis is a matter of life and death. In practice, difficulties can arise in securing timely sessions. Reports suggest that patients are sometimes asked to pay additional charges for emergency slots or are told that treatment is delayed due to non availability.

Whether these situations result from system inefficiency, limited monitoring, or gaps in regulation, the effect is the same. Patients and families are placed in vulnerable positions. Dialysis should be a guaranteed medical service, not a transactional negotiation.

Quality of Supplies and Patient Experience

The quality and handling of syringes and other consumables is another area of concern. Patients have reported the use of poor quality or outdated materials, which increases health risks. In some cases, supplies meant to be free under public schemes are charged to patients instead.

These issues point to the need for strong oversight not only in hospitals but also across the entire supply chain. Suppliers, quality managers, procurement officers, and auditors share responsibility for safety and compliance. Oversight by FDA Maharashtra, CDSCO, and the National Health Authority should ensure strict quality control and transparent processes wherever violations are confirmed.

Upholding Patient Dignity

People who undergo long term dialysis, including those who pay from their own pockets, deserve dignity, protection, and fair concessions. Healthcare must never be reduced to bargaining. The principle is simple. Dialysis is a right to care, not a privilege to purchase.

The path forward is to close the gap between government intent and actual delivery. This requires tighter audits, clear accountability, and ethical practice at every level of the system.