At Delhi’s ‘free’ cancer hospital, patients ask: ‘How can I afford it?’

Then there are the tests. In July, a PET-CT scan cost her Rs 12,000 at a private diagnostic centre. “The testing was also done here before; now, for most tests, they refer us outside,” she said.

Before her diagnosis, Sabra worked as a tailor in Jaffrabad. She first noticed a lump in her breast five years ago and has since undergone four surgeries, the latest in January 2025, and continues to receive chemotherapy. For her, the treatment has become a question of how long her family can afford to pay. “Till my husband supports me,” she said, sitting in the hospital’s waiting area on the first floor, if he refuses to spend money on a dying woman, I’ll have nowhere to go.”

A floor above, a 42-year-old corporate-sector employee moved between the hospital’s private wards and an unfinished section that had been intended to house more of them. Construction had stopped, leaving part of the floor abandoned.

His father had been in the intensive care unit for 12 days. The family had already spent more than Rs 4 lakh, he said. His father was diagnosed with multiple myeloma six years ago, and the expenses had included a PET-CT scan, dialysis and several blood tests.

“The PET-CT and dialysis alone cost us about Rs 60,000,” he said.

What troubled him almost as much as the expense was having to pay for tests at private centres after coming to a government hospital expecting them to be covered. “I wasn’t aware that DSCI-referred patients get some discount at private testing centres,” he said.

Sabra and the 42-year-old are not alone. Patients say they are increasingly sent outside DSCI for medicines, scans and tests, leaving them to pay costs they expected the government hospital to cover.

The hospital describes itself as having “ultra-modern diagnostic facilities.” Yet some of the equipment needed to provide those services lie unused on its premises.

The problem extends beyond DSCI. A recent audit of 26 city government hospitals, ordered by the Delhi High Court, found medical equipment lying unused across the Capital’s public health system.

Nothing illustrates the findings more starkly than DSCI, where the consequences are being felt in patient care — and in the bills patients are left to pay.

Machines gather dust, patients suffer

The waiting area at DSCI sits at the centre of the hospital — a large hall with a transparent plastic roof. Patients and attendants crowd the hall, with some lying on the floor, while open pipes from a nearby bathroom fills the area with foul smell.

In the waiting area, Sarita, 62, from Murshidabad, moves slowly behind her son. Her body has grown visibly frail; a feeding tube trails from her nose. Sarita has lymphoma, a cancer of the immune system. For the past two months, she has been coming to DSCI for treatment. Now doctors have asked her to undergo a PET-CT scan to assess her response to treatment. But the scan is not available at the hospital.

“When I went to the radiology department, I was told the test was not available,” said her son, Mohan. A PET-CT at a private centre can cost between Rs 8,000 and Rs 30,000. Mohan is a daily-wage labourer. A Rs 12,000 scan, he said, would eat up nearly three-quarters of his monthly income.

“They are asking me to get the test done at a private centre,” he said. “The security guard said he could get it done at a discounted price of Rs 12,000. But how can I afford it?”

Across the road from DSCI, in the DDA market at Pocket E, those private centres have become part of the hospital’s ecosystem. A cluster of diagnostic centres has sprung up around the hospital, catering in part to patients sent there for tests.

At one of the diagnostic centres, a staff member described the routine. “We get two to three patients from DSCI a day. For a PET-CT, we offer a special discounted price of Rs 8,000. They deposit Rs 1,000 at the counter, and the next day, we arrange an ambulance. The patient comes to DDA market, and we take them to the testing centre,” he said.

Some patients, however, specifically ask to have the scan done at another centre, considered one of the best. “The price then rises to Rs 22,000,” he said.

For patients like Sarita, the cost is harder to bear because DSCI has the machines to do the scan. They are simply lying idle.

According to records submitted to the High Court, DSCI’s Department of Nuclear Medicine has three high-end machines installed in 2017 at a cost of $6.3 million, plus Rs 4.06 crore in local and turnkey costs. One, a medical cyclotron used to produce isotopes for PET scans, has been sitting unused since 2018.

“The radioactive sugar molecule has a short life. It decays quickly and requires specialised handling,” the official said. “The machine was operational until 2018 but has been unused since then because of a lack of qualified manpower. We are filling these positions now.”

Two other sophisticated imaging machines, used to guide cancer treatment and track how patients respond to radiotherapy, are also sitting idle and under evaluation: a dual-head gamma camera with SPECT capabilities and a PET scanner integrated with a multidetector, multislice CT scanner.

Pocket E, DDA market where a cluster of medical shops and diagnostic centres have come up around DSCI. (Express Photo by Sohini Ghosh)

It is not only expensive equipment that lies unused. Parts of the hospital itself have been left to deteriorate.

On the second floor, across from the private rooms, a section of the hospital lies in ruins. It was once a day-care chemotherapy unit, where more than 150 patients were treated each day. Now, it stands abandoned. A warning on the door reads: “Don’t enter without permission.” Inside, steel vents hang loose from the ceiling. Beds sit unused. Wires and pipes dangle from the ceiling to the floor. Plastic waste is scattered across the room, while dust has accumulated on the floor.

“Due to a lack of medical supplies and manpower, this facility is shut,” a source said.

The staff shortage

At DSCI in Dilshad Garden, there are 236 beds: 169 inpatient beds, 29 for observation and 38 chemotherapy recliners. But patient numbers have fallen sharply, from around 1,500 a day to about 500, sources said, largely due to staff shortages.

More than 40% of DSCI’s 814 sanctioned posts are vacant, as per data shared by hospital sources. Even the positions being filled are often temporary. The latest recruitment drive, with interviews held on August 5, selected or waitlisted 13 senior residents across departments. Their appointments are for 44 days, extendable under institute rules.

“These temporary posts create a sense of instability in the careers of young oncologists,” a source said. “Hence, they are not invested and quit the hospital within a few months for more stable and attractive jobs.”

For doctors who have watched the institute change, the effects are no longer confined to staffing charts. “The treatment is compromised, and the turnaround time for patients increases,” said a senior doctor.

“The institute was built with patient care at its centre. There was a time when even if a patient came at 2 am, we would not turn them away. Now there is a cap of around 25 to 30 patients per doctor per day. The vacancies need to be filled, but bureaucratic hurdles have made that difficult.”

Another senior doctor, who was directly involved in the administration, remembers a different DSCI — its most successful years, between 2006 and 2015. “We drew such a large number of patients, not only from neighbouring states but also abroad, that we had planned to expand it by adding another 1,000 beds … We wanted to make this the largest cancer-care facility in the country.”

Then, the doctor said, came 2019. “We drastically started witnessing its downfall,” the doctor said. “A sudden vacuum of leadership was created, followed by a musical-chair arrangement that resulted in the present unfortunate situation.” The doctor alleged that there was a perception the changes were being made “deliberately to benefit private centres”.

Fight against time

For patients, the consequences are increasingly visible. Many are being referred to other hospitals altogether — some of which provide treatment free of cost.

Take Sunita Ghai’s case. In 2025, when the 70-year-old was diagnosed with uterine cancer, her son, Nikhil Ghai, a photographer from East Delhi, took her to DSCI. The hospital could not provide the radiation therapy she needed and referred her to a private hospital run by a public charitable trust because of the “non-availability of the facility.”

“She was treated for free,” Nikhil said. The reason: Eight items in the hospital’s radiotherapy department reached the end of their usable life and were lying idle on the premises for years. Among them is a dual-photon-energy linear accelerator, which uses high-powered X-rays at two energy levels to destroy cancer cells. A course of treatment using such a machine can cost Rs 2 -3 lakh at a private centre. DSCI bought the machine for Rs 9.2 crore in 2007. It has been non-functional since 2020, officials said.

Now, Ghai and his mother are back at DSCI. Fluid has built up in Sunita’s lungs, and she has been advised to undergo a minor surgery. After spending six days in a private hospital’s ICU, the family has exhausted its savings, leaving Ghai with little choice but to return to the government hospital.

The family has been waiting outside a room marked “Minor OT” for hours. “I could not find a wheelchair for my mother… Why should the facility open at 2 pm instead of its regular hours? Cancer patients are fighting against time. It took two weeks to get the biopsy results here.”

At DSCI, patients are fighting that clock in more ways than one — waiting for tests, waiting for treatment and, increasingly, waiting for the hospital itself to function.

Will fix gaps with clear timelines, says Delhi Health Minister

Delhi Health Minister Pankaj Singh said the BJP-led government had taken cognisance of the functioning of DSCI and was taking steps to “address the gaps”.

“Our priority is to ensure that no cancer patient in Delhi is forced to choose costly private treatment, and we are committed to restoring DSCI to full functional capacity at the earliest,” Singh said.

“Most of this equipment was brought in by the previous AAP government, and unfortunately, several of these machines have been lying underutilised or non-functional for a while now,” Singh told The Indian Express.

“We have taken serious cognisance of the matter and have asked for a detailed report from the hospital administration on the exact status of every machine, along with a clear timeline for repair and recommissioning,” he said.

Singh said the government would fast-track recruitment.

“Recruitment of specialists across departments has already begun, and we are prioritising nuclear medicine and radiotherapy, given how critical these departments are for cancer care,” he said. “The machines have also started functioning gradually as vacancies are being filled and supply issues are being addressed.”