Kerala Turns Travel Into Treatment: KSRTC Free Rides Ease Cancer Care Burden
By Arunima Rajan
Kerala's new initiative offering free bus travel for cancer patients will increase adherence to treatment
In Kerala, the bus is no longer just transport, it is treatment. According to a new directive by the Kerala State Road Transport Corporation (KSRTC), patients undergoing cancer treatment can now travel free of cost on KSRTC buses for chemotherapy, radiation and other treatment-related visits, whether in public or private institutions. The move signals a shift, travel is no longer a welfare concession but part of the patient’s right to care.
Mobility ≠ Welfare; it’s Treatment
For many cancer patients, travel is a hidden barrier to care. Consider the case of *Siddique, an 82-year-old cancer patient, who regularly travels to multiple cities for his treatment. From Kanyakumari, he goes to the Regional Cancer Centre in Thiruvananthapuram for specialist consultations. For a second opinion, he travels to Chennai. After undergoing two surgeries, he recently decided to stop his treatment. “There is too much expense involved in travelling between my hometown and other cities for treatment. At my age, when there is no hope of complete recovery, I don’t want to spend more on travel and treatment,” says the octogenarian, who has discontinued his treatment due to the hassle.
When Movement Determines Outcome
According to Pavan Choudary, Chairman, MTaI, for decades, India’s primary healthcare workers have recognised that access to care often depends as much on transport as on treatment. “Many once requested that government schemes include travel costs, knowing that patients could neither easily undertake nor afford the journey to higher hospitals. Today, improved road and transport infrastructure is bridging that gap, bringing healthcare literally closer to the patient. Cancer care suffered heavily during the COVID-19 lockdowns when mobility collapsed - a stark reminder that early diagnosis and successful treatment, especially in cancer, rely on movement. As transport networks expand and logistics evolve, mobility is indeed becoming a vital driver of healthcare equity - improving access, adherence, and ultimately, outcomes for patients who once stood farthest from care.”
Transport: The Invisible Determinant of Care
Dr Sudheer Kumar Shukla is a public health researcher, Health Systems Transformation Platform (HSTP), New Delhi (an institution established by Tata Trusts). Shukla points out that Kerala’s initiative reframes mobility as an instrument of health equity. “By recognising that the journey to treatment is itself part of treatment, the State has moved beyond the walls of hospitals to address a crucial but often invisible determinant of care - transport. Free travel across the Kerala State Road Transport Corporation (KSRTC) network transforms mobility from a welfare gesture into a rights-based entitlement, ensuring that no patient is denied care because of the cost or fatigue of reaching it,” he says.
RFID = credibility, data linkage, scalability; enables future outcome-tracking
He continues: “The policy’s digital foundation, through RFID-based identification, adds both credibility and scalability, allowing future integration with health-outcome data. The measure goes beyond fare relief; it restores dignity to care by making travel a shared public responsibility. In a country where non-medical expenses can exceed medical ones, Kerala’s approach is a quiet revolution - one that places compassion within the architecture of governance. By turning travel into treatment, the State reminds us that the road to recovery begins long before the hospital gate”.
By reducing the travel burden the policy may increase patient retention and adherence to repeat treatments. Patients are less likely to default because of distance fatigue.
Integrating Mobility in to Universal Health Coverage
Dr Nishikant Singh is a public health researcher at Health Systems Transformation Platform. “Kerala’s reform also invites India’s health-system planners to think bigger. Mobility must be treated as a structural component of universal health coverage; integrated, funded, and measurable. Two extensions could strengthen the scheme’s reach: first, expanding it beyond KSRTC to include private and inter-state buses; and second, covering a clinically justified attendant for patients who cannot travel alone, such as children, frail elders, or those recovering from chemotherapy. International precedent supports this vision. Western Australia’s Patient Assisted Travel Scheme, New South Wales’ IPTAAS, and the NHS in England all subsidise travel for both patients and escorts when clinically warranted. These are not acts of generosity but expressions of equity. Kerala’s policy stands out because it transforms a logistical challenge into a therapeutic necessity, aligning transport with care itself. The next frontier lies in ensuring that no patient—or caregiver—is left behind on the journey to healing,” he adds.
Policy Coherence and Implementation
Sachin K Indane, co-founder & CEO, Isansys Lifecare India Pvt Ltd, sees the order as a part of wider ecosystem of reforms. “Kerala's policy on patient mobility appears well-rounded and thoughtful, reflecting the state's commitment to inclusive and accessible healthcare,” he says. “The approach of fixing transparent rates for ambulance services alongside free and discounted transport for vulnerable groups like cancer patients, children, and economically weaker sections is commendable, as it reduces financial barriers to essential medical care. The integration of free travel on public transport for cancer patients significantly alleviates logistical challenges during lengthy treatments. Furthermore, involving local self-governments in caring for bedridden patients shows a strong community-oriented strategy that likely improves home-based and palliative care. The policy's clear guidelines on interstate patient movement and hospital staff shift systems demonstrate attention to operational efficiency and patient safety, essential for timely access to medical facilities. Overall, Kerala’s policy balances equity, affordability, and practical implementation, making it a robust model to support patient mobility in diverse medical scenarios. If coupled with simple yet robust technology to monitor these patients while in transit will further enhance the safety and quality of care.”
He also notes the potential of simple monitoring technology. “Mobility is a big enabler for creating access to healthcare. Safe and monitored mobility can ensure patients can reach the care properly. We at Isansys have a solution where patients can be monitored in real time with our system working on just a SIM card. The solution helps move the patients safely without a need for expensive 5G ambulances etc. with GSM network becoming robust and economical, we enable real time patient status to caregivers irrespective of the location. We moved a few days old child with cardiac anomaly from a village to Bangalore through a drive of 4.5 hours. Over 90% of the time, the doctors in Bangalore were able to see live status of the child and advise team on the ambulance till patient safely arrived for paediatric surgery.”
The Road Ahead
The scheme is not without hurdles. It currently applies only to patients, not attendants. Implementation details, from the way cards are issued to on-ground awareness among government employees, will determine its reach. Data on uptake and patient outcomes will reveal whether it truly changes adherence behaviour. Still, by integrating transport within the cycle of care, Kerala has showed that mobility is medicine. It’s a small administrative order but has symbolic weight. The order could definitely serve as a blueprint for other states to rethink the hidden costs of care.
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