Kerala HC asks Centre if better health care in State is a “handicap” for establishing AIIMS

The Kerala High Court wants the Union government to explain why Kerala has not been prioritised for an All India Institute of Medical Sciences. The proposal has remained unresolved for almost 10 years. The court is examining a petition seeking an AIIMS under the Pradhan Mantri Swasthya Suraksha Yojana.

The Union government told the court that Kerala had better healthcare conditions than other States. It was therefore giving priority to States with weaker health systems. The Bench questioned whether Kerala’s existing hospitals had become a disadvantage, even though the State has the country’s highest population density.

The matter is currently under inter-ministerial consultation. A final decision may come only after approval for continuing the PMSSY scheme during the next five financial years, from FY 2026-27 to FY 2030-31. The court has asked for a conscious decision on Kerala’s proposal.

An All India Institute of Medical Sciences, or AIIMS, is a major public medical institution. It typically provides specialised and complex treatment, trains doctors and other health professionals, and supports medical research. Such institutes matter because they can serve patients who need care beyond the capacity of ordinary hospitals.

An AIIMS can also become a referral centre for surrounding districts. Patients may receive advanced consultations, surgery, diagnostics, and emergency treatment in one institution. Its teaching role helps develop skilled medical staff, while research can improve understanding and treatment of diseases. These functions make an AIIMS more than a large general hospital.

The article does not describe AIIMS’s structure in detail. It does show why the issue matters in Kerala: the court said existing hospitals may not be sufficient for the needy and poor, despite the State’s comparatively better healthcare conditions and high population density.

The proposal for an AIIMS in Kerala has been pending for almost 10 years. That long delay is central to the Kerala High Court’s concern. The Bench asked why Kerala had not been prioritised while the Union government continued considering the institute’s establishment.

The idea was raised in June 2016. Afterward, four locations were identified for the proposed institute. The court referred to these details in an earlier order while asking the Union government to take a conscious decision about the proposal.

The proposal is still not approved in principle. The court observed that it remains at the stage of inter-ministerial consultation. Any decision may depend on approval to continue the PMSSY scheme for the next five financial years, covering FY 2026-27 to FY 2030-31. Until then, the location work has not produced a final institute.

The Union government says it is prioritising States with weaker healthcare systems because their residents have greater gaps in medical facilities. Its representative told the High Court that Kerala’s healthcare status was much better when compared with other States and Union Territories. That relative position, the government said, explains why approval has been delayed.

The policy reflects a scarcity-based approach. When resources and new institutions are limited, the government may direct investment first to places with fewer hospitals or poorer healthcare capacity. In this case, Kerala’s existing system is being treated as stronger, rather than as evidence that the State should receive an AIIMS immediately.

The court challenged that reasoning. It asked whether Kerala’s hospitals were being treated as a disqualification or handicap. The Bench also noted that Kerala has the country’s highest population density and said existing hospitals may still be insufficient for needy and poor patients.

If Kerala does not receive an AIIMS, patients may continue relying on existing hospitals for care that the court believes they cannot fully provide. The Bench specifically said current hospitals would not be sufficient to provide medical facilities to needy and poor people. That concern is important because Kerala has the country’s highest population density.

An AIIMS could add another major public institution for specialised treatment and referrals. Without one, patients may face continued pressure on existing facilities, especially when demand is concentrated in a densely populated State. The article does not provide figures on waiting times, travel, costs, or treatment outcomes, so those effects cannot be measured from the available information.

The immediate consequence is continued uncertainty rather than a confirmed cancellation. The proposal remains under consultation, and approval depends partly on continuation of PMSSY for FY 2026-27 through FY 2030-31. The court is pressing for a clear decision.

The Pradhan Mantri Swasthya Suraksha Yojana, or PMSSY, is a Government of India health scheme. Its broad purpose is to improve access to advanced medical care and strengthen public medical education. It does this through projects such as establishing new AIIMS institutions and upgrading selected government medical colleges and hospitals.

The article connects Kerala’s proposal directly to PMSSY. The petition before the High Court seeks an AIIMS under this scheme. The court also noted that a decision could be taken only after the scheme’s continuation for the next five financial years is approved. Thus, the scheme’s future affects the timing of Kerala’s proposal.

The source does not list PMSSY’s full funding rules or every type of project it supports. It establishes that Kerala’s AIIMS request is being considered within the scheme and that inter-ministerial consultation is still underway. No in-principle approval has yet been granted.

Governments normally weigh several factors when deciding where to build public hospitals. Healthcare need shows where services are weakest. Population size and density show how many people may depend on a facility. Regional balance can prevent investment from clustering in only a few places. Existing capacity also matters, because governments may prioritise areas with serious shortages.

The Kerala dispute illustrates how these criteria can point in different directions. The Union government says Kerala’s healthcare conditions are better than those in other States and Union Territories, so weaker regions should come first. The High Court points to Kerala’s highest population density and says existing hospitals may not be enough for needy and poor people.

The article does not identify a formal scoring system or final allocation rule. It shows that the decision is still under inter-ministerial consultation. The court is asking the Union government to make a conscious decision, balancing Kerala’s current facilities against its population and continuing demand.