Ten-storeyed twin towers for treating patients near Osmania General Hospital (2016), four super-speciality hospitals in four corners of Hyderabad (2017) and five new medical colleges (2018); these were some of the promises over the years for improving healthcare in Telangana.

But, all these promises have tumbled at budgetary hurdles. As doctors at Gandhi Hospital demand medical facilities for treating COVID patients, the lacunae in medicare in the State becomes more apparent.

The Gandhi Hospital in Hyderabad is about 300 km from Adilabad, 313 km from Bhadrachalam, 292 km from Kaleshwaram and 200 km from Narayanpet. The plight of a COVID-19 patient who has to be ferried to this medical facility from these far off places can be easily imagined.

“Symptomatic patients and those who have co-morbidities are deteriorating rapidly within a span of 12 or 24 hours. Transporting such patients to these distances would be of limited use,” says Dr. Mahesh Kumar, who has been campaigning for better medicare in the State. The situation would have been different had the State executed a plan to build five medical colleges in Mahabubnagar, Siddipet, Nizamabad, Suryapet and Nalgonda. Budgetary support was earmarked for these in 2018-19.

In 2020-21, the Telangana government earmarked ₹5,666 crore for health, which is 3.5% of the overall budget. This was lower than an average of 5.3% by 29 other states. This is also lower than Telangana’s own budget of 2016-17, where ₹5,960 crore was earmarked for health. The budget that year included a plan for creating four super-speciality hospitals in Hyderabad, ₹600 crore for acquiring new medical equipment and ₹316 crore for augmenting medical facilities. The plan was toned down to three super-speciality hospitals around Hyderabad in the 2017-18 budget, which had an outlay of ₹5,920.27 crore.

The budgetary support for medical health has consistently declined over the past few years in Telangana. In 2016-17, it was 4.3%, in 2017-18, it was 4.6%, in 2018-19 it was 4.7%, it dropped to 4% in 2019-20 and is now estimated at 3.5% of the overall budgetary support.

This decline has had its impact on the State’s health goals.

According to the Socio Economic Survey-2019, the Maternal Mortality Rate was 92 (SRS 2011-13). This was projected to decline at 11 pts per year and reach 38 by 2016. But the newest Sample Registration System of 2015-17 shows the MMR for Telangana at 76, almost twice the projection. “Primary and secondary healthcare are important but every case is now reaching tertiary health centre. This is problematic and leads to overcrowding,” says Dr. Kumar, citing data from the National Health Mission.

Telangana had 668 public health centres, 114 community health centres and 4,863 sub-centres in 2015. These numbers changed marginally to 882 PHCs, 90 CHCs and 4,797 sub-centres in 2019, according to the State annual report on health.

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