In a wide-ranging interview, Satya Kumar Yadav reflects on the gaps, pressures and gradual progress in AP’s healthcare sector. The discussion offers a closer look at the policy choices, administrative actions and ground realities that continue to shape healthcare governance in the State.
What kind of legacy did the NDA government inherit in the health sector from the previous government, which had claimed to prioritise it and introduce several reforms?
The previous government projected major healthcare reforms, but little was visible on the ground. Announcements were made, including on medical colleges, but execution was weak. When we took charge, we inherited misgovernance — poor attendance monitoring, disrupted outpatient services, weak inpatient care and dysfunctional equipment in many hospitals. Doctors were often absent without accountability, and several were placed in mismatched roles. Transfers were arbitrary, and despite guidelines, influential doctors returned to their original postings, with nearly 80% of transfers reversed. I treated this as a challenge to restore discipline, enforce proper transfers and rebuild credibility in the system.
How do you assess the previous government’s ‘Family Doctor’ reform in primary healthcare?
The ‘Family Doctor’ concept was not new; earlier there was Sanchaara Chikitsa (mobile treatment). Renaming it cannot be called reform. In five years, the previous government did not establish a single new Primary Health Centre, nor did it recruit enough doctors. In 2021, GOs were issued for 88 PHCs but funds were not released.
After we took office, we sanctioned Rs 194 crore, added 12 PHCs and ensured funding for 100 PHCs
Under the National Health Mission plan, every 3,000 people should have a Village Ayushman Arogya Mandir. The State was allotted 10,032 clinics, but only about 1,500 had buildings when we took charge. Though funds were available under the Finance Commission and PM-ABHIM, the State share was not provided, leading to a loss of about Rs 122 crore in 2021 and another Rs 255 crore later.
In five years, only 3,105 clinics were built, mostly using diverted funds from MGNREGA and partial Finance Commission grants.
Staffing was also poorly planned. Many Community Health Officers had no village accommodation. This was the situation we inherited, and we are now working to fund, staff and make these clinics fully functional.
What steps were taken to strengthen healthcare infrastructure after NDA came to power in AP?
Once we assumed office, our efforts ensured that the Centre sanctioned Rs 1,200 crore under the 15th Finance Commission and another Rs 560 crore under PM-ABHIM. Andhra Pradesh can proudly claim to be the first State to achieve such performance-based incentives under NHM.
In fact, within just 20 months we secured 42% of the allocated funds, compared to the previous government’s 48% over four years. This efficiency earned us an additional Rs 100 crore as a performance incentive. With these resources, we are constructing 4,500 new buildings, each costing Rs 55 lakh under PM-ABHIM.
Called a ‘villain’ for pushing tough health reforms
Did you face pressure from ministers or leaders over doctors’ transfers?
Absolutely. I am even being called a ‘Pathala Bhairavudu’ (villain) for taking a tough stand on healthcare reforms, but the system needed correction after the previous government. Many sought transfers through ministers or leaders, but every such move affects patient care. I have no personal interest — my concern is patients. So we made transfers transparent and mandatory. Exceptions are allowed only on serious health, mutual or spousal grounds. Our aim is to keep the focus on service.
In Agency areas like Alluri Sitarama Raju district, poor infrastructure forces pregnant women to be carried to hospitals. Your response?
It is an unfortunate reality. Tribal areas have long suffered neglect, and when such incidents happen, the Health Department alone cannot solve them if connectivity is poor. So we are focusing on roads under PM Gram Sadak Yojana, which had stalled earlier due to lack of matching funds. We also strengthened the feeder ambulance system for remote villages where large vehicles cannot reach. Earlier only 119 were functional; now 122 are running.
In addition, we sanctioned five 100-bed multi-specialty hospitals in tribal areas, each costing about Rs 50 crore. Earlier spending was limited, but after we took charge additional funds were allocated and we are now working to complete them under the Special Assistance for Capital Investment Programme.
How do you plan to sustain these hospitals in remote regions?
We are encouraging PPP models alongside government investment. Under NTR Vaidya Seva, private players are reimbursed for free services. To make it viable, we are offering up to 40% viability gap funding and land support. The policy is simple: private hospitals provide 70% of services free and charge for the remaining 30%. We are also planning an investors’ meet in the health sector. In the first phase, we identified 61 constituencies without 50-bed hospitals. Multi-specialty hospitals of 100–200 beds will be established there.
MoU signed with Fssai for food testing laboratories
After the recent milk adulteration case in Rajahmundry, why does the State still lack a food testing lab even a decade after bifurcation?
Food adulteration and water contamination are serious concerns that directly affect public health. For years, the State lacked adequate laboratories, and the Institute of Preventive Medicine was neglected after bifurcation.
Out of 729 sanctioned posts, only 144 were filled, and at headquarters alone, 279 posts were sanctioned but only seven were in position. We signed an MoU with the Food Safety and Standards Authority of India, which sanctioned Rs 85 crore in the first year. With their support, new labs were established in Visakhapatnam, Guntur and Tirupati. Construction is complete in Visakhapatnam and it will be operational next month, while Guntur and Tirupati are under construction. During this process, the Tirupati laddu adulteration case emerged and we requested special support. FSSAI sanctioned a dedicated lab for Tirumala
How many labs will be operational and what about staffing?
In total, five State food laboratories are being set up — Visakhapatnam, Guntur, Tirupati, Kurnool and the special lab at Tirumala. We also secured permission to recruit 150 staff members for the Institute of Preventive Medicine. Additionally, the Centre sanctioned mobile food safety vans, each staffed with a food analyst and driver, to conduct on-the-spot testing across districts. Salaries and training will initially be funded by the Centre, reducing the burden on the State.
How is the government addressing food safety?
We are conducting raids across hotels, sweet shops and food outlets in Guntur, Vijayawada and other districts, issuing notices and spreading awareness. There are two levels of surveillance: normal surveillance, which involves routine checks with 40 samples per inspector, and statutory surveillance, which provides legally admissible evidence for prosecution.
Can we have a toll-free number for food adulteration at the State level?
Yes, we do have a toll-free number, 1800-425-35387, specifically for food adulteration complaints. This number should be widely publicised through awareness campaigns so that citizens know they can report violations.
Network hospitals are waiting for more than Rs 2,500 crore in arrears. What is your take on this?
We inherited Rs 2,500 crore in arrears under Aarogyasri. Hospitals had provided treatment but payments were pending for years, creating mistrust between the government and healthcare providers. We are clearing dues systematically, releasing about Rs 350 crore per month. At the same time, we are working on a one-time settlement model with hospitals and banks to clear legacy dues permanently.
What about Aarogyasri coverage caps and accountability?
We recognised that the existing coverage caps were insufficient for families facing catastrophic health expenses. That is why we increased Employee Health Scheme coverage to Rs 25 lakh. We are implementing a hybrid model that combines government support with private participation, ensuring sustainability. Accountability has also been strengthened.
How are you tackling complaints of corruption in hospitals?
We introduced a system of mandatory signage boards in every hospital, clearly stating that if anyone demands a bribe, patients can call the 104 IVRS helpline.
Opposition alleges government hospitals lack basic medicines and PHCs are out of anti-venom. How do you respond?
Medicine shortages were a serious issue when we took charge, with suppliers refusing to supply due to pending dues. We cleared Rs 600 crore in arrears to suppliers, restoring confidence in the system. Emergency medicines are now being supplied to 712 hospitals across the State. Procurement has been decentralised to avoid bottlenecks, and strict monitoring has been introduced to prevent shortages. Allegations of shortages, such as in the oxytocin case, are being addressed with transparency and accountability. Patients should not suffer due to administrative lapses, and we are ensuring that essential medicines are always available.
With delays, old 108/104 vehicles and funding issues affecting services, what reforms have been introduced?
Ambulance services are a lifeline, especially in emergencies, and we recognised that they needed urgent reform. When we took charge, only about 600 ambulances were functional. We increased this number to 731 by refurbishing old vehicles and adding new ones. OEM maintenance contracts were introduced to ensure that vehicles are serviced regularly and remain in good condition. Cameras have been installed in ambulances to monitor patient care during transit, and a live tracking portal has been launched so that response times can be monitored in real time.
What is the current response time and how do you plan to reduce it?
The golden hour is crucial in saving lives, especially in cases of trauma and cardiac emergencies. We have introduced strict monitoring systems to ensure that patients are admitted within this critical window. Today, 96% of admissions are happening within the golden hour, which is a remarkable achievement compared to the past. The STEMI programme has been a game changer in this regard. By providing free injections to patients suffering from heart attacks, we have saved thousands of lives. Andhra Pradesh has become a national leader in this initiative.
The High Court recently commented on bone marrow and organ transplants. Your response?
The High Court’s observations highlighted gaps in Aarogyasri coverage, particularly for advanced procedures like bone marrow transplants. We have taken these comments seriously and expanded coverage to include such treatments. In the past year alone, we supported 3,257 procedures and spent Rs 624 crore on cancer care. Organ donation has also been encouraged, with 99 donations facilitated and 301 transplants completed. A milestone achievement was the first liver transplant conducted at King George Hospital in Visakhapatnam.
Trauma care is often lacking in emergencies. What steps are being taken to improve this?
We have sanctioned 44 Critical Care Blocks and trauma centres, which will be operational by the end of the year. Under PM-ABHIM, Rs 600 crore was sanctioned for this purpose. Fourteen centres are nearing completion, and another ten have been sanctioned. The Centre also announced trauma centres every 50–100 km along highways, and Andhra Pradesh has proposed 49 such centres.
Claims of Medical colleges’ privatisation lack credibility
How do you respond to claims that PPP medical colleges amount to privatisation?
Their claims lack credibility. Announcing huge buildings without land acquisition, tenders or funds does not amount to building a medical college. In places like Parvathipuram, not even land was identified, yet they tried to pass off unfinished structures as colleges. When challenged in the Council, they walked out instead of debating with facts. Yet only Rs 1,500 crore was spent, and just five colleges saw partial progress, with construction at 12–15%.
Critics say PPP is privatisation. How do you address that concern?
The truth is, the previous government had already blurred the line by introducing management and NRI quotas in government colleges, charging Rs 12 lakh for management seats and Rs 20–22 lakh for NRI seats. We inherited this framework. Our PPP model, however, has safeguards: the government retains land ownership, private partners bear construction and operational costs, and 50% of seats remain under government quota.
How does PPP align with NMC norms and benefit students and patients?
NMC guidelines now require 420 beds for 100 MBBS seats and 605 beds for 150 seats. Many earlier colleges sanctioned with 200–300 beds no longer meet norms. PPP ensures compliance, adds infrastructure and increases student intake. For every 100 seats, about eight extra seats are added; across ten colleges that equals 110 additional seats—like establishing a new college.
Beyond new colleges, how are you strengthening existing facilities, especially for rising burdens like cancer?
We are not just building new institutions — we are completing stalled projects and upgrading hospitals. The State Cancer Centre sanctioned in 2017 with Rs 120 crore had stalled for five years; we completed it. We launched a Radiological Oncology Unit in Visakhapatnam, a Comprehensive Cancer Centre in Kakinada, and upgraded Guntur with a LINAC machine, making it a Level-1 cancer centre. New cancer centres in Anantapur and Kakinada are targeted this year.
With most of the health budget going to salaries, has capex improved?
That has been our consistent demand in cabinet meetings, and we have already made significant progress. In 2024–25, the total health allocation was Rs 19,000 crore, but only Rs 2,070 crore went to capital expenditure. This year, we raised capex to Rs 3,060 crore, an increase of Rs 1,000 crore. Revenue expenditure remains around Rs 16,300 crore, covering medicines, surgical supplies, ambulance services and sanitation.
What steps are being taken to strengthen secondary and primary healthcare infrastructure?
For secondary healthcare, we prioritised Rs 450 crore to strengthen community health centres, area hospitals and district hospitals. For primary healthcare, Finance Commission grants are being matched with State funds to improve PHCs and sub-centres. This ensures that both tiers of healthcare delivery are upgraded simultaneously, addressing gaps in rural and urban areas.
AYUSH seems to be receiving special attention. Can you elaborate?
Yes. Under the National AYUSH Mission, earlier governments neglected proposals —only Rs 38 crore was spent in the first two years after 2019. We revived it by submitting proposals worth Rs 100 crore in our first year, securing Rs 83 crore, and Rs 250 crore in the second year, securing Rs 166 crore. We sanctioned four new AYUSH medical colleges — Ayurveda in Dharmavaram and Kakinada, Unani in Podduturu (Kadapa), and Naturopathy in Visakhapatnam — each costing about Rs 70 crore. Five integrated AYUSH hospitals and 1,500 dispensaries are also being upgraded. This year, Rs 325 crore has been allocated for AYUSH, including Rs 125 crore for capital expenditure.
Is the upcoming Investment Summit focused on medical colleges under PPP?
No, the summit is not about medical colleges. Those projects are already moving forward with approvals and central government support. The summit is focused on multi-specialty and super-specialty hospitals in rural and tribal areas, where we are encouraging private investment with viability gap funding from the Centre. The idea is to attract investors, strengthen infrastructure and eventually position Andhra Pradesh as a medical tourism hub. We are experimenting with new collaborations—for example, with the Gates Foundation and Tata Medical & Diagnostics—to develop citizen-centric healthcare models like the Sanjeevan Model.
How is technology being integrated into this vision?
Technology is central to our vision. We are piloting speech-to-text outpatient services in Guntur, where doctors’ consultations are digitised in real time. Accuracy is already above 90%. These digital records flow seamlessly into Ayushman Bharat IDs, ensuring continuity of care.
So the summit is about both infrastructure and technology?
Exactly. On one side, we are building multi-specialty and super-specialty hospitals with private participation. On the other, we are integrating digital health technologies to modernise patient care. Together, these initiatives will strengthen healthcare delivery, attract investment and make Andhra Pradesh a leader in medical innovation and medical tourism.
Full freedom for ministers, no interference
With Chandrababu Naidu on one side, Pawan Kalyan on the other and Lokesh trying to outdo them, has there been any interference in your department or freedom of functioning, given the coalition nature of the government?
There is one more global leader in the NDA — Narendra Modi. Let me be absolutely clear: there has been no interference whatsoever. In our government, ministers have complete freedom to manage their departments. Transfers, appointments and administrative decisions are taken independently. If Lokesh garu or anyone else has a request, it is routed through proper channels, but there is no compulsion or external pressure. In cabinet meetings and review sessions, we are free to raise issues openly.
The Chief Minister conducts monthly reviews, guiding us with his experience and offering solutions to problems. His approach is consultative — he discusses even small matters with ministers and colleagues, encouraging collective decision-making. So yes, ministers enjoy complete freedom in their respective portfolios while benefiting from the Chief Minister’s continuous guidance.
Is there dissatisfaction over the 60-30-10 nominated posts formula?
In any coalition, distractions and dissatisfaction are natural. We are different parties brought together in the larger interest of the State. Each party has its own ideological background and cadre expectations. But let me clarify — there was never any formal agreement on percentages of posts or positions. What exists is a practical understanding: depending on the strength of each party in a constituency and the availability of suitable workers, appointments are made.
What is one biggest change that will leave Satyakumar’s mark?
This is a coalition government, and as the lone minister from BJP I cannot claim credit for achievements individually. All credit goes to the collective leadership, especially the Chief Minister, who guides us at every step. But if I must highlight my focus, it is on three things: containing corruption in hospitals and the health system, strict accountability for doctors and staff — ensuring attendance, discipline and ethical conduct — and leveraging technology to improve healthcare quality. One major initiative is the Sanjeevani programme, which is citizen-centric healthcare.
A candid conversation with TNIE’s BSN Malleswara Rao, S Guru Srikanth, S Viswanath, Phanindra Papasani and Y Brahmaji at the inaugural of AP Dialogues.