KOLLAM: For five years, 56-year-old Krishna S (name changed) from Wayanad has been battling a kidney ailment. Her treatment began at the Kozhikode medical college hospital in 2020 and continued smoothly for three years. But when the nephrologist treating her was transferred to Kottayam, her treatment was disrupted.
“With no nephrologist available in Wayanad, I had no choice but to follow my doctor to his private clinic in Kozhikode. He visits once a week and I travel over two hours for every session, which costs around Rs 25,000 to Rs 30,000,” Krishna said.
Similar is the case with Kollam resident George Kunjumon, 75, who developed a lump at the back of his neck. His surgery was postponed multiple times at the district hospital due to staff shortage, he said.
“The doctors advised surgery to remove the lump, but it was postponed several times because of a shortage of staff. I later went to a private hospital but couldn’t afford the cost. Now I have decided to live with the condition as long as my health allows,” George said.
The experiences of Krishna and George highlight a troubling trend — while Kerala’s government hospitals are witnessing record outpatient (OP) numbers, their wards are growing emptier. Both had initially chosen government hospitals for treatment but later abandoned them because of delays and a lack of specialists.
In 2023-24, outpatient visits under the department of health services (DHS) touched a record 11.2 crore, even as inpatient (IP) admissions continued to fall. Only 7.56 lakh patients were admitted to DHS facilities last year, compared to 8.92 lakh in 2022-23 and 15 lakh in 2019-20. Surgical procedures show a similar slide.
The state’s public hospitals performed 1.29 lakh major surgeries in 2017-18, but the number dropped to 55,000 during the Covid pandemic (2020-21). The figures have since recovered only partially — 89,775 surgeries in 2023-24, down from 1.05 lakh in 2022-23.
Health experts pointed out that the data exposed a deeper fault line in the state’s healthcare system — underutilised infrastructure and eroding public trust.
“Government hospitals are now preferred mainly for consultations, which explains the rise in OP numbers. But when it comes to serious issues or surgeries, people avoid them due to long delays. In many hospitals, the equipment exists but not the doctors. For instance, orthopaedic surgeries often get postponed because either the surgeon or anaesthetist is unavailable,” said a senior health department official. Dr B Ekbal, former senior neurosurgeon, said the figures reflect an acute shortage of human resources in government hospitals.
“Over the years, technology and equipment in our public hospitals have improved significantly. But human resources such as doctors, nurses, and paramedical staff have not kept pace. Because of this shortage, staff are forced to work overtime. In many hospitals, posts are filled through transfers, creating further gaps. Many specialists begin duty as early as 6.30am and continue till 7 m. It is only their commitment that keeps our health system running. The government must urgently recruit more personnel,” Dr Ekbal said.
He also stressed on the need for better infrastructure. “Public hospitals still lag behind in basic facilities such as rooms for bystanders and toilets. Risks like the tragedy at Kottayam MCH, where a woman died after a dilapidated toilet building collapsed, lurk elsewhere too. The government must prioritise safe spaces,” he said.
