Kerala’s AIIMS tests Centre's Budget credibility, federal trust

Malayalam actor-turned-politician Suresh Gopi has rarely been associated with restraint. When the Union Minister and Thrissur MP recently revived the AIIMS hospital debate in Kerala, observers found it theatrical and confrontational.

Insisting that Kerala must get an All India Institute of Medical Sciences (AIIMS), he first projected Alappuzha as the preferred location and quickly added Thrissur as an alternative.

He returned to the issue in the run-up to the Union Budget, this time sharpening his language and directly attacking opponents, using an abusive phrase that drew criticism and underscored how the AIIMS debate had slipped from policy discussion into political spectacle. The spectacle ensured attention, and AIIMS once again dominated public discussion in the state.

Budget silence is real trigger

But the renewed controversy was not really triggered by what Gopi said on stage. It was driven by what the Union Budget did not say. Once again, there was no announcement, no allocation, and no timeline for an AIIMS in Kerala.

In a budget keenly watched in the state, the omission became the real story. This silence assumed greater significance because expectations had already been raised formally, especially with Assembly elections round the corner.

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In 2024, Union Health Minister JP Nadda wrote to Kerala Health Minister Veena George on the proposal for an AIIMS in the state. He said the proposal had been examined and the Union Health Ministry had sought the Finance Ministry's approval to set up the institute under the Pradhan Mantri Swasthya Suraksha Yojana (PMSSY).

For the Kerala government, the letter signalled that the proposal had moved beyond the preliminary stage to reach the budgetary approval phase.

State vs Centre

It was after this communication that successive Union budgets were presented. Initially, the omission of AIIMS-Kerala was seen as a delay. When the latest budget again failed to touch upon AIIMS, the absence became politically charged.

As criticism mounted, the BJP quickly shifted the responsibility to the Pinarayi Vijayan government in the state. The party argued that Kerala had failed to meet mandatory norms and was blaming the Centre to conceal its own administrative shortcomings.

According to the BJP, states are expected to suggest three or four potential locations for an AIIMS, while Kerala proposed only one site, at Kinalur. The party also claimed that around 200 acres of land are required for the facility, but Kerala provided just 151.58 acres. It further alleged that the proposed site lacks four-lane highway connectivity and faces local opposition.

BJP leaders have repeatedly cited this explanation to justify the absence of an AIIMS announcement in the subsequent Union Budgets.

Kerala govt disputes argument

The state government, however, has strongly disputed this claim, pointing out that communication between the Union Health Ministry and the state Health Department clearly indicated that only one location was sought, not multiple sites.

Kerala also argues that land requirements and site conditions have not been applied uniformly across the country. In several states where AIIMS institutions were sanctioned, the full 200-acre benchmark was not met at the time of approval. Despite this, projects were cleared and later adjusted through phased expansion or revised planning.

From Kerala's perspective, the focus on acreage and site count appears selective. George pointed out that Kerala revised its proposals in response to evolving guidelines from the Centre, not due to indecision.

State passes resolution

George argued that procedural compliance was acknowledged at the Central level, which is precisely why the matter was forwarded to the Ministry of Finance.

“Two more Union budgets have passed since then. No AIIMS yet,” she told The Federal, referring to the timeline initiated by the Union Health Ministry. “We had multiple communications with JP Nadda, and in October 2024, he sent a letter stating that the proposal had been cleared and forwarded to the Finance Ministry. It was clear from that communication that only one location was required, and we had provided that.”

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The remark was not framed as a fresh appeal but as a question about accountability. If the proposal had been examined and moved to the finance stage, the minister asked, why did it still not reflect in the budget?

A resolution was moved under Rule 118 in the Legislative Assembly on Tuesday (February 3), expressing concern and strong protest over what it described as the Centre’s continued neglect of Kerala on various issues.

Presenting the resolution, Pinarayi said Kerala’s demand for an AIIMS had remained pending for nearly two decades. He noted that the state government had identified land and completed most of the formalities related to acquisition, but the Union government had taken no action. The resolution, he said, strongly urges the Centre to sanction an AIIMS for the state

Healthcare pressure

Beyond the political exchange lies a deeper healthcare concern. Kerala’s public health system, while strong at the primary level, faces immense pressure at the tertiary level.

Government medical colleges and speciality hospitals handle patient volumes far beyond capacity. Complex treatments often involve long waiting periods or referrals outside the public sector, imposing financial and emotional strain on families. An AIIMS is widely seen as critical to strengthening advanced care, medical education, and research within Kerala.

The repeated absence of AIIMS in subsequent Union Budgets has therefore carried real consequences. It has prolonged uncertainty for patients and healthcare professionals and weakened confidence in assurances from the Centre. While political leaders continue to speak of development and healthcare expansion, the lack of a concrete budgetary commitment has become increasingly difficult to reconcile with those claims.

Political symbolism

Suresh Gopi’s dramatic intervention, rather than offering clarity, highlighted internal contradictions within the BJP. Even as he projected urgency from public platforms, state party leaders distanced themselves, describing his remarks as personal views and reiterating that the Union government would take a decision based on established norms. This dissonance reinforced the sense that AIIMS had become more of a political symbol than an administrative priority.

Also Read: Star but a loose cannon: Why Suresh Gopi is a double-edged sword for Kerala BJP

Public response has reflected growing fatigue. There is limited patience for renewed declarations unaccompanied by funding. For many in Kerala, the 2024 letter from Nadda marked a moment when optimism seemed justified. The budgets that followed, silent on AIIMS, transformed that optimism into scepticism.

A test of budget credibility

AIIMS in Kerala has thus evolved into more than a demand for a hospital. It has become a measure of budget credibility and federal trust. Each budget that passes without an announcement sharpens the controversy and deepens the question of intent.

Until AIIMS finds a place not in speeches or explanations but in the Union Budget itself, the debate will remain unresolved. For Kerala, the issue has moved beyond anticipation. It is now a test of whether acknowledged proposals are matched by political will.