**Executive Summary**
This document is a response to Unstarred Question No. 2345 in the Lok Sabha regarding the reduction in the cost of healthcare services and enhancement of qualified doctor supply in rural districts like Dharmapuri, Tamil Nadu. The response, dated February 13, 2026, clarifies the roles of the State and Central Governments in healthcare provision. The response addresses the Central Government's support for States/UTs in improving healthcare accessibility and affordability.
**Key Points / Main Content**
* **State vs. Central Responsibilities:**
* Healthcare is primarily a state subject; therefore, improving healthcare facilities is the responsibility of State/UT Governments.
* The Central Ministry of Health and Family Welfare provides technical and financial support to States/UTs based on Program Implementation Plans (PIPs) under the National Health Mission Scheme (NHM).
* **Government Initiatives:**
* The government implements Indian Public Health Standards (IPHS) to improve health infrastructure, resources, and services in public health facilities nationwide.
* e-Sanjeevani telemedicine services have been operationalized for provider-to-provider (e-Sanjeevani AB-AAM) and patient-to-doctor (e-Sanjeevani OPD) consultations.
* "You Quote, We Pay" (YQWP) scheme is used to address the shortage of specialist doctors in government hospitals, allowing specialists to name their own salary.
* The government is ensuring training and capacity building of healthcare professionals for e-Sanjeevani.
* The Tamil Nadu State Government is implementing multiple interventions to reduce healthcare costs and improve access to qualified medical professionals in rural areas, including Dharmapuri. These interventions involve strengthening infrastructure, digital health initiatives and telemedicine under NHM.
* Other initiatives to reduce out-of-pocket expenditure include Free Diagnostic Services, population-based screening, organized cancer screening, home-based healthcare delivery, and the Chief Minister's Comprehensive Health Insurance Scheme (CMHIS).
* Preventive and promotive healthcare interventions are being strengthened.
* **Central Government Support:**
* The Central Government supports States/UTs through the National Health Mission (NHM) to strengthen public healthcare systems, aiming for accessible, affordable, and quality healthcare.
**Impact Analysis**
**State/UT Governments**
* **Impact:** Responsible for improving healthcare facilities within their respective jurisdictions.
* **Action Required:** Develop and implement Program Implementation Plans (PIPs) to request technical and financial support from the Central Government under the NHM.
**Healthcare Professionals**
* **Impact:** Potential for improved training in telemedicine, higher compensation through YQWP, and access to better resources.
* **Action Required:** Engage with e-Sanjeevani telemedicine platform and participate in training programs. Specialist doctors can apply under the YQWP scheme.
**Citizens / Patients**
* **Impact:** Greater access to affordable and quality healthcare, including telemedicine services and reduced need for long-distance travel for consultations. Potential reduction in out-of-pocket expenditure through various government initiatives.
* **Action Required:** Utilize available public healthcare services, including telemedicine, diagnostic services, and health insurance schemes.
Key Entities Referenced
Ministry of Health and Family Welfare: Central ministry responsible for health policy and providing support to states for healthcare initiatives.
National Health Mission (NHM): Scheme providing technical and financial support to states/UTs to strengthen public health systems.
e-Sanjeevani: Government's telemedicine service enabling provider-to-provider and patient-to-doctor consultations.
Indian Public Health Standards (IPHS): Standards implemented to improve health infrastructure, medicines, and services in public health facilities across all States.
Tamil Nadu: State where the specific district of Dharmapuri is located, and whose healthcare services are discussed.
GOVERNMENT OFINDIA
MINISTRYOFHEALTH AND FAMILYWELFARE
DEPARTMENT OFHEALTH AND FAMILYWELFARE
LOK SABHA
UNSTARREDQUESTION NO. 2345
TO BE ANSWERED ON13th FEBRUARY2026
REDUCTION IN COSTOFHEALTHCARE SERVICES
2345. SHRIMANI A:
Will the Ministerof HEALTH ANDFAMILYWELFAREbe pleased tostate:
(a) whether the Government proposes to reduce the cost of healthcare services and enhance the supply of
qualified doctors in rural and underserved districts such as Dharmapuri in Tamil Nadu through the use of
digital healthtechnology, telemedicineandreforms inmedical education;
(b) if so, the details of steps taken/proposed to be taken by the Government specifically to strengthen
healthcare infrastructure, tele-consultation facilities, incentivise medical professionals to serve in
Dharmapuri andexpandmedicaltrainingcapacityintheState,includingtechnology-enabledinterventions;
and
(c) If not, the reasons for not implementing such targeted measures for Dharmapuri and other similar
districts?
ANSWER
THE MINISTER OFSTATE IN THE MINISTRYOFHEALTH AND FAMILYWELFARE
(SHRIPRATAPRAO JADHAV)
(a) to (c): Health is a state subject, hence, the responsibility for improving the healthcare facilities lies
with the respective State/UT Governments. However, the Ministry of Health and family Welfare
provides technicalandfinancial support tothe States / UTstostrengthen the public healthcare system,
based on the proposals received in the form of Program Implementation Plans (PIPs) under National
Health Mission Scheme (NHM). The Government of India provides approval for the proposal in the
form of Record of Proceedings(RoPs) aspernorms andavailableresources.
The Government has implemented the Indian Public Health Standards (IPHS) to improve
health infrastructure, medicines, equipment, human resources and services in public health facilities,
and provide uniform, high-quality health services across all States. The Government has
operationalized e-Sanjeevani telemedicine services across the country, enabling health facilities to
providebothprovider-to-provider(e-SanjeevaniAB-AAM)andpatient-to-doctor(e-SanjeevaniOPD)
consultations, facilitating remote specialist advice,follow-up care, andtimelyinterventions, reducing
the need for patients to travel long distances. “You Quote, We Pay" (YQWP) scheme is an initiative
to address the severe shortage of specialist doctors in government hospitals. It allows specialists to
name their own salary, with the Government often accepting competitive bids for positions like
anesthetists, gynecologists, andpediatricians, resulting in compensationup tothree times higherthanregular salaries. Further, the Government ensures the training and capacity building of healthcare
professionals for the effective use of tele-medicinetechnology through the e-Sanjeevaniplatform.
As per the information provided by the State Government of Tamil Nadu, the State
Government is implementing multiple interventions to reduce the cost of healthcare services and
improve access to qualified medical professionals in rural and underserved districts, including
Dharmapuri, through strengthening public health infrastructure, digital health initiatives and
telemedicine under the National Health Mission (NHM) and allied schemes namely Health Sector
Grants of the 15th Finance Commission, Pradhan Mantri Ayushman Bharat Health Infrastructure
Mission (PM-ABHIM), etc.
Further, to reduce out-of-pocket expenditure, initiatives such as Free Diagnostic Services,
population-based screening, organised cancer screening, home-based delivery of healthcare services,
and financial protection through the Chief Minister’s Comprehensive Health Insurance Scheme
(CMHIS) are being expanded. In addition, preventive and promotive healthcare interventions are
being strengthened toreduce catastrophic healthexpenditure.
The Central Government hastaken several initiatives for supplementing the efforts of the State
for providing quality and affordable healthcare services to the people. Under National Health
Mission (NHM), Ministry of Health and Family Welfare provides technical and financial support to
the States/UTs to strengthen the public healthcare system towards the objective of providing
accessible, affordable andqualityhealthcareto all those who accesspublic healthfacilities.
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