Why KCR government is crossing swords with Centre over medical colleges now

A recent tweet by Telangana Governor Dr Tamilisai Soundararajan, praising a central scheme that targets the tertiary health care system in the country, has become the new political flashpoint in the Centre-state tussle. Taking cue from the tweet, while the Telangana government accused the Narendra Modi government of refusing government medical colleges to the state, representatives of the central government including Union ministers rebutted that the K Chandrashekar Rao government never bothered to apply for any.

From innocuous tweet to raging debate

On March 5, Governor Tamilisai, reacting to a tweet by a doctor, lauded Prime Minister Narendra Narendra Modi’s vision behind the newly-constructed super speciality block of government medical college at Kerala’s Kozhikode. The construction was taken up under Prime Minister Swasthya Suraksha Yojana (PMSSY).

“Amazing infrastructure to match international standards from honb @PMOIndia GOI funded visionary schemes PMSSY one medical colleges in every district across nation. Such facilities will add on to promote medical tourism potential in future (sic),” she tweeted.

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Commenting on her tweet, when a Twitter user asked how many medical colleges were allotted to Telangana by the Centre, the governor retorted that the KCR government was sleeping when other states were applying for new medical colleges under PMSSY.

“When every state applied for new med colleges under PMSSY scheme Telangana failed to apply in time as stated by Union Health minister @MansukhMandavia you sleep and wake up late and ask. TN got 11 medical colleges in single year (sic),” she said.

The tweet triggered an emotional outburst on Twitter with netizens slamming the Centre for allegedly meting out a step-motherly treatment to the state.

‘Telangana discriminated under CSS’

Telangana health minister T Harish Rao reacted sharply to the governor’s charge. Referring to the Centrally Sponsored Scheme (CSS), under which the Centre sanctioned 157 medical colleges in three phases in a fund sharing basis between the central government and states, Rao said not one was allotted to Telangana despite repeated requests to the Centre.

“FACT is Gross injustice meted out to Telangana in sanctioning of Medical Colleges, despite repeated pleas from state govt to Centre. Of 157 medical colleges approved by centre, TS got ‘0’. Union Govt discriminated & deceived TS in all three phases of allotment of Colleges (sic)” Rao retorted on Twitter.

Fact or fiction?

The state government, however, provides no clarity on the time it applied for establishment of new medical colleges under CSS. Although CSS was launched in 2014 itself, little correspondence took place on the scheme between the Centre and state on setting up new medical colleges, say sources.

On August 8, 2019 then Telangana Health Minister Eatala Rajender (now in the BJP) wrote to then Union Health Minister Harsh Vardhan, requesting for the sanction of new medical colleges at Khammam, Karimnagar, Sangareddy, Macherial, Bhadrachalam, Bhupalpally, Tandur or Vikarabad under the central scheme.

On August 30, 2019, responding to Rejender’s letter, Harsha Vardhan said that Telangana could not be covered under Phase-1 and Phase-2 of the scheme. He, however, said that the scheme is being extended, and states will be allotted colleges based on the merit of their Detailed Project Reports.

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“…extension of the scheme has been approved by the Union Cabinet. The State/UT Governments are being requested to send their proposals under the scheme along with a Detailed Project Report as per our guidelines for consideration by the ministry. However, approval will be granted on merit basis,” the letter read.

No proposal, however, was received by the Centre till December 2019, said Union Tourism Minister G Kishan Reddy, who earlier claimed that the state had sanctioned nine colleges.

Also, neither the Telangana health minister nor any functionary of the state government have so far made public any letters written by the state government, requesting the establishment of medical colleges under the scheme.

No clarity on application from Centre or state

Worsening the confusion, at least three Union ministers have given different versions about Telangana’s purported request to the Centre for medical colleges.

Talking to the media on the issue, Union Finance Minister Nirmala Sitharaman said the Centre so far has received only two proposals to set up medical colleges in Khammam and Karimnagar which were rejected on the basis of guidelines.

“The scheme envisages to set up colleges at deserving places where none are existing. Khammam and Karimnagar did not fit the bill as medical colleges already exist. This is the reason why Telangana did not figure in the 157 colleges proposed under the scheme,” she said, adding that the Centre cannot be blamed for the state’s lapse.  “You have not done proper homework before sending proposals and now want to blame the Centre,” she said.

Responding to Sitharaman’s statement, IT Minister KT Ramarao, sought to know why her version doesn’t match those presented by Union Health Minister Mansukh Mandaviya and Union Tourism Minister G Kishan Reddy.

“Union Minister Kishan Reddy is saying that nine medical colleges have been approved for Telangana, another minister Mansukh Mandaviya is saying that not a single proposal has been received from Telangana for medical colleges, while Finance Minister Nirmala Sitharaman is saying that only two proposals have been received (sic),” Ramarao. He too didn’t give the exact number of requested medical colleges that the Centre allegedly refused to entertain.

About Centrally Sponsored Scheme

The CSS, meant to set up new medical colleges unlike PMSSY, was launched in January 2014 with the aim of meeting the shortfall of human resource in the health sector.

“The government is implementing a centrally-sponsored scheme for the establishment of new medical colleges by upgrading district/referral hospitals preferably in underserved districts of the country with fund sharing between the central government and states in the ratio of 90:10 for NE/special category states and 75:25 for other states,” says the description on the scheme on the Health Ministry’s website.

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As many as 58 colleges have been approved in 2014 itself in phase-1, while 28 medical colleges got approval in 1918 under phase-2.

In a written reply to Congress MP Rahul Gandhi on February 4 2020, then Health Minister Vardhan said as many as 89 Detailed Project Reports (DPR) had been received including 26 in aspirational districts and the Union cabinet approved 57 of them.

While Telangana did not figure in the list given by Vardhan in 2020, Andhra Pradesh got approval for seven colleges proposed in West Godavari, Prakasam, Krishna, Guntur, YSR Kadapa, Visakhapatnam and Vizianagaram districts while Tamil Nadu got 13. The Bharat Rashtra Samithi (BRS) government and its supporters on social media cried foul and called this discrimination against Telangana.

Politics behind medical colleges

BJP official spokesperson B Rachana Reddy said BRS leaders were beating around the bush instead of proving their sincerity in getting new medical colleges sanctioned under CSS. Alleging that BRS ministers were politicising the absence of Telangana from the list of 157 medical colleges, Reddy asked them to reveal what had prevented the KCR government from sending DPRs when Andhra Pradesh was able to secure seven colleges and Tamil Nadu 13.

“Let the government release the list of proposals sent to the Centre for new medical colleges under the CSS and set the record straight so that people know who is harming the state’s interests,” she said.  Not applying for medical colleges under the scheme was a ploy to blame the Modi government during election year to get political mileage, Reddy alleged.

Difficult to justify state’s stand, say insiders

For insiders, this is an intriguing issue. Confirming that the Telangana government had not evinced much interest in the CSS, sources in the department of medical education said it was difficult to justify the state’s stand when non-BJP states such as Tamil Nadu, Andhra Pradesh, Kerala and Punjab managed to get medical colleges under the scheme.

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“The Centre follows certain guidelines. Land has to be shown to set up colleges. Facilities as per the National Medical Council norms have to be created. Staff have to be recruited. And a 25 per cent matching grant has to be released. It is difficult to meet these requirements given the state of affairs now in the state. And above all, the timeline to complete the project is 2023 and 2024 which are election years. All these points might have forced the state government to avoid the scheme,” a source said on conditions of anonymity.