What did Tamil Nadu’s budget have for the health sector?

Compared to 2024-2025, Tamil Nadu allotted a little more for the health sector in its budget for 2025-2026, maintaining its focus on non-communicable diseases (NCD), particularly cancer. The allocation for health rose by 8.4% — from ₹20,197.40 crore to ₹21,906 crore. While a few announcements are welcome, experts say the budget falls short of addressing some of the crucial issues in the State’s health sector.

Similar to last year, cancer prevention and management remains one of the priority areas for the State government. One of the main announcements is the provision of HPV vaccination to all girls aged 14 years to prevent cervical cancer. An amount of ₹36 crore was allocated for 2025-2026. Another announcement was to take screening for major cancers and heart diseases to women closer to their homes, through mobile medical teams in collaboration with NGOs for which ₹40 crore was allotted. To introduce early cancer detection using advanced diagnostic methods, the government plans to enhance medical equipment and manpower in secondary care facilities and medical college hospitals at a cost of ₹110 crore over the next three years.

The Government Arignar Anna Memorial Cancer Hospital and Research Institute, Karapettai, Kancheepuram district, which was designated as a State-level nodal cancer centre, is set to be upgraded and function as an autonomous facility with 800 beds, offering cancer diagnosis, treatment, palliative care and other services. A sum of ₹120 crore will be provided for the next two years.

Among other announcements, ₹1,092 crore was allocated to the Dr. Muthulakshmi Reddy Maternity Benefit Scheme, ₹1,461 crore for the Chief Minister’s Comprehensive Health Insurance Scheme (CMCHIS) and ₹348 crore for ambulance services. The National Health Mission has been allocated ₹2,754 crore.

Cervical cancer vaccine decision welcomed

A number of doctors and health activists welcomed the decision of the State government to provide HPV vaccination for girls. Malliga J.S., head of preventive oncology at Cancer Institute (WIA), Adyar, said for a State government to focus on the prevention of cervical cancer and roll out the HPV vaccination was landmark. “This is the right step forward. We hope that all eligible girls are covered with vaccination and this becomes a sustainable programme covering new cohorts,” she said. Noting that screening is equally important for the prevention of cervical cancer, she said she also hoped that HPV DNA testing would be rolled out in the future.

Cervical cancer, she said, was the second commonest cancer in women in the State, and it still was the top cancer in a few districts.

Priya Kapoor, consultant, surgical oncology, Apollo Proton Cancer Centre, Taramani, noted that the allotment of funds for early cancer detection and screening were important steps as early detection was crucial for treatment of cancer. “The cost of treatment for a person diagnosed with stage I breast cancer is around ₹4 lakh, while it is around ₹15 – 20 lakh for a person with stage III cancer. Doing a screening mammogram every year costs ₹1,500. So, screening and early detection makes it cost-effective; the benefits are immense. The government allocating funds for this purpose is the way ahead,” she said.

“When compared to the West, we have higher mortality due to cancer. Patients present in advanced stages because of the lack of screening. In the United States, 75% of patients with breast cancer are in stages I and II, while in India, 75% of patients are in stage III. This also impacts the treatment success rates. The West has screening protocols in place for breast cancers and colon cancers. As a result, the disease is picked up in the precancerous stage or stage I. In our country, it is mostly in stages III and IV. When we spend a little on screening, we can save a lot on treatment,” she said.

She also pointed out that cervical cancer can be prevented by vaccination. HPV vaccination has 99% efficacy. It can prevent not only cervical cancer but also cancers affecting the vagina, vulva and penile, she said.

‘No impetus to primary health care’

Some experts however felt that the budget was silent about a number of other pressing needs of the Health Department and hoped these would be addressed in the upcoming demands for grants for the department.

T. Sundararaman, former executive director, National Health Systems Resource Centre, who also chaired the advisory committee on CMCHIS, said there was hardly any significant announcement for the State’s health sector in the budget. “There is a great need to strengthen primary health care in Tamil Nadu. The role of primary health care in non-communicable disease management is only at the beginning stage in the State, and ‘Makkalai Thedi Maruthuvam’ is an ad hoc, stop-gap programme that focuses only on two to three diseases. There are no significant announcements to strengthen primary healthcare services,” he said. He added that preventable mortality due to NCDs was very high in Tamil Nadu.

Prof. Sundararaman noted that similarly, there was no significant effort to improve CMCHIS. “Diagnostics is very weak in Tamil Nadu and the public health workforce is far short of requirements,” he added.

‘CMCHIS needs a re-look’

G. R. Ravindranath, general secretary, Doctors Association for Social Equality, said, “The DMK, before coming to power, had announced that spending on health would be increased by three times but this is yet to be achieved.”

With the government allocating ₹1,461 crore for the CMCHIS, he said that the scheme did not benefit the public but only private hospitals. “The State government should reconsider the scheme. It should gradually reduce the fund allocated for health insurance and utilise it to improve government health infrastructure directly,” he said.

He pointed out that there was no mention of a salary hike for government doctors; a long pending demand to grant pay band-4 at 12 years of service. “There is nothing on recruitment of doctors and nurses as per the patient load. Now, medical and paramedical personnel are being recruited on a contractual basis. This is anti-labour, and the government should change its policy,” he added.

‘Lack of investment in human resources’

P. Saminathan, State president, Service Doctors and Post Graduates Association, said investment in human resources is lacking. “There has been an increase in the number of medical colleges/health institutions but comparatively, there has been no increase in human resources. The State government should increase the posts of doctors, staff nurses and paramedical personnel,” he said.

He added that super specialist departments should be established in newer medical college hospitals.