A Kerala High Court division bench, comprising chief justice Soumen Sen and justice Syam Kumar, heard writ petitions demanding an AIIMS for the state under the PMSSY. Deputy solicitor general OM Shalina submitted that the Union government was prioritising states with weaker healthcare infrastructure in allotting AIIMS under the scheme, and stated that Keralam had comparatively better healthcare facilities.

In an affidavit responding to two pleas by public action groups seeking an AIIMS in Kasaragod or Kottayam, the Centre said any decision on a new AIIMS can be taken only after approval for the continuation of the scheme is communicated and funds allocated. A proposal to extend PMSSY for another five years is at the stage of inter-ministerial consultations. The proposal was first put before the Union government in 2016, and the state had identified locations for the hospital.

The court said the matter has been pending for 11 years and that the large presence of private hospitals cannot also be a point of disqualification. The bench asked: “So, does the state of Keralam not require an AIIMS? Is that the stand of the Centre?” It also said: “Not everyone can afford to go to Aster....Kerala has high population density. There are states with multiple AIIMS. Why is there an AIIMS in Delhi? All the affluent people are there,”