Across primary and secondary facilities, over 61% and 56% sanctioned posts were vacant. Tertiary and AYUSH facilities also suffer from alarmingly high vacancy rates, resulting in an overall personnel shortage of 60%. Such gaps are not just theoretical; they translate into overworked staff, unattended beds, and poor-quality healthcare.
Prime Minister Narendra Modi’s inauguration of the Homi Bhabha Cancer Hospital & Research Centre at Muzaffarpur (August 2025), was hailed as a landmark step for bringing tertiary care closer to North Bihar. Yet behind the new buildings and bold headlines lies a stark paradox: Bihar’s visible expansion of health infrastructure has not yet translated into reliable, equitable care for the people who need it the most.
The state’s statistics point to the problem. Bihar’s bed ratio stands at 0.32 per 1000 population- far below the National average of about 1.7 per 1000. The low doctor-to-patient ratio makes the situation worse, with 1 doctor in Bihar serving about 30,000 people. These raw numbers show that building hospitals is just one piece of the puzzle; staffing, functioning services, and public trust are the rest.
To better understand the situation on the ground, TheRise analyzed the Primary Health centres of the West Champaran in Tirhut Division, of Bihar. Many PHCs and sub-district hospitals in the region lacked even the basic diagnostic facilities, and several have no female doctors, which is a chronic barrier for women patients. This results in underutilization of public facilities despite sanctioned staff strength on paper.
While for minor ailments, residents of the West Champaran still rely on government PHCs, but for chronic or serious conditions such as diabetes, cardiac disease, complicated infections, families have to travel to bigger medical hubs such as Gorakhpur (UP), Muzaffarpur, or Patna.
Muzaffarpur acts as the tertiary hub in Tirhut Division. Hospitals such as Sri Krishna Medical College and Hospital (SKMCH) and the Sadar hospital provide high-end diagnostic facilities such as CT/MRI scan, dialysis, and have high-quality labs, drawing patients from peripheral blocks for advanced diagnostics and specialist care. This concentration has turned Muzaffarpur into a funnel where patients have to travel long distances, incurring costs and delays, to access services that are unavailable closer to home.
PHC officials in Harna Tanr, Bagaha in West Champaran, told TheRise that complex cases are referred to Sub-Divisional Hospital Bagaha, which is about 25 km away, and to GMCH Bettiah, which is more than 8o km away from the primary health centre.
Moreover, personnel picture has continued to remain bleak for decades. The Comptroller and Auditor General’s performance audit for 2016–22 flagged acute shortages: against the projected population, Bihar needed 124,919 allopathic doctors to meet WHO standards, but had only 58,144, a deficit of 53% below the WHO standard and 32% lower than the national average. Further, across primary and secondary facilities, over 23,475 (61%) and 18,909 (56%) sanctioned posts were vacant. Tertiary and AYUSH facilities also suffer from alarmingly high vacancy rates, leaving an overall shortage of 35,317 personnel (60%). Such gaps are not just theoretical; they translate into overworked staff, unattended beds, and poor-quality healthcare.
This human resource crisis is compounded by financial inefficiency. Bihar’s budgetary outlay on health also shows a worrying disconnect between commitment and execution. The state’s ₹20,335 crore health budget for 2025-26 looks ambitious; yet past audits show that between FY 2016–17 and 2021–22 nearly 31% of health allocations remained unspent. Procurement delays, bottlenecks in fund flow, and weak district-level coordination mean that capital works often get completed without operational readiness.
It all begins with grand foundation-stone ceremonies, where the politician poses beside plaques inscribed with their names, cutting red ribbons and promising a new dawn in the healthcare of Bihar. Then come the long years of delay — tenders stalled, funds frozen, and files lost in bureaucratic loops. When the buildings finally rise, they stand hollow: no beds, no doctors, no staff. The inauguration boards gleam at the gates, but inside, expensive machines gather dust. Across Bihar, these ghost hospitals stand as monuments to misplaced priorities, where money is spent, promises are made, but care remains undelivered.
While the government hospitals grapple with absenteeism and repeated medical negligence, the private sector has stepped in to fill the trust gap by offering faster diagnostics and quality care. However, such services remain unaffordable for a large section of Bihar’s population. Financial protection schemes like Ayushman Bharat PM-JAY have expanded coverage, issuing over 35.4 crore Ayushman cards as of September 9, 2024, broadening the safety net on paper. Yet in remote and tribal villages, awareness remains poor, empanelment of local hospitals is delayed, and transport costs for a referral typically remain uncovered.
If the Muzaffarpur Cancer Hospital and other new launches are to mean more than photo-ops, Bihar must prioritize the invisible architecture of healthcare: recruitment and retention of medical staff; functional labs and quality diagnostics at PHC/SDH levels.
Infrastructure can be built overnight, but public trust is earned over time. Unless the state marries its visible capital projects with a relentless focus on staffing, accountability, and community trust, Bihar’s new hospitals will remain islands of excellence in a sea of dysfunction.
Sabya Sachi Parth is a TRIP intern under Hamra Bihar.
Mentored and Edited by Sneha Yadav.
References
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