Tamil Nadu doctors warn gold ring scheme hospital model costs three times budget

A government doctors' association has warned that the hospital-based delivery model for Tamil Nadu's newborn gold ring scheme will cost nearly three times the administrative budget sanctioned in the government order, urging the State to shift to a bank-led distribution system instead.

The Service Doctors and Post Graduates Association (SDPGA) estimated that a district-level implementation involving two hubs and 25 spokes handling 25,000 deliveries per year would require a combined annualised expenditure of ₹84.18 lakh—approximately 1.98% of the ₹42.50 crore annual gold procurement value for that district. This far exceeds the 0.66% administrative cost ceiling set by the government order, which allocated only ₹5 crore State-wide for monitoring, transport, evaluation, consumables, software, and hardware under the ₹750.83 crore Thaimaman Thanga Mothiram Thittam.

Security infrastructure pushes costs higher

The hub-and-spoke framework outlined in the government order requires hospitals to take custody of, secure, and physically transport one-gram gold rings from hub centres to delivery points across the district. SDPGA president P. Saminathan, in a letter to the Health Secretary, pointed out that this compels the Health Department to build what he described as a parallel bullion-security apparatus unrelated to clinical care.

The association's district costing factored in capital outlays for reinforced concrete strong rooms with double locking, fire-rated vaults with dual-custody protocols at two district hubs, biometric access and CCTV at 27 sites, and steel safes at spokes—totalling ₹12.68 lakh annualised. Recurring annual costs of ₹71.50 lakh would cover six-member armed police or home guard posts at each hub, additional security for every spoke, and armoured cash-in-transit vehicles with a driver and two escorts.

Bank channel could cut costs by two-thirds

The SDPGA recommended channelling the scheme through scheduled banks, either via direct disbursal against a PICME-linked entitlement certificate or through a memorandum of understanding for bank-run logistics using existing bullion, currency-chest, and cash-in-transit infrastructure. Such an arrangement, the association said, could reduce administrative costs to a negotiated handling fee of 0.15% to 0.30% of the value handled—roughly ₹6.4 lakh to ₹12.75 lakh per year at the district level—freeing health staff to focus on patient care.

Saminathan cited the Revenue Department's earlier Thalikku Thangam Scheme, which used a bank model, as a proven template that could be replicated for the gold ring programme. The State government has budgeted ₹17,000 per delivery for 4,41,667 deliveries under the scheme.

Source: The Hindu