Between 2021 and 2025, Tamil Nadu's public healthcare saw a 49% rise in daily outpatient numbers and a 37% increase in bed capacity. The government built new hospitals and upgraded many, but staffing has not kept pace. Despite efforts to reach "zero vacancy," health officials admit doctor and nurse posts have not increased proportionally. Instead, existing staff are redeployed, with nearly 500 doctor posts cut in the past and 572 junior resident positions recently reduced. New hospitals like the Government Pentland Multi Super Speciality Hospital, Vellore, operate without new sanctioned staff, relying on transfers from other centers. Government Orders show that for 617 new rural health sub-centres, no new posts were added; nursing staff were moved from existing facilities. Doctors warn this affects care quality and increases workload. Tamil Nadu now has over 11,000 government health facilities, including 299 hospitals and 36 medical colleges. Still, many doctors say the workforce is roughly half what is needed. "The doctor-patient ratio has remained inadequate for decades," said K. Senthil, president of the Tamil Nadu Government Doctors Association. Paramedical staff are also scarce, forcing doctors and nurses to cover administrative tasks. Nursing shortages are severe. For example, a single nurse may manage up to 60 patients or entire hospital floors during shifts. Advocacy groups demand 10,000 new regular nursing posts and regularisation of 8,000 nurses on contract pay. Secondary care centers like district and taluk hospitals face the worst staffing gaps. Some hospitals run with just a handful of doctors, using redeployment from other facilities to cover shortfalls. Upgraded hospitals often lack matching increases in staff. Doctors highlight mismatches in specialist postings, such as placing surgeons where essential equipment is missing. They also criticize reliance on contract and bond-period postgraduate doctors instead of adding permanent posts. Health Minister Ma. Subramanian noted that while new regular posts are limited, many contract posts have been created through health missions. He said 17-18 new district hospitals will see new posts soon. Efforts continue to fill over 1,500 doctor positions through recruitment boards. The government aims for "zero vacancy" by January 2026 and plans to create new posts based on patient load moving forward.