Rajasthan Launches ‘After Hours Surgery’ Policy to Tackle Surging Hospital Waitlists and Boost Timely Care

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JAIPUR, Rajasthan — In a bold move to dismantle the chronic surgical backlogs that have long plagued India’s public healthcare system, the Rajasthan government officially launched its “After Hours Surgery” policy on February 13, 2026. Part of the 2026-27 state budget, the initiative mandates round-the-clock surgical services in major government hospitals, aiming to slash waiting lists that currently force patients to wait up to four months for even routine procedures. By leveraging existing infrastructure and introducing financial incentives for nighttime medical staff, the state seeks to transform the delivery of elective care for its 80 million residents.

A 24/7 Solution for a Growing Crisis

The policy, announced by Deputy Chief Minister and Finance Minister Diya Kumari, targets a systemic bottleneck: the “daytime-only” operation theater (OT) model. Despite having the physical infrastructure and trained specialists, many of Rajasthan’s largest tertiary care centers have historically shuttered their elective OTs by late afternoon, leaving thousands of patients in a state of medical limbo.

Under the new mandate, major facilities—including the 6,000-bed Sawai Man Singh (SMS) Hospital in Jaipur, JLN Hospital in Ajmer, and PBM Hospital in Bikaner—will transition to 24/7 surgical operations. To support this transition, the government has allocated funds for 12 new modular operation theaters across six flagship hospitals. These modular units are designed with advanced HVAC and sterilization systems, significantly reducing the risk of post-operative infections, which is a critical concern during high-volume throughput.

“The sheer volume of patients we see daily is staggering,” said Dr. Deepak Maheshwari, Principal of SMS Medical College. “By utilizing our theaters through the night, we can significantly bring down the waiting list, ensuring that a patient diagnosed today doesn’t have to wait until next season for relief.”

Addressing the National Backlog

Rajasthan’s crisis mirrors a broader national struggle. In Delhi, hospitals like Lok Nayak report wait times of up to eight months for specialized plastic or burn surgeries. In Bihar, the shortage of beds—estimated at 0.5 per 1,000 people, far below the World Health Organization’s recommendation of 3—further compounds the surgical delay.

In Rajasthan, routine operations like hernia repairs, gallbladder removals, and cataract surgeries currently carry a 2-to-4-month wait. This delay is not merely an inconvenience; it often leads to clinical deterioration. A simple fracture that remains unaddressed for weeks can lead to malunion, while a delayed hernia repair can escalate into a life-threatening emergency.

Incentives and Accountability: The Policy ‘Carrot and Stick’

To ensure the success of the graveyard shift, the government is introducing a two-pronged approach:

Financial Incentives: Surgeons, anesthesiologists, and nursing staff will receive additional compensation for after-hours work. These payments will be funded through the Ayushman Bharat-Mukhyamantri Ayushman Arogya Yojana packages.
Strict Regulation: In a move to ensure doctors remain focused on public service, the government has vowed disciplinary action against any state-employed physician found performing surgeries in private hospitals after their official shifts.

Naresh Goyal, Commissioner of the Medical Education Department, was clear on the government’s stance: “We are encouraging our doctors to provide overtime within the public system where they are needed most. Consequently, we will be cracking down on unauthorized private practice.”

Balancing Efficiency with Patient Safety

While the policy has been met with optimism, medical experts urge a cautious approach regarding surgeon fatigue and patient outcomes. The “after-hours” model raises a valid question: Is a surgery performed at 3:00 AM as safe as one performed at 9:00 AM?

Recent research published in the British Journal of Surgery (2024) suggests that nighttime elective procedures can be linked to higher mortality rates in some settings, though the authors note this is often due to staffing levels rather than the time of day itself. Conversely, studies on emergency surgeries often show no significant difference in outcomes, provided the surgical team is well-rested.

Dr. Rajiv Ranjan Prasad, former Superintendent of PMCH, emphasizes that “round-the-clock efficiency depends entirely on adequate staffing. You cannot simply ask the daytime staff to work longer; you must have dedicated night shifts to prevent burnout and medical errors.”

The Indian Medical Association (IMA) has also voiced the need for regulated duty hours, suggesting that the “After Hours” policy must include “sleep hygiene” protocols for surgeons to ensure that the increased quantity of care does not come at the expense of quality.

Public Health and Economic Impact

For the average citizen, the implications are profound. Shorter waitlists mean patients can return to the workforce sooner, reducing the economic burden on families who often lose income while waiting for treatment.

The policy aligns with the state’s “Nirogi Rajasthan” (Healthy Rajasthan) vision, which focuses on preventive care and infrastructure expansion. If successful, Rajasthan could serve as a pilot model for other Indian states grappling with similar surgical bottlenecks.

Potential Challenges Ahead

Staffing Shortages: Similar initiatives in Delhi have seen modular OTs sit idle due to a lack of trained technicians and anesthesiologists.
Sustainability: Ensuring a consistent flow of funds through the Ayushman Bharat scheme to pay for overtime incentives.
Monitoring: Establishing a transparent system to track surgical outcomes during nighttime hours to ensure safety standards remain high.

Conclusion: A Paradigm Shift in Public Care

The “After Hours Surgery” policy marks a significant shift from “business as usual” in Indian public health. By treating surgical capacity as a 24-hour resource rather than a 9-to-5 service, Rajasthan is taking a pragmatic step toward universal health accessibility. However, the true measure of success will lie in the government’s ability to maintain staffing levels and prioritize doctor welfare alongside patient volume.

Would you like me to look into how other states are responding to Rajasthan’s model or provide more details on the Ayushman Bharat funding structure for these incentives?

Medical Disclaimer

Medical Disclaimer: This article is for informational purposes only and should not be considered medical advice. Always consult with qualified healthcare professionals before making any health-related decisions or changes to your treatment plan. The information presented here is based on current research and expert opinions, which may evolve as new evidence emerges.