Be it the neo-natal care at Lal Ded Hospital or the nature and delivery of health care at SMHS or other district hospitals, the state of our health care system(s) is not picture perfect, so to speak. This is not to put the onus of blame on to medics, paramedics and allied staff but to put matters into perspective. Admittedly, there is a mismatch between the supply and demand of health care. With a demographic and population increase in Kashmir, there is an increase in the demand of health care and services but the supply, given infrastructural constraints, doctor patient ratios, and general awareness amongst the public about health issues, has not matched with demand. These structural issues create pressures on the medical fraternity and, among other things, lead to rather poor delivery of health care. There is also the factor of rather dim doctor patient interface. Amidst this melee, space gets generated for what is called “private practice” in Kashmir wherein doctors treat patients for a fee. (While “private practice” fills in the void created by structural debilities in the system, it militates against the poor and vulnerable sections of society and raises other ethical and moral issues). All these factors impinge negatively on health care systems and delivery in the valley. The question is : can health care systems be improved in a manner that redound to the benefit of the people? Can the interests of doctors be aligned with the welfare of the people? These are difficult questions to answer but , in order to streamline and make health care efficient , effective and defined by equity, there has to be a drastic increase in the budget outlays towards the health sector. The outlay with respect to the GDP has to increase manifold. Complementing this has to be the efficiency of spending. But, given the various structural issues with the bureaucracy and its structures, and the overall inertia that defines the administration(s), this might not be possible. The way out of the morass would be Public Private Partnerships(PPP’s) in the health sector Kashmir. Moreover, what can be done is invite philanthropic- local and global- interest in the health care sector at all levels in Kashmir. Last but not the least, given the choice of their profession- a noble one- an extra obligation is entailed upon medics to do their jobs with more care, diligence and sobriety. Failing this, no amount of restructuring can actually ameliorate the problems that define the health care sector in Kashmir.