The Sher e Kashmir Institute of Medical Sciences(SKIMS) is in the news , this over some kind of an alleged irregularity in an appointment. While there may or may not be merit to the nature of the allegation, but there are larger themes that need to be addressed and dealt with in terms of the premier health institute of Kashmir. It amounts to stating the obvious that SKIMS, being the valley’s most premier and perhaps even busiest hospital, its governance be constituted in a way that redounds to the benefit of the people. At the end of the day, broadly speaking, it is governance of institutions that not only sets them apart but also makes them run efficiently, effectively and equitably. The same holds true for SKIMS. Given the load on the premier hospital, from all quarters , nooks and crannies of Kashmir, it stands to reason to state that the hospital is indeed under pressure. There is also the supply and demand of health services in Kashmir that creates additional layers of stress on the SKIMS. The governing body and the management have to deal with these , and more or less, have performed, reasonably okay. But, more needs to be done to make the hospital run even more efficiently. The bane of the hospital’s governance and management has been internal politics and politicking. This can perhaps best be obviated by separating the management , administrative and operational aspects of the hospital. Only those with proven management skills and expertise can and must run the hospital along the lines of modern management methods and techniques. While hospital administration , by its very nature, is rather different, this does not mean that non medical specialists in management cannot run , govern and manage the institute. In fact, those trained in management and administration can run it more effectively and ably, given that they might not develop vested stakes in the hospital. The tenures of the management must be contingent on their performance and performance management reviews must be carried regularly to assess the overall health of the hospital, so to speak. Moreover, there should be no scope for politics and political interference in the hospitals governance and management. This will undercut and negate many of the issues that SKIMS suffers from. Layers of accountability and oversight mechanisms must be created to ensure transparency in various domains. In combination, these measures can not only redeem the SKIMS but also create a robust institution whose benefits can be enjoyed by the broader populace.