In January 2018, the premier tertiary care hospital Sher-e-Kashmir Institute of Medical Institute (SKIMS) was at the centre of extreme confusion and disorder after three senior doctors were caught during a sting operation as indulging in private practice despite the ban. The government suspended the three doctors and attached Director A G Ahanger with the General Administration Department. The issue snowballed into a political controversy when Omar Abdullah alleged the move (government order) as politically motivated. The rot in the system and general functioning of this premier institute also got highlighted when instead of one, two directors assumed the office – an interim director chosen by the Mufti (Mehbooba)-led government and Dr Ahanger whose suspension was stayed by the court. Even associations and lobbyists were at the forefront of the chaos that prevailed for some time. However, the basic and the most underlying problem remains unresolved until this day – the fact whether the head of an institute can ignore whatever happens in the institution, all the affairs, the management and its functioning. The question whether the director knew about private practice and the conduct his senior doctors of SKIMS, and whether he allowed it or opposed it still has not been answered. But there is a more disturbing fact than mere ignorance about the state of affairs in the institute. Respecting both the court and the government’s order – shall an official against whom an inquiry is initiated or who is accused in mismanagement or breach of code of conduct, be allowed to function in full capacity or not? Both internal and external politics in SKIMS have ruined this institution completely. There have been numerous allegations against the hospital administration, allegations like nepotism, corruption, arrogance of its top officials and misappropriation of funds. During the Covid crisis all eyes in Kashmir were set on this institute and how it would particularly function and bring relief to the people. It has been largely a disappointment as except paid publicity nothing good seems to have come out of it. The government must initiate a fresh inquiry and probe the functioning of this institute. Whether it is general procurements, appointments, promotions, demotions or use of funds; a thorough scrutiny is very much needed. The judicial system also needs to rethink the decision in this particular case. What if an official is really involved in mismanagement while he or she is allowed to continue, therefore aggravating the case further? The government also needs to be cognizant of the lobbyists and supporters and be free and fair in its decision. SKIMS must be saved, if lives are to be saved.