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By:

Rajendra Joshi

3 December 2024 at 3:50:26 am

Procurement first, infrastructure later

Procurement at multiples of market price; equipment before infrastructure; no accountability Kolhapur: Maharashtra’s Medical Education and Public Health Departments have been on an aggressive drive to expand public healthcare infrastructure. Daily announcements of new centres, advanced equipment and expanded services have reassured citizens long denied dependable public healthcare. Procurement of medical equipment, medicines and surgical supplies is reportedly being undertaken at rates two to...

Procurement first, infrastructure later

Procurement at multiples of market price; equipment before infrastructure; no accountability Kolhapur: Maharashtra’s Medical Education and Public Health Departments have been on an aggressive drive to expand public healthcare infrastructure. Daily announcements of new centres, advanced equipment and expanded services have reassured citizens long denied dependable public healthcare. Procurement of medical equipment, medicines and surgical supplies is reportedly being undertaken at rates two to ten times higher than prevailing market prices. Basic economics dictates that bulk government procurement ought to secure better rates than private buyers, not worse. During the Covid-19 pandemic, equipment and consumables were procured at five to ten times the market rate, with government audit reports formally flagging these irregularities. Yet accountability has remained elusive. The pattern is illustrated vividly in Kolhapur. The Dean of Rajarshi Shahu Government Medical College announced that a PET scan machine worth Rs 35 crore would soon be installed at Chhatrapati Pramilaraje (CPR) Government Hospital for cancer diagnosis. But a comparable machine is available in the market for around Rs 6.5 crore. A senior cancer surgeon at a major cancer hospital in western Maharashtra, where a similar machine was recently installed, remarked that the gap between what his hospital paid and what the government is reportedly paying was enough to make one ‘feel dizzy’. The label of a ‘turnkey project’ does not adequately explain a price differential of this magnitude. High Costs CPR Hospital recently had a state-of-the-art IVF centre approved at a sanctioned cost of Rs 7.20 crore. Senior fertility specialists across Maharashtra note that even a modern IVF centre with advanced reproductive technology equipment typically costs between Rs 2.5 crore and Rs 3 crore. The state’s outlay is reportedly approaching Rs 15 crore. Equipment arrived in June 2025 and lay idle for months owing to indecision about the site. Similarly, digital X-ray machines approved for CPR Hospital and a government hospital in Nanded; available in the market for roughly Rs 1.5 crore; were reportedly procured at Rs 9.98 crore per unit. Doctors in CPR’s radiology department, apprehensive about being drawn into potential inquiries, reportedly resisted accepting the equipment. One departmental head was transferred amid disagreements over signing off on the proposal. What’s Wrong These cases point to a deeper structural failure: Maharashtra has perfected what might be called the ‘equipment first, infrastructure later’ model. In any public hospital, the administrative sequence ought to be: identify space, create infrastructure, sanction specialist posts, and only then procure equipment. Compounding the procurement paradox is a parallel policy decision. On 20 December 2025, the state government decided to introduce radiology diagnostic services through a Public-Private Partnership model (PPP). Following this, an order issued on 6 February 2026 authorised private operators to provide PET scan, MRI and CT scan services at six government medical college hospitals: in Pune, Kolhapur, Miraj, Sangli, Mumbai and Baramati. CPR already has a 126-slice CT scan machine and a 3 Tesla MRI scanner, with another CT scan proposed. If the PPP arrangement proceeds, the hospital could simultaneously run one PET scan machine, two MRI scanners and three CT scan machines. Medical experts warn this could lead to unnecessary diagnostic testing simply to keep machines occupied, thus exposing patients to excess radiation while government-owned equipment gathers dust. A similar pattern was seen during the pandemic, when the Medical Education Department spent hundreds of crores on RT-PCR machines, only to award swab-testing contracts to a private company. Many of those machines remain unused today.

Choking Mumbai

For decades, Mumbai was perceived as a rare urban oasis, where the saline sweep of the Arabian Sea blunted the worst ravages of India's air pollution. That illusion has now been dispelled. A meticulous four-year study by Respirer Living Sciences (RLS), using data from its AtlasAQ platform, reveals the bleak truth that the city’s air is thick with pollutants all year round, with no ‘clean season’ left.


Mumbai’s annual average levels of PM10 (particulate matter ten microns or less in diameter) have consistently breached the national safety threshold of 60 micrograms per cubic metre (μg/m³). This is not merely a seasonal malaise tied to cooler winter months, as once assumed. Alarmingly, the city’s pollution levels persist even through the hot season, a time when improved atmospheric dispersion should offer natural reprieve.


Across the city - from Chakala in Andheri East to Deonar, Kurla, Vile Parle West and Mazgaon - pollution has become an unrelenting, ubiquitous presence.


The culprits are well known: traffic emissions from a burgeoning number of vehicles; unregulated dust from frenzied construction; industrial activity in and around the ports; and a conspicuous lack of dust control measures. Mumbai’s ceaseless growth now risks becoming a chronic liability.


Worryingly, the regulatory response remains sluggish. Mumbai’s urban planning continues to treat clean air as a peripheral concern, not a foundational necessity. Development plans rarely integrate environmental impact assessments in a meaningful way.


A sharper, citywide strategy is urgently needed. Dust suppression rules at construction sites must be enforced strictly, with financial penalties for violators and incentives for best practices. Traffic management systems should be overhauled to ease congestion and encourage the use of public transport. Expansion of clean, reliable mass transit network needs to be urgently prioritised. In addition, comprehensive real-time air monitoring at the ward level should be deployed, enabling authorities to respond to localised pollution spikes swiftly rather than relying on citywide averages that conceal dangerous hotspots.


Longer-term, clean air targets must be hardwired into the city’s master planning and transport policies. Green buffers along major traffic corridors, stricter emission norms for commercial vehicles and incentives for rooftop gardens and urban afforestation could all play a part. Industrial zones near port areas should be subjected to rigorous air quality compliance measures, not token self-certifications. Private developers and large infrastructure firms, often among the worst offenders, must be made stakeholders in the clean air mission through binding regulations.


Mumbai’s commercial dynamism - as a magnet for migrants, entrepreneurs and investors - depends not just on glittering skyscrapers but on something far more basic: the ability to breathe. Unless clean air becomes an unshakeable priority, the city risks suffocating its own future. For a metropolis that prides itself on its resilience against terror attacks, monsoon floods and economic shocks, the real test will be whether it can muster the will to fight an invisible, pervasive enemy slowly corroding the lives of its 20 million citizens.

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