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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.

Europe’s Tourist Fatigue

From Barcelona to Dubrovnik, a quiet war is brewing between hosts and holidaymakers.

I started an endless journey of discovering the world beyond India 12 years ago, and one thing that I often say is that every country is more about the people residing there than the monuments. I have visited over 50 countries so far, and I am currently engrossed in tasting the essence of what life is while being in Serbia which is a landlocked country in Southeast and Central Europe. While things are absolutely safe here, reports of the anti-tourism protests in the other parts of Southern Europe have put me into thinking. Being a Chartered Accountant by qualification, foreign language tutor by profession, and a passionate traveller who dedicates over half of every year exploring some or the other country, I cannot resist deliberating on the root cause that has triggered these protests in a few of the most sought-after tourist attractions of the world.


Anti-tourism protests have intensified across Southern Europe driven by residents’ frustrations over tourism’s impact on housing, infrastructure, and local culture. Cities like Barcelona, Palma de Mallorca, Venice, Lisbon and the Canary Islands have become focal points for these demonstrations. As Indians we would often wonder why someone would protest against tourists since a tourist brings in a lot of wealth and job opportunities for the locals. In India, we are always happy to receive foreign tourists and are curious about how they chose India as their destination and what we can do more to ensure they have the best possible and the most memorable experience and stay in our country.


However in places like Barcelona and Mallorca in Spain, or Paris or Dubrovnik in Croatia, the story is completely different. While there is no denying that these countries live off tourism and provide jobs to many people, the cost of living in these places surge astronomically due to unending swarms of tourists. It becomes nearly impossible for the locals to afford to rent a place in such cities, since there is very high demand for accommodation and very little supply leading the locals to be often priced out. For instance, it is impossible to find a one- bedroom apartment in Barcelona for anything less than 1,200 Euros when an average person earns only about 800-1,000 Euros a month. Hence the anger.


It cannot be denied that India, too, is feeling the undercurrents of over-tourism, mostly from domestic tourists, in places like Shimla and Manali, which used to be serene places before morphing into concrete jungles. The bigger problem with the Indian tourists is that they leave a lot of litter behind wherever they go and spoil the natural beauty of the once heavenly place. This has also been observed in places like Ladakh and Spiti valley.


There is also a huge rise in the number of digital nomads. Many people from western European countries and the USA, who have high levels of income, decide to work from relatively not-so well-off places like Spain, Portugal or Croatia further increasing the demand for places to live.


Recently there was a crackdown in Barcelona by the Government on the many unauthorised Airbnb accommodations in the city. Most people find it lucrative to rent the apartment on Airbnb instead of renting it long term to a local. This further augmented the housing crisis in Barcelona.


With media reports helping to boost awareness, the problem seems to have been identified. However, change in the tourism industry is often gradual and requires consensus from a slew of stakeholders. The entire process requires time especially when it comes to implementation of the proposed schemes. Efforts have begun Across Europe with initiatives being designed in a bid to balance tourism with the needs of local residents giving due importance to the environmental, social and economic challenges that have arisen due to over-tourism.


With awareness initiatives, there are hopes that travellers too will increasingly act consciously ensuring that they are not misusing the benefits of being a tourist. At the same time, local communities, too, have jumped in following up with the concerned authorities to look for a solution and execute the same.


Having said that, protests against over-tourism seem to be more of a first world problem, probably a problem India may want to happily have, considering it would generate a source of livelihood for millions of youths in India who are looking for jobs.

(The writer is a Mumbai-based Chartered Accountant, foreign language tutor and an inveterate wanderlust. Views personal.)

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