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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.

Fractured Crown

Between Siddaramaiah’s grip on power and Shivakumar’s restless ambition, the Karnataka Congress is trapped in a succession spiral.

Karnataka
Karnataka

Karnataka today has two chief ministers - one by office, the other by expectation. The power tussle between Siddaramaiah and his deputy, D.K. Shivakumar, has slipped so completely into the open that the Congress’s ritual denials sound like political farce. A whispered ‘understanding’ after the 2023 victory that each would get the CM’s post after two-and-a-half years has hardened into a public confrontation between a chief minister determined to finish five years and a deputy increasingly unwilling to wait.


The recent breakfast meeting between the two men at Siddaramaiah’s residence was presented as a truce where the ‘high command’ was invoked as the final arbiter. “There are no differences between us,” Siddaramaiah insisted, twice for emphasis. Few were convinced and soon, Shivakumar was again hinting darkly at change.


For weeks, Shivakumar’s loyalists have been holding meetings, mobilising legislators and making pilgrimages to Delhi to get the Congress high command to honour its promise. They insist that the Congress leadership agreed to a rotational chief ministership in 2023 and that November 2025 was always meant to mark Shivakumar’s ascent. The high command, for its part, has perfected the art of strategic vagueness by neither confirming nor denying the pact.


This suggests that the Congress does not merely hesitate to act against Siddaramaiah, but increasingly lacks the capacity to do so. From the outset of his second innings, Siddaramaiah has given no signal of easing aside. As he approaches January 2026, poised to overtake D. Devaraj Urs as Karnataka’s longest-serving chief minister, the symbolism is unmistakable. The mantle of social justice politics that Urs once embodied now firmly sits on Siddaramaiah’s shoulders. And it is this social coalition that shields him.


His fortress is AHINDA - minorities, backward classes and Dalits. Leaked figures from the unreleased caste census suggest that these groups together approach or exceed two-thirds of the state’s population. Lingayats and Vokkaligas, once electorally dominant, are rendered numerical minorities in this arithmetic. Siddaramaiah governs not merely as a Congress leader, but as the putative custodian of Karnataka’s demographic majority.


That claim is reinforced through policy. Minority scholarships have been revived, contractor quotas restored, residential schools expanded. More than Rs. 42,000 crore has been earmarked for Scheduled Castes and Tribes. Kurubas, his own community, have been pitched for Scheduled Tribe status, with careful assurances that their elevation will not disadvantage others.


DK Shivakumar brings organisational muscle, financial clout and control over the Vokkaliga heartland. In electoral campaigns, these are formidable assets. But in a confrontation with a leader who embodies a 60–70 percent social coalition, they are blunt instruments.


The Congress high command understands this equation, even if it publicly pretends otherwise. It also remembers, uneasily, what Siddaramaiah did the last time his authority was constrained. In 2020, when the Congress–JD(S) coalition collapsed after 16 MLAs defected to Mumbai,13 of them hailed from Siddaramaiah’s camp. At the time, he held the post of coordination committee chairman. Instead, he emerged as the principal beneficiary of collapse, returning as Leader of the Opposition with a tighter grip on the party.


If the Congress high command could not punish him then, it is doubtful it can coerce him now.


Shivakumar’s predicament is thus more tragic than tactical. He is not battling a rival alone, but an entire political structure built to outlast him. The promised coronation looks increasingly like a mirage drifting just ahead of a man condemned to keep walking.


For the Congress, the cost of this paralysis is already visible. A government elected on guarantees and governance is consumed by succession. The party’s authority is dissolving while its factions harden.


The Congress returned to power in Karnataka after years in the wilderness, only to re-enact the same leadership dysfunction that has crippled it elsewhere. Regardless of whether Siddaramaiah survives this storm, it is becoming increasingly clear that the Congress cannot survive the slow corrosion of its command in one of the few states it holds today. 


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