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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.

How Singh defended 1991 Union budget

Updated: Jan 2, 2025

Manmohan Singh

New Delhi: Manmohan Singh, the architect of India's economic reforms, had to literally face a trial-by-fire to ensure widespread acceptance of his path-breaking 1991 Union budget that saw the nation rise from its darkest financial crises.


Singh, the newly-appointed finance minister in the PV Narasimha Rao-led government, did it with great elan -- from facing journalists at a post-budget press conference to irate Congress leaders unable to digest the wide-ranging reforms at the parliamentary party meeting.


Singh's historic reforms not only rescued India from near bankruptcy but also redefined its trajectory as a rising global power.


Singh made an unscheduled appearance at a press conference on July 25, 1991, a day after the presentation of the Union budget, "to ensure that the message of his budget did not get distorted by less-than-enthusiastic officials", Congress leader Jairam Ramesh wrote in his book "To the Brink and Back: India's 1991 Story" that recounts the fast-paced changes that took place after Rao became prime minister in June 1991.


"The finance minister explained his budget - calling it 'a budget with a human face'. He painstakingly defended the proposals to increase fertiliser, petrol and LPG prices," Ramesh recounted in the book published in 2015.


Ramesh was an aide to Rao during his initial months in office.


Sensing the disquiet in the Congress ranks, Rao called a meeting of the Congress Parliamentary Party (CPP) on August 1, 1991, and decided to allow party MPs to "vent their spleen freely".


"The prime minister stayed away and allowed Manmohan Singh to face the flak on his own," Ramesh wrote, adding that two more meetings took place on August 2 and 3, in which Rao was present throughout.


"In the CPP meetings, the finance minister cut a lonely figure and the prime minister did nothing to alleviate his distress," Ramesh recounted.


Only two MPs - Mani Shankar Aiyar and Nathuram Mirdha - backed budget wholeheartedly.


Aiyar had supported the budget, contending that it conformed to Rajiv Gandhi's beliefs on what needed to be done to stave off the financial crisis.

Bowing to pressure from the party, Singh had agreed to lower the 40 per cent increase in fertiliser prices to 30 per cent but had left the hike in LPG and petrol prices untouched.


The Cabinet Committee on Political Affairs met twice on August 4 and 5, 1991, to decide on the statement Singh would make in the Lok Sabha on August 6.


"The statement dropped the idea of a rollback, which had been demanded over the past few days but now spoke of protecting the interests of small and marginal farmers," Ramesh said in his book.


"Both sides had won. The party had forced a rethink but the fundamentals of what the government wanted -- the decontrol of prices of fertilisers other than urea and an increase in urea prices -- had been preserved," he recounted.

"This was political economy at its constructive best -- a textbook example of how the government and the party can collaborate to create a win-win situation for both," he added in the book.

-PTI

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