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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.

Sacred Boundaries

India has long prided itself on its secularism. This a hallowed concept, more often than not, has been invoked to protect minority rights while being used as a cudgel to shame the Hindu majority into tolerance without reciprocity. The latest uproar surrounding the Shani Shingnapur temple trust’s decision to dismiss 167 employees, including 114 Muslims, has prompted hand-wringing across the usual ‘liberal’ quarters. The decision, unpleasant as it may appear, is logical.


This is not a case of religious bigotry run amok, but one of religious autonomy being reasserted.


To put it plainly are there any Hindus appointed to the boards of mosques or churches in India? Would the Sunni Waqf Board even entertain such a thought? Waqf boards, flush with vast landholdings and opaque finances, are strictly governed along sectarian lines. The same applies to churches, Catholic or Protestant. These institutions jealously guard their inner workings, including employment, from even the faintest whiff of any non-Christian or Hindu participation. But no outrage follows their decisions. Why then must Hindu institutions alone be expected to play by a different rulebook?


The Shani Shingnapur temple is one of the most iconic shrines in Maharashtra, famous not only for its deity but also for the unique custom of homes without doors, built on an abiding faith in divine protection. That such a place should become a battleground for performative secularism is ironic. But it is also revealing that in modern India, Hindu religious institutions are expected to extend an inclusivity that is neither expected nor offered by others.


Those who were dismissed claim they worked outside the sanctum, building grills, managing cows or maintaining gardens. That may well be true. But such claims cannot override a community’s right to define who may or may not work in its sacred spaces. To suggest otherwise is to infantilise Hindus. A temple is not a government department. It does not owe religious neutrality to anyone. It owes fidelity to the tradition it upholds.


Critics have pointed out that many of those sacked are poor. That, too, is tragic. But economic hardship does not entitle anyone to employment in a religious institution that does not reflect their faith. That is a harsh truth - no less harsh than the realities faced by countless Dalit Hindus who, to this day, are turned away from mosques or churches despite converting, seeking refuge in a faith that still views them with suspicion. If poverty is to be the ultimate moral barometer, how many Muslim-majority nations permit non-Muslims to even enter mosques, far less be employed by them? Saudi Arabia bars non-Muslims from even entering Mecca or Medina. In Pakistan, Ahmadi Muslims - let alone Hindus - face systemic disenfranchisement from religious and civic life.


This episode is not a pretty one. But if it sparks a wider conversation about religious equality in India, one that forces every community to reflect on its own hypocrisies, then some good may yet come of it.

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