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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.

Science and the Fear of Bold Ideas

While modern science celebrates originality, the systems that fund and evaluate research often reward caution over bold ideas.

AI generated image
AI generated image

Science proudly claims to reward originality. Research proposals must explain what is new. Journals ask authors to highlight novelty. Prestigious prizes celebrate discoveries that open entirely new directions.


In principle, scientific progress depends on bold ideas. Yet many researchers recognise a quiet contradiction. Novelty is welcomed, but usually only within comfortable limits. Ideas that extend existing work are readily accepted. Ideas that challenge established thinking often encounter hesitation. The system asks scientists to be original, but it frequently rewards them for being careful.


This tension is not entirely new. Even in earlier centuries, scientific institutions balanced curiosity with caution. The Royal Society in seventeenth-century England famously adopted the motto nullius in verba (meaning “take nobody’s word for it”) to encourage independent thinking. Yet, the same institutions also relied on consensus and reputation to determine which claims deserved attention. The desire for bold discovery has always existed alongside the instinct to protect established knowledge from what might appear speculative or premature.


From Bold to Safe

The contradiction becomes visible during research proposal reviews. A scientist may present an idea that crosses disciplinary boundaries, questions a widely accepted assumption, or proposes a new way of approaching a familiar problem.


Instead of excitement, the discussion often becomes cautious. Reviewers begin to ask predictable questions. Is the idea too speculative? Is there enough preliminary data? Can the outcome be predicted? Will the project produce publications within the grant period? Does it fit the priorities of the funding call?


None of these questions are unreasonable. Funding agencies must ensure that public resources are used responsibly. Reviewers must distinguish promising science from unrealistic claims.


But when these concerns dominate the discussion, something subtle happens. The proposal gradually shifts toward safety. The applicant is advised to narrow the scope, reduce uncertainty, and align the work more closely with existing literature. The original idea is reshaped until it becomes easier to evaluate.


The proposal is rarely rejected because it is new. It is modified because it is too new. When this pattern repeats across funding systems, it slowly shapes the culture of research. Scientists begin to recognise which kinds of projects are most likely to succeed.


The safest approach is often to extend existing work. A method may be improved slightly. A parameter may be adjusted. A known concept may be tested in a different system. Such work is valuable and often necessary. Science does depend on steady and cumulative progress.


But a system that mainly rewards incremental advances rarely produces dramatic shifts in understanding.


This is why the language used in science policy often sounds more ambitious than everyday research practice. We frequently hear phrases such as leap-frogging innovation, pole-vaulting science, and blue-sky research. These expressions suggest bold intellectual leaps capable of transforming entire fields.


In practice, however, such leaps are difficult to pursue within the prevailing structure of research funding and evaluation.


Several forces quietly push science in this direction. Modern research systems rely heavily on measurable performance. Scientists are evaluated through publications, citations, patents, and grants. Institutions are judged by rankings and visible productivity.


Under these conditions, researchers naturally choose projects that can produce results within predictable timeframes. A radically original idea may take years to mature and may even fail. An incremental project, in contrast, is far more likely to generate publishable results within the duration of a grant.


Established Frameworks

The incentives therefore encourage caution. This tendency intensified during the late twentieth century as universities across the world adopted managerial systems of evaluation.


Evaluation also becomes more difficult when ideas fall outside established frameworks. Reviewers are usually experts in existing fields. They understand accepted theories, standard methods, and familiar lines of research. This allows them to judge proposals efficiently.


Radically new ideas often require reviewers to imagine possibilities that lie beyond current knowledge. That process demands time, patience, and intellectual openness. In busy review systems, safer proposals often appear easier to support.


The history of science repeatedly reminds us that important discoveries often appear uncomfortable in their early stages.


Alfred Wegener’s proposal that continents move across the Earth was dismissed for decades before plate tectonics transformed geology. Barbara McClintock’s discovery of mobile genetic elements puzzled many scientists because it challenged prevailing assumptions about genes. Dan Shechtman’s work on quasicrystals contradicted accepted crystallographic principles and faced strong resistance when first reported.


The pattern stretches even further back. When Galileo argued that the Earth moved around the Sun, his claims conflicted not only with religious doctrine but also with prevailing scientific understanding. In the nineteenth century, Ignaz Semmelweis struggled to persuade physicians that simple handwashing could prevent deadly infections in hospitals. These episodes reveal a recurring feature of scientific change that ideas which later appear to be obvious often look improbable when first proposed.


These examples do not mean scepticism is unnecessary. Science depends on critical scrutiny and rigorous testing. Not every unconventional idea deserves support.


But they do remind us that radically new ideas often appear improbable before they become obvious.


Quiet Lessons

Young researchers learn these realities very quickly. By observing which proposals receive funding and which kinds of research attract recognition, they begin to understand the unwritten rules of the system.


Without anyone explicitly telling them, they learn that extending established work is often safer than exploring radically new directions.


Over time this quiet lesson shapes scientific ambition itself. Many capable researchers choose safer paths, not because they lack imagination, but because the structure of the system encourages them to manage risk carefully.


In India, this issue has special relevance at a time when new institutions are shaping the country’s research ecosystem. The creation of the Anusandhan National Research Foundation offers an opportunity not only to expand research funding but also to rethink how originality itself is supported.


If the goal is to encourage transformative science, funding structures must accommodate ideas that do not fit conventional templates.


One possible approach would be a dedicated programme under ANRF called the Bharat Navdisha Initiative (BNI). Such a programme could invite proposals that aim to explore entirely new scientific directions rather than incremental extensions of existing work.


Projects submitted under such a programme would not always fit easily within conventional evaluation frameworks. Their outcomes may be uncertain and their timelines unpredictable.


For this reason, the review process must also be different. Evaluation should be slow, careful, and grounded in deep scientific discussion. Reviewers should have sufficient time to examine the intellectual foundations of the idea, question its assumptions, and assess whether the scientific risk is justified.


The central question should not be whether the proposal appears unusual. The real question should be whether the scientific reasoning behind it is sound and whether the idea could open a genuinely new direction.


Balanced Approach

Administrative convenience should not determine the fate of bold ideas. Thoughtful scientific debate should.


Science requires both stability and imagination. Incremental research strengthens existing knowledge and builds reliable foundations. At the same time, progress also requires a smaller but carefully protected space for bold exploration that may alter the direction of entire fields.


At present, that space remains limited. If institutions truly wish to encourage transformative discoveries, they must do more than ask for novelty in proposal forms. They must create funding structures and evaluation processes that allow unusual ideas to be examined seriously before they are pushed toward safer ground.


Creating initiatives such as the Bharat Navdisha Initiative would send an important signal. It would show that bold thinking is not only admired in speeches, but also supported where it matters most.


(The author is an ANRF Prime Minister Professor at COEP Technological University, Pune; former Director of the Agharkar Research Institute, Pune; and former Visiting Professor at IIT Bombay. Views personal).

 


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