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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.

Singh and ‘primer’ on Atomic Energy

Updated: Jan 2, 2025

Manmohan Singh

Mumbai: As erudite as he was, one of the first things Manmohan Singh did after he became prime minister in 2004 was to ask Dr Anil Kakodkar, then chairman of the Atomic Energy Commission, for a "primer" on his department.


It was not that Singh, an economist-turned-politician, was unfamiliar with India's nuclear energy and weapons situation, noted Dr Kakodkar, reminiscing about his interactions with the former PM.


Before he became PM, Singh had served as a member of the AEC.


"I was surprised at this demand for a primer, because of the time constraints a prime minister has. I told him that the primer on the subject cannot be restricted to two pages," Kakodkar told PTI.


"He said page restrictions did not matter."


Soon, he had a detailed note running into 15-20 pages ready for the prime minister.


"Dr Singh had an eye for details. He read the primer for an hour and a half, with me sitting beside him, understanding the nuances involved in this strategic department. At the prime minister's level, you do not expect this," Kakodkar said.


The Department of Atomic Energy reports directly to the Prime Minister's Office. Kakodkar served as DAE secretary and chairman of the AEC from 2000 to 2009.


It was under Singh that the historic Indo-US nuclear deal was signed in October 2008, paving the way for strategic cooperation not only with the US but also other developed countries in areas of nuclear energy, space and defence research.


There was a section within the government that wanted to expedite the nuclear deal citing economic benefits, Kakodkar said.


"He was an economist who was well aware of the economic benefits after the Indo-US nuclear deal. But Dr Singh ensured that India goes ahead with the deal only after securing its strategic interests. He was very firm on that," he said.


One of the hallmarks of the Indo-US nuclear deal was that not all atomic reactors were placed under the safeguards of the International Atomic Energy Agency (IAEA).

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