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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 was committed to idea of accountability:RTI activists

Updated: Jan 2, 2025

Manmohan Singh

New Delhi: Former prime minister Manmohan Singh, who ushered in an era of transparency, accountability and democratic empowerment with the implementation of the Right to Information Act, was a little "uncertain about its impact" on government functioning, but was committed to the idea of "accountability and transparency", RTI activists and former information commissioners said.


Singh, a two-term Prime Minister who passed away at the All India Institute of Medical Sciences (AIIMS) here on Thursday at the age of 92, implemented the RTI Act in 2005.


The Act gave citizens the power to seek information from the government for a payment of Rs 10, ending decades of secrecy in government functioning.


"He told me he was a little uncertain about the impact of RTI on government functioning. Normal scenes of bureaucracy. He was a true bureaucrat who understood the importance of secrecy in the government. So he was a little apprehensive, but he was committed to the idea of accountability and transparency," the country's first chief information commissioner, Wajahat Habibullah, told PTI.


He said Singh was certain that the Central Information Commission (CIC) should be led by a person from the civil service for the simple reason that he would understand the functioning of the government and know what kind of information can be disclosed and what should be withheld.


Habibullah said there were agreements and disagreements, but Singh was unflinching in his commitment to accountability and transparency.


Aruna Roy, a bureaucrat-turned activist who was one of the key figures in shaping the RTI Act, said the statute would probably be counted as one of the most important ones because it caused a fundamental shift in the citizens' relationship with the State.


"In our many interactions with Dr Manmohan Singh on many of the legislations, including the RTI, he was always engaged and forthright about being committed to bringing in an era of transparency in India. He was diffident about having a provision for penalties against bureaucrats not complying, with an argument that the law was enough of a shock and a shift away from the prevailing culture of secrecy, and he was concerned about the bureaucracy having to face too much pressure. Nevertheless, finally, the law did have penalties -- although in a weakened form," she said.


Roy said irrespective of Singh's apprehensions, the Prime Minister's Office during his tenure was one of the best in replying to RTI applications and complying with the Act's requirements.


"His government initiated social audits in MGNREGA and was aware that transparency was an essential prerequisite to the more effective functioning of social sector legislations with a vast canvas, such as the employment guarantee, the right to food, the right to education and the forest rights Act. There can be no doubt that these landmark legislations empowered the citizens to realise their rights through transparency and RTI," she said.


Roy said by passing a strong RTI legislation, the UPA government brought in an era of consultation, deliberation and citizen monitoring, much needed in a democracy where the citizens' participatory fora were restricted to a once-in-a-five-year vote.


"Manmohan Singh did an outstanding job by bringing in the RTI Act. We will eternally be grateful to Manmohan Singh for bringing in one of the best Acts in the world. And he implemented it with reasonable effort. In implementation also, he did a fairly reasonable job," former information commissioner and RTI activist Shailesh Gandhi said.


Noted RTI activist Venkatesh Nayak said the Act was passed and implemented under Singh's first tenure as the prime minister, even though he reportedly expressed misgivings about the breadth and scope of the proposed transparency law.


"It was also during his tenure that the first attempt was made to amend the Act to keep file-notings out of its ambit. However, the true believer in democracy that he was, the amendment proposal was never tabled in Parliament due to vocal opposition from the civil society and the media. It was shelved despite being approved by the cabinet," he said.


Nayak said during his decade-long tenure as the prime minister, the largest number of guidance notes were issued to explain the details of the RTI Act for effective implementation as the Department of Personnel and Training was under his charge.


"Guidelines for implementing the proactive information disclosure scheme were issued in 2013 in two instalments. In 2023, the Supreme Court gave these guidelines its stamp of approval and made them enforceable," he said.

Noted RTI activist Anjali Bharadwaj said the Act has initiated the vital task of redistributing power in a democratic framework.


"It is perhaps this paradigm shift in the locus of power that has resulted in repeated efforts by governments to weaken it.

-PTI

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