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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.

Stage Politics

It is no secret that the ruling Mahayuti alliance that governs Maharashtra is united in name more than nature. Brought together less by ideological kinship than by arithmetic and ambition, the coalition comprising the Bharatiya Janata Party (BJP), the Eknath Shinde-led Shiv Sena and the breakaway faction of the Nationalist Congress Party (NCP) headed by Ajit Pawar has been riddled with mistrust, factional resentment and veiled rivalries despite their remarkable win in the 2024 Assembly polls.


These tensions spilled into public view recently at Raigad Fort to commemorate the 345th death anniversary of Chhatrapati Shivaji Maharaj with Union Home Minister Amit Shah sharing the stage with Maharashtra’s top brass on the occasion. While Shah, Chief minister Devendra Fadnavis and Deputy CM Eknath Shinde made speeches, Pawar, the second Deputy CM, was pointedly not invited to speak, prompting many to view it as Amit Shah’s snub to Ajit Pawar.


Pawar later claimed he had chosen not to speak because the event had run late. Few were convinced. The order of speeches - Shinde, then Fadnavis, then Shah - left little doubt about who was granted legitimacy and who was made to wait. The fact that even BJP MP Udayanraje Bhosale, a descendant of Chhatrapati Shivaji, was allowed to speak before Pawar only reinforced the hierarchy. For those watching closely, the message from Shah and the BJP central leadership was clear: when it comes to allies, ideological loyalty trumps convenience.


That loyalty still resides with Shinde. Though his recent grumbles about delayed file clearances and lopsided fund distribution have exposed fault lines within the coalition, his version of the Shiv Sena remains an ideological sibling of the BJP. At a private meeting in Pune the night before the Raigad event, Shinde reportedly told Shah that files related to Shiv Sena-held departments were languishing in the finance ministry controlled by Ajit Pawar. The Shiv Sena, Shinde complained, was being treated as a junior partner.


Pawar has denied the allegations, insisting that cooperation within Mahayuti remains smooth. The BJP’s decision to exclude him from the dais at Raigad suggests that Delhi remains wary of Pawar, who split the undivided NCP led by his uncle Sharad Pawar.


That wariness may stem from Pawar’s proximity to his uncle Sharad, whom he joined later that same day at a meeting of the Rayat educational institution. While the younger Pawar insisted this was routine business, the optics - on the same day he was diplomatically iced out of a major state event - were telling.


In contrast, Shinde was in full political bloom at Raigad. He reaffirmed his cultural credentials, echoed the BJP’s historical narrative and aligned himself once again with Hindutva sentiment.


For now, the Mahayuti lumbers on, held together by electoral calculus rather than political chemistry. The Raigad incident proves that the BJP retains a soft spot for the ideologically aligned Shinde while Pawar, for all his administrative heft, still struggles for political acceptance.

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