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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.

Stop the Hysteria, Start Listening

Updated: Feb 25, 2025

The German election results have shown that branding every populist movement as ‘fascist’ is lazy, self-defeating and untrue.

Friedrich Merz
Friedrich Merz

Germany’s latest election result may have sent shockwaves through the ‘left liberal’ political establishment, but was hardly surprising to anyone with any modicum of common sense. Olaf Scholz’s Social Democrats (SPD) collapsed to their worst postwar performance, securing a meagre 16 percent of the vote. Friedrich Merz’s conservative CDU/CSU emerged victorious with 28.6 percent putting him on course to become the next Chancellor. But it was the second-place Alternative for Germany (AfD), with an unprecedented 20 percent, that truly rattled the political and media classes.


Predictably, the reaction was alarmist. Protesters flooded the streets, and Scholz himself called the result “bitter,” an acknowledgment of his own party’s failure but also a not-so-subtle condemnation of the electorate. Liberal commentators quickly reached for their favourite historical parallel: “the return of fascism.” But is this truly what is happening? Or is the AfD’s rise a sign of something far more mundane - an electorate frustrated with a government that has ignored its concerns for too long?


The AfD is routinely cast as a neo-Nazi party, a charge that both its leadership and many of its voters reject. While it is undoubtedly nationalist, conservative and at times inflammatory, to conflate it with the Nazi Party of the 1930s is intellectually dishonest and historically ignorant. The lazy tendency to brand any right-wing movement as “fascist” is not only a rhetorical overreach but also a dangerous one.


For much of the postwar era, Germany’s political class successfully maintained a rigid cordon sanitaire against the far-right. But that strategy only works if the mainstream parties actually address voters’ anxieties. The AfD’s rise is not due to some latent German desire to resurrect the Reich, but rather to legitimate concerns about immigration, economic insecurity and the erosion of national identity. In vast swathes of the former East Germany, where state neglect has bred resentment, the party now commands over 30 percent of the vote.


Many of its supporters do not see themselves as radicals but as ordinary Germans abandoned by a political elite obsessed with abstract ideals rather than everyday realities. Their grievances about crime, integration and economic stagnation are dismissed as bigoted or backwards. The Left’s answer to their discontent is to call them ‘Nazis.’ That’s not just wrong; it’s counterproductive.


The SPD’s catastrophic defeat is emblematic of a broader trend across Europe, where centre-left parties are losing touch with their traditional base. Once the champions of workers and the middle class, they have become preoccupied with progressive social issues that resonate in university seminar rooms but not in working-class neighbourhoods.


Scholz, much like his counterparts in France, Britain and the United States, underestimated the depth of public frustration with mass migration and economic stagnation. His government’s handling of both issues was widely seen as incompetent, and his party paid the price. Meanwhile, the CDU/CSU, despite winning, finds itself at an ideological crossroads. Merz insists he will never govern alongside the AfD, yet his own policies, especially his hardline stance on immigration, overlap significantly with theirs. That reality is unlikely to change, no matter how loudly the political establishment protests.


Germany is not an anomaly. Across the West, right-wing populist movements are making electoral gains, not because of some grand resurgence of fascism, but because liberal democracies are failing to respond to the needs of their citizens. Whether it’s Giorgia Meloni in Italy, Marine Le Pen in France or Donald Trump in the United States, the pattern is the same: voters are rejecting parties that prioritize ideology over pragmatism.


Trump himself was quick to congratulate the CDU’s victory, while drawing parallels to his own movement. In a post on Truth Social, he framed the German election as a rejection of “a lack of common sense agenda,” particularly on energy and immigration.


Across Germany, the AfD capitalized on widespread frustration with energy policies that have left citizens with soaring utility bills and an immigration system that feels increasingly out of control. It is easy to dismiss this discontent as xenophobic or irrational. It is much harder to confront the reality that mainstream parties have done little to address the underlying causes of voter anger.


Branding the AfD and its voters as ‘fascists’ might make some feel morally superior, but it does nothing to solve the problems that led to their rise. If anything, it ensures that they will only grow stronger.

1 Comment


Srinivasan S
Srinivasan S
Mar 03, 2025

The world is sharply turning right. India, France, US and now Germany. The reasons may be too complicated to understand because there are numerous forces acting on world politics. France wants immigrants to leave. Indians want a Hindu Rashtra. US has MAGA issues. There is a vein of neo-Nazism flowing in Germany. It is difficult to put a finger on a single reason for this trend. Economics alone cannot be blamed for the rise of the right wing in Germany and elsewhere. Autocracy seems to be the flavor. The tectonic shift in geopolitics is leading to tremors in the world order. Interesting months ahead for academicians like me.

Good article.

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