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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.

Trouble in the House of Shinawatra

Thailand’s youngest prime minister stumbles as scandal, street protests and economic woes collide.

Thailand’s youngest and second-ever female prime minister, Paetongtarn Shinawatra, has found herself at the heart of a familiar storm: scandal, instability, and whispers of yet another coup. Just a year into her historic premiership, the 38-year-old scion of Thailand’s most polarising political dynasty has been suspended from office following the leak of a phone conversation with Cambodian strongman Hun Sen. The conversation, reportedly centred around a long-simmering border dispute, was explosive not for what was said but how it was said.


In the leaked clip, Paetongtarn appears to take a conciliatory tone on the cross-border tensions, which flared into deadly clashes in May, leaving at least one Cambodian soldier dead. That she referred to Hun Sen as “uncle” and called a senior Thai military commander her “opponent” only added fuel to the fire. Critics have accused her of betraying national interests; protesters have taken to the streets of Bangkok in droves. Her coalition, once touted as a phoenix-like return of the Shinawatra machine, has begun to crack. The defection of Deputy Prime Minister Suriya Jungrungreangkit, now acting as interim leader, is a blow that may prove fatal.


Few families have loomed as large over a democracy as the Shinawatras have over Thailand. The dynasty began with Thaksin, Paetongtarn’s father, a billionaire telecom tycoon who became prime minister in 2001 and governed with populist flair until he was ousted in a military coup in 2006. Since then, the family has remained both omnipresent and embattled. Thaksin’s brother-in-law briefly became prime minister in 2008, followed by his sister Yingluck, who met the same fate as Thaksin: deposed by the military in 2014. In 2023, Paetongtarn led the Pheu Thai party’s election campaign while heavily pregnant, only to fall short at the ballot box. But after the removal of Prime Minister Srettha Thavisin by Thailand’s Constitutional Court in August 2024, she was anointed by the ruling coalition as the compromise candidate. Her premiership, ratified in Parliament without contest, marked a generational handover - but one laced with peril.


Paetongtarn, or Ung Ing as she is affectionately known, was groomed for power in the shadows of Thai politics. At eight, she followed her father into foreign ministry corridors. At 20, she sheltered with her family in a safe house during the 2006 coup. Two years later, she watched her father flee into exile. But if these traumas left scars, they also instilled steel. Educated in Thailand and Britain, she worked in the family’s business empire before plunging into politics in 2021.


But the once-iron grip of the Shinawatra clan on rural and working-class voters has slackened. The 2023 general election marked the first time in over two decades that their party failed to dominate. In power, Paetongtarn has struggled to assert herself amid factionalism, elite suspicion, and rising public discontent. Her signature policy - a much-hyped digital wallet scheme to inject stimulus via cash handouts - remains undelivered. Meanwhile, the country’s economic woes have only deepened.


The SET stock index has plunged over 20 percent this year alone. Foreign investment is now fleeing in response to political instability and unresolved trade disputes. A volatile border and diplomatic faux pas with Cambodia will hardly help. Analysts worry that critical negotiations with the United States on tariffs and investment could be derailed. Businesses are in limbo. The public is losing patience.


The political arithmetic is no more encouraging. Paetongtarn’s suspension by the Constitutional Court has triggered a 15-day window during which the court will decide whether to dismiss her permanently. A no-confidence motion looms in Parliament. If it passes, it could precipitate an early election or a cabinet reshuffle that further sidelines the Shinawatras. The military, though officially aloof, is watching. Thailand has seen a dozen successful coups since 1932. In a country where uniforms often trump ballots, the risk of another is never far off.


What makes Paetongtarn’s position especially precarious is not just her youth, or even the dynasty she embodies, but the toxic polarisation of Thai politics. Royalists, old-guard generals, and conservative elites have long viewed the Shinawatras as interlopers, manipulating democracy to serve populist ends. Meanwhile, her supporters see her as the best hope for modernising the country and ending the cycle of coups and court interventions. But neither camp is ascendant today.


As Thailand edges closer to the precipice, Paetongtarn faces a brutal lesson: in Thai politics, it is not enough to inherit a name. One must also survive it.

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