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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.

Ultramodern Times: Laughing at the Machine in the Age of AI

When my generation first watched Modern Times, we laughed easily. The scenes were funny, and the central character unforgettable. That character was the Tramp, a small man in an oversized coat, tight trousers, worn shoes, a bowler hat, and a thin walking stick. For many readers today, the Tramp may need a brief introduction. Charlie Chaplin created him to represent an ordinary person, poor, vulnerable, often confused, but never without dignity or hope. Yet beneath the laughter, we sensed a warning. You need not know the film; its images make the message easy to grasp.


In Modern Times, the Tramp becomes humanity itself, caught inside the machinery of industrial progress. He works on an assembly line, tightening bolts again and again as the speed keeps rising. His body starts moving like a machine. His hands keep turning imaginary nuts even after he steps away. He is pulled into giant gears, pushed along conveyor belts, and made to eat through a feeding device designed to remove lunch breaks. These scenes are genuinely funny, yet their meaning is serious. When efficiency becomes the only goal, people are treated like tools, not humans.


Human Cogs

The film was released in 1936, a time when factories and machines were celebrated across the world. Industrial growth was seen as success. Speed was praised. Productivity was admired almost without question. Chaplin did not deny that machines brought benefits. What he questioned was blind belief. Through humour rather than speeches, he asked a simple question. If progress harms health, dignity, and peace of mind, can we still call it progress?


For many of us who watched this film while growing up, Modern Times shaped our thinking. We admired science and technology, but we also learned to be careful. Chaplin showed that technology is never just about tools. It shapes how people work, live, and think. It can reduce physical labour, but it can also increase pressure and control. Chaplin did not reject machines. He warned us against letting systems set the terms of our lives.


One of his boldest choices was to keep the film mostly silent, even though sound films were already popular. This gave the story a universal quality. Without spoken words, the struggle was easy to understand anywhere. The machines were loud. The Tramp struggled silently. No explanation was needed.


Now imagine Chaplin alive today, deciding to make Ultramodern Times. The setting would no longer be a noisy factory full of gears and belts. The machines would be quieter, smaller, and often invisible. Yet their influence would be greater. The age of iron and steam would give way to the age of software, data, and artificial intelligence.


The modern Tramp might sit in front of several screens, eyes fixed, fingers moving without rest. Instead of tightening bolts, he would be clicking, scrolling, replying, and filling forms. Algorithms would decide how fast he must work, what tasks matter, and how his performance is scored. Notifications would replace factory whistles. Work would not end when he left the office. It would follow him home, into evenings.


Chaplin might show the Tramp proudly wearing a smartwatch. It would count steps, heartbeats, sleep hours, and productivity. The joke would be gentle but unsettling. The device promises control, yet the Tramp becomes anxious when the numbers do not look right. He stops listening to his body. He listens to data instead. Control is no longer enforced by steel, but by dashboards, ratings, and alerts.


Synthetic Thought

A classroom would likely appear in this ultramodern film. Students would stare at tablets and laptops while a teacher struggles to hold attention. Information would be everywhere, instantly available through digital tools and AI assistants, but understanding would be thin. Attendance would be perfect, recorded automatically, yet curiosity would be missing.


Artificial intelligence would offer Chaplin rich material for humour. The Tramp might receive perfectly written reports generated in seconds, while he struggles to write a single honest paragraph. Speed would defeat reflection. Polished language would replace original thought. The audience would laugh, then pause. What do we gain when machines help us write, and what do we lose if we stop practising thinking?


Social media would appear as another invisible factory. Chaplin might show crowds more interested in photographing themselves than observing the world. The Tramp could do a real act of kindness that goes unnoticed because no camera records it. A staged gesture, however, would earn applause, likes, and brief fame. When visibility matters more than value, behaviour changes.


Automation and jobs would remain central themes. The Tramp might carefully train an AI system to do his work. He would feel proud of helping progress. Then he would discover that the system has replaced him. The humour would lie in his confusion. He followed the rules. He embraced efficiency. Yet efficiency had no place for him afterward.


Still, Chaplin would not end Ultramodern Times in despair. Modern Times did not do that either. Even when everything goes wrong, the Tramp walks forward, hopeful, beside his companion. Chaplin believed that creativity, empathy, and humour cannot be automated or coded.


This belief remains his greatest lesson for the age of AI. Technology moves in sudden leaps. Humanity moves slowly. When the two fall out of balance, problems appear. Chaplin showed this gap without preaching, trusting laughter to carry the truth.


Nearly a century later, Modern Times remains a mirror. The machines have changed. The questions have not. Does technology make life better, or only faster? Does efficiency improve well-being, or just output? Are we using intelligent machines, or are they quietly shaping us?


Chaplin reminds us that progress has meaning only when it improves human life. Machines may become faster, smarter, and more powerful, but they cannot decide what is right or worthwhile. That responsibility remains with people. The real danger lies not in AI itself, but in letting technology race ahead without human judgment, care and balance.


(The author is an ANRF Prime Minister Professor at COEP Technological University, Pune; former Director of the Agharkar Research Institute, Pune; and former Visiting Professor at IIT Bombay. Views personal.)

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