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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.

Vacancies, Not Merit, Driving PG Admissions Policy

Anger over relaxed admission norms sparks nationwide backlash; the deeper structural failures demand scrutiny.

A large number of vacant seats in the third round of counselling for postgraduate medical admissions has pushed policymakers into a controversial corner. In a bid to fill these seats, the Medical Counselling Committee’s decision to sharply lower cut-offs has triggered widespread criticism from across the medical fraternity. The National Medical Commission (NMC) has publicly expressed its disapproval, professional associations of doctors have warned of serious consequences for patient care, and the matter has now reached the Supreme Court. Against this backdrop, a fundamental question confronts the Union government: will it prioritise the quality of medical education or dilute standards merely to fill vacant seats?


For the 2025–26 academic year, India has 80,291 postgraduate medical seats. Of the 31,215 seats available in the third round of counselling, as many as 17,623 remained vacant. In addition, 11,837 ‘virtual’ seats created due to upgradation also went unfilled, even after 135 new seats were added. Traditionally, postgraduate medical admissions have been intensely competitive. This year’s unprecedented vacancies, however, prompted the Medical Counselling Committee to relax eligibility norms for the third round.


As a result, the cut-off for the general category has been lowered from the 50th percentile to the 7th percentile, while for Scheduled Castes, Scheduled Tribes and Other Backward Classes it has been reduced to zero percentile — effectively allowing candidates with minus 40 marks to qualify. Given that the NEET-PG examination follows a negative marking system, even candidates with negative scores out of 800 can now become eligible for admission.


This decision is as startling as it is risky. Allowing candidates who have effectively failed the examination to enter postgraduate medical programmes raises serious concerns about academic standards and, more critically, about the quality of future patient care. Medical professionals across the country have flagged precisely this issue. The government must now decide whether it wishes to produce merely degree-holding doctors or invest in building a healthcare system strengthened by rigorously trained specialists.


The controversy also demands a more uncomfortable introspection: why did the system reach a point where such drastic dilution of cut-offs appeared necessary? The answer lies less with the students and more with structural deficiencies in medical education.


In the wake of the Covid-19 pandemic and the acute shortage of medical manpower it exposed, the Union government accelerated the expansion of medAical seats across the country. However, this expansion has not been matched by a commensurate investment in faculty strength and infrastructure


Maharashtra, often considered among the better-performing states, offers a telling example. Of its 25 government medical colleges, 10 have less than 50 per cent of the required teaching staff. At the newly established Ratnagiri Government Medical College, faculty availability stands at just 11.76 per cent of NMC norms, with not a single department having a professor. According to a report by the Maharashtra University of Health Sciences, not a single new teacher has been appointed across 25 medical colleges. The NMC has also issued show-cause notices to several states, including Tamil Nadu, over inadequate faculty strength.


Such shortages inevitably place an excessive burden on existing faculty, directly affecting the quality of training. If this is the condition at the undergraduate level, it is hardly surprising that students struggle to meet minimum benchmarks in postgraduate entrance examinations. When the source itself is depleted, the outcome is bound to reflect that deficit. Seen in this light, vacant postgraduate seats are not an aberration but a symptom of deeper systemic neglect — and a warning about how much quality has already been compromised in undergraduate medical education.

The issue is now under judicial scrutiny, with a public interest litigation challenging the relaxation of NEET-PG cut-offs. The petition argues that the very purpose of the exam — introduced to curb donation-based admissions and ensure merit-driven selection — has been undermined. Medical associations have echoed this concern, warning that short-term administrative fixes could have long-term consequences for healthcare delivery.


At stake is more than the fate of a single admission cycle. The government’s response will signal whether India intends to protect the integrity of postgraduate medical education and strengthen its healthcare workforce, or whether it is willing to trade standards for numbers. The future credibility of Indian medical education may well hinge on that choice.


(The writer is a senior journalist based in Kolhapur. Views personal.)

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