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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.

Dangerous Departures

Updated: Oct 30, 2024

Dangerous Departures

In yet another shocking incident adding to Mumbai’s infamous tryst with stampedes, chaos erupted at Mumbai’s Bandra Terminus following a weekend stampede that left at least ten persons injured, two critically so. A crowd surged toward the Gorakhpur-bound train with nearly 1,500 people vying for seats in 22 unreserved compartments, leading to the stampede. Several others narrowly avoided tragedy, with some even pushed onto the tracks. This is not a unique episode but rather a recurring theme in Mumbai’s bedevilled crowd management, one that has haunted the city’s public spaces, particularly as festive seasons magnify the crowds.


Mumbai is no stranger to stampedes. A horrifying incident in 2017 at Elphinstone Road Station left 23 people dead and nearly 50 injured. The cause was a familiar one: an overwhelming crowd confined to a narrow footbridge during peak rush hour. The tragedy sparked an outcry, with promises from authorities to upgrade infrastructure and enhance safety protocols. Yet seven years on, crowd-related incidents continue to be a constant danger. Today’s incident reveals a similar lapse—a lack of foresight in managing the thousands who gather on platforms ahead of Diwali, eager to return to family. That the Gorakhpur Express was unreserved and heavily crowded was predictable.


The issue lies beyond simply crowd density; it is emblematic of deeper systemic negligence. The Brihanmumbai Municipal Corporation (BMC), responsible for local public safety, along with the Railways Ministry, bear responsibility for ensuring order at such high-risk hubs. Although the BMC acknowledged the “festive rush,” it appears little was done to pre-empt it. Swift action could have been taken to either disperse the crowd or reroute passengers. Instead, chaos prevailed.


Political reaction has been swift but uninspiring. Aaditya Thackeray, son of Uddhav Thackeray, launched a scathing attack on the Union Railways Minister, Ashwini Vaishnaw, branding the incident a result of the minister’s “incapable” leadership. This hardly addresses the immediate need: a substantive plan to manage crowds and prevent similar incidents.


Mumbai’s transport infrastructure remains sorely outdated. Platforms are undersized, signalling systems frequently falter, and crowd control mechanisms are grossly inadequate. Despite repeated accidents, there has been little investment in comprehensive crowd management systems or the deployment of personnel trained in emergency response. While railway footbridges were widened after the Elphinstone tragedy, Bandra’s incident demonstrates that such incremental changes are insufficient. Mumbai, which sees a swelling populace during festivals, demands a robust strategy to address its vulnerabilities. This should include technology-driven crowd monitoring, clear communication channels to inform passengers of platform conditions, and additional security and medical staff on high-demand days. It is essential that crowd management training for personnel becomes a priority rather than a reaction to tragedies.

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