There is a particular kind of institutional decision that reveals itself not with a bang but with an eerie, unsettling silence – the silence of radiology reporting of CT scans that pile up unread, of clinicians left to diagnose in the dark. That silence has now descended upon dozens of Government health institutions across J&K, following the National Health Mission’s abrupt decision to discontinue tele-radiology services with immediate effect. The facts of the matter are damning in their simplicity. The contract with Krasnaa Diagnostics Limited – which had for years provided remote radiology reporting across 77 health institutions, compensating for the chronic shortage of specialist radiologists – expired in June 2025. Ten months elapsed. No fresh tender was finalised. No alternative arrangement was secured. And then, on 20th April, the directive arrived: discontinue services with immediate effect. The result is a diagnostic vacuum that now imperils emergency and trauma patients across sub-district hospitals, community health centres and district hospitals alike, with those in remote, underserved areas bearing the heaviest burden.
Radiology is not a peripheral convenience in modern medicine. From detecting a cerebral haemorrhage to identifying a fractured spine, from diagnosing pneumonia to staging a malignancy, imaging reports are integral to almost every pathway of treatment. To disrupt them is a risk to lives. In an era when no responsible health system would countenance such a gap, allowing one to arise through sheer administrative inertia is indefensible. The absence of foresight at the Directorate level is particularly troubling. Procuring services through a competitive tendering process takes time – a fact that any competent administrator must account for. Yet it appears that no parallel process was initiated during the ten months the contract lay lapsed. With no transition plan, no interim provider and no safety net for patients, it is a systemic failure of planning and accountability. When patients are left without critical diagnostic reports, the authority responsible must answer for it.
The remedy is clear and must be implemented without further delay. Pending the finalisation of a fresh rate contract, tele-radiology services must be immediately restored – whether through a temporary extension with the existing provider or an emergency interim arrangement. The process for fresh tendering must be fast-tracked. Above all, the authorities must internalise a principle that ought never to require stating: patient welfare is not a line item to be suspended during administrative transitions. Unilateral decisions must be avoided.
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