Video Posted on
A CBSE official suspended, two school teachers and a private tutor arrested in the CBSE paper leak scandal that has left lakhs of students worried and confused. On this episode of We The People, we ask: are these stopgap measures enough to rid the system of its inefficacies or are such leaks mere symptoms of larger problems plaguing India’s education system? Is India’s exam-centric education system that puts such high premium on marks at the root of the problem at hand?
Video Posted on
Union Cabinet clears the Government’s ambitious healthcare scheme ‘Ayushman Bharat’ which aims to provide health cover worth 5 lakh rupees to 10 crore poor families every year. The scheme will have a central budgetary support of 85,000 crore till March 2020. Here’s what Vinod Paul, Member of NITI Aayog and architect of the scheme, had to say. Sujatha Rao, Former Secretary, Health and Shailaja Chandra, Former Secretary, AYUSH also react.
TSR Subramanian will be remembered for spearheading a PIL known as TSR Subramanian and Ors vs Union of India when the Supreme Court concluded that ‘fixed tenure of bureaucrats will promote professionalism, efficiency and good governance’
Shailaja Chandra | Updated: Feb 27, 2018 11:16 IST
Why will TSR Subramanian, TSR as he was always known, be remembered? Certainly he was a respected cabinet secretary and one who managed the functioning of government during the turbulent coalition years of the late nineties but maintained equanimity while remaining honest and outspoken.
He will also be remembered for lifting the veil on the inner working of politicians and civil servants through a series of readable books and scathing opinion pieces.
More recently he will be remembered for spearheading a PIL known as TSR Subramanian and Ors vs Union of India when the Supreme Court concluded that “fixed tenure of bureaucrats will promote professionalism, efficiency and good governance” and attributed “much of the deterioration in the functioning of bureaucracy to political interference.” On national TV, he did not hedge around when he found a chief minister or a government treating a bureaucrat unfairly and came down heavily regardless of who might get annoyed. Indeed all these qualities endeared him to the civil services which is why officers feel the loss.
But there was something more and that bears a telling as we bid him good bye.
On a personal note, I came to know the man for some six months in 2015-16 when he chaired the committee for the evolution of the new education policy — a report that never saw the light of day, — and which TSR, I believe, saw as his greatest failure. Because I witnessed what he brought to the table in conducting this mammoth exercise it bears a telling.
The first was the incredible way in which he managed to pull together four retired have-beens with nothing in common — be it education, service experience or vision.
Listening to over 200 presentations from state governments, educationists, NGOs, academics and individuals and cutting short nonsense but equally responding with passion to revelations which went to the root of the problem was quintessential TSR.
Funnelling each sub-sector’s deficiency into a sharp, situation analysis and making practical recommendations is what he hammered out with speed, dexterity, accuracy and zeal to do what was right — not what people wanted to hear.
During this period, he suffered from a serious health problem which would have grounded anyone with less tenacity and determination.
A stroke and it’s aftermath notwithstanding, he was back in the office in just a few weeks — ebullient as ever — raring to make up for lost time.
His commitment to combining pre-school education with primary education in the interest of giving opportunities otherwise denied to poor children was boundless.
His belief that many institutions of so called importance had outlived their utility and were clearly white elephants won him many enemies who must be now having the last laugh.But to them and to all who read this today I will say, “ It is better to have tried and lost than never to have tried at all.”
(The writer is former secretary to the Government of India, and former chief secretary, Delhi.)
The midnight drama at the Delhi chief minister’s house, wherein the chief secretary (CS) was reportedly roughed up by two MLAs in the CM’s presence is a first in the annals of the civil service. One has heard of humiliation of officers, but seldom involving the chief secretary. The CS is not an ordinary bureaucrat. He is the head of the civil administration in the state or union territory, an officer who represents not just his own service but all services within the civil administration. The buck stops with him no matter which department is involved. His word in sorting out contending arguments and dissension among officers is final.
Much more than, say, a secretary to the Government of India, the CS has to show leadership while overseeing that public interest is preserved in letter and spirit. It is his duty to run an efficient administration and give the CM fair and impartial advice. It is not for nothing that the CS has a commanding presence in the administration.
Because there can be no democracy and participatory governance without the rule of law, the authority to administer has to be integral to governance. Which is why the symbols of authority are given to every CS, in states and UTs. In Delhi, the CS has an even more challenging role — he has to report simultaneously to the CM and the lieutenant governor (LG) and walk a tightrope between the vision and concerns of both, even when they are not always on the same page.
To do this every day is not easy, but because of the immense authority vested in the CS to organise and get things done, it is not impossible either. But it will work only as long as both the CM and the LG understand and respect the role of the CS. If that is whittled down, the tremors will be felt across the services. An insult to the CS is seen as an insult to the official brotherhood.
Delhi is different in many ways. In the states, the CS is invariably the choice of the CM and there is understanding and mutual trust between them. If the CS is unbending or difficult, it is easy to make a change quietly and elegantly. In the UT cadre or the AGMUT cadre as it is officially known, that is not so. By and large, the Ministry of Home Affairs (MHA), the authority controlling the cadre serving the NCT of Delhi as well as Goa, Arunachal Pradesh, Mizoram, Daman and Diu, Puducherry, Chandigarh and the Andaman and Nicobar administration, does not stand in the way of the CM having a CS of his choice. Having said that, the officer knows his career is largely to be decided by the MHA and not by the CM of Delhi or elsewhere.
Therefore, it is not necessary for the CS to always find a way to meet the demands of the CM, which is a point of difference with other state cadres. CMs recognise this and make the best use of what they have been given.
Even so, anyone who becomes a CS hasn’t reached the position to pick fights or cause obstruction. Successful projects bring their own sense of achievement and leading a team of officers and staff, including doctors, engineers, teachers, inspectors and clerks, brings its own zeal to succeed. So no CS would thwart good ideas which are in public interest out of pique or just to score brownie points with the central government. On the contrary, an achievement is as much recognised as the effort of a chief secretary’s leadership as of the political executive.
Sheila Dikshit and then LG of Delhi, Vijai Kapoor — one a Congress CM and the other an appointee of the NDA government — succeeded in bringing the unit area of house tax, the new Cooperative Societies Act, construction of 42 flyovers and privatisation of the power sector despite standoffs and differences. The system, then and now, is far from ideal. But in whatever way you look at it, Delhi will continue to be the seat of the central government unless the capital of the country is relocated.
Until that happens, the NCT of Delhi will be governed in the truncated manner. But the beauty lies in the fact that if there is a will to function, it is possible for right-minded people to work together.
That brings one to the midnight altercation or assault, depending on whose version gets established. If the CS was called at midnight, it should have been a matter of criticality — something which could not wait. One cannot imagine that the release of an advertisement or rations to poor people, howsoever important, could not have waited till the following morning.
It is most unusual for a CS to be summoned, and that too repeatedly, without an agenda. Indeed if there was an agenda, the CS should have taken the senior-most officer dealing with the subject with him. That he went alone adds to the impression that this was an agenda-less meeting in the presence of 11 MLAs and perhaps, an effort to overawe the officer, a reprehensible tactic certainly.
Chaos and bedlam at the top will shake the load-bearing pillars — the political executive and bureaucracy — on which the edifice of governance rests. The two pillars need to hold the structure together, or else one would develop cracks and bring the other down with it or lead to a go-slow which would prevent doing things that matter the most. And that includes all the services that one expects a government to deliver efficiently and prudently. It is an administrative breakdown that must be quelled for the sake of the citizens of Delhi.
The writer is former chief secretary, Delhi.
Why is IMA protesting against the proposed National Medical Commission bill. Here’s a special debate with IMA President Ravi Wankhedkar & Former Health officials.
The National Medical Commission Bill 2017, well-intentioned and forward-looking, has unfortunately stirred a hornet’s nest. It has brought to the fore a disturbing aspect of an ongoing controversy — the activities of medical lobbies that have persistently thwarted efforts to put consumer interest above their own. Parliament needs to face some unsavoury facts.
Two lobbies are at work backing the professional interests of the allopathic community on the one hand and AYUSH practitioners (mainly ayurveda, unani and homoeopathy physicians) on the other. There are some 10.4 lakh private medical establishments with hospitals accounting for under 8 per cent of them. Most are lone practitioners running small nursing homes and clinics. Most do not possess a medical qualification. A 2016 WHO study has brought out that only 58 per cent of urban doctors had a medical degree and only 19 per cent in rural areas. Only 31.4 per cent of allopathic doctors were educated to the secondary school level and 57.3 per cent did not have any medical qualification. NSSO reports show how barring the metros and large cities, there are more unqualified practitioners than regular doctors.
The interests of all allopathic doctors, regardless of their competence, are looked after by the Indian Medical Association (IMA), a voluntary registered society with state chapters which register doctors as members and lobby with the government, resorting to agitations and strikes whenever doctors’ interests are affected. An all-India membership of over two lakh gives the IMA immense clout so that most chief ministers and even the Union health ministry avoid confrontation.
Many of the IMA’s members are single practitioners and they run their clinics with the assistance of young school dropouts engaged as helpers. They train them to handle acute illnesses and treat acute medical conditions with antibiotics, IV fluids and steroid injections. Once sufficiently skilled, these assistants set up independent practice using the prefix “doctor”. They run a lucrative business charging a fraction of a qualified doctor’s fees. When patients do not respond to treatment, they refer them to a known qualified medical practitioner who remunerates them with a 30 per cent commission.
The IMA and the Medical Council of India, both at the apex level and in their state units, are aware of what is happening. While their public position is that quackery must be stopped, covertly, both organisations look the other way. The nexus between the unqualified practitioners or RMPs (Rural not-Registered medical practitioner) is apparent from the virtual absence of action against thousands of quacks. The IMA, instead, targets ayurveda, unani and homoeopathy practitioners who hive off their business. Since RMPs are part of the business and generate referrals, action — when taken — is perfunctory.
The National Medical Commission Bill 2017 and for that matter the National Health Policy 2016 overlook this countrywide phenomenon altogether. Under law, the Medical Council of India and the state medical councils are enjoined to take action against those who practise allopathic medicine without being enrolled on the allopathic medical register. As consumer safety is at stake, this is a serious omission from a bill which seeks to replace the medical council.
The practitioners of Indian medicine also constitute another powerful lobby. The National Integrated Medical Association (NIMA) lobbies forcefully in favour of “ integrated practice”. At two national events, the prime minister publicly stated that ayurveda practitioners practise modern medicine and very few use traditional medicine. Even his observation does not seem to have had the required impact.
While the propagation of traditional medicine is publicly pursued with passion, the preponderance of treating with modern medicine is ignored. Authentic ayurveda is now confined to Kerala and western Maharashtra, other than a few government-run universities and colleges in different states. In North India, it is difficult to find even 10 practitioners of pure ayurveda excluding doctors employed by government establishments and colleges.
The development and propagation of the ayurveda system is left to a handful of committed researchers and faculty members in institutions like the Banaras Hindu University, Gujarat Ayurvedic University and Arya Vaidya Sala at Kottakkal and Amrita Vishwa Vidyapeetham in Kerala. The faculty in these institutions is worried. “If AYUSH graduates are allowed to practise allopathy, where does the status and the future of ayurveda stand? They should not be allowed to practise allopathy as otherwise the AYUSH systems will die,” lamented all faculty members I spoke to.
The new Bill must take stock of and address what the country actually needs. The first need is for thousands of community-level accredited practitioners — not full-fledged doctors — who after training should be equipped to provide the first line of care for acute conditions and to make referrals to a regular doctor within a GPS-supervised system. The realisation that neither allopathic nor AYUSH doctors will ever go to lakhs of villages — not even tehsils — must dawn on policymakers. That is precisely why a new system of community-based trained health workers (not government employees) who are enrolled on the state medical register is needed. This can only be done if the medical education law provides for it.
Second, the new Bill should promote integrative medicine enabling people to access multiple choices but available under one roof, particularly for chronic conditions or even as adjuvant therapy. The developed world has recognised that with an increase in life expectancy, chronic diseases, allergic syndromes and rare medical conditions cannot be cured — but the symptoms can be mitigated through traditional medicine. A quest for bridge courses to learn ayurveda has already begun in different countries. The new Bill should recognise the scope for integrative medicine but without mixing medical systems and practitioners.
Citizens are agitated over the mismanagement of both publicly-run and private medical education establishments. The government has done well to bring forward new legislation to replace the medical council. But unless the Bill confronts reality and addresses it, keeping consumer interest paramount, the new law will make little difference to people’s lives. The parliamentary standing committee has an opportunity to make a difference, if it shuns the rhetoric of self-interest professional groups and confronts reality.
The writer is former secretary, Department of AYUSH, government of India, and former chief secretary, government of Delhi.