Why Indian governance needs to decouple public health from bureaucracy
I have some of the best friends of the Karnataka bureaucracy, the nation’s capital, and those who fly our flags around the world. I admire them and have tender affection for them. The bureaucracy sustains the strong complex of loud politics and delivers results in spite of itself, even if at times at a snail’s pace, it does a good job overall.
However, I also believe that public health is too important a problem to be handled by Indian administrative services. Covid-19 has exposed the hiccups the civil service has fallen on, in large part because the nation is run by a bureaucracy that is untrained in public health.
I would roughly recommend a three-pronged solution to this problem. Be careful, it will get worse from here–beyond Covid-19–and the IAS will not be able to keep custody. India faces cascading risk resulting from natural disasters, extreme weather events, climate change and future pandemics. The consequences of this nature on public health will go beyond the comprehension of bureaucracy.
Give it a thought–a bureaucrat moving from one department to another can only understand this. A transport secretary moves to become the finance secretary, then to women and children or as the secretary to the business manager. How can you establish competence and creativity? This amounts to a jack-of-all-trades model of nothing.
Here is what we need to do:
Create side entrances in the Ministry of “ Public Health ”
Identifying new and emerging talents, voices and thoughts rather than sticking to old guards will inject new energy into the national veins. Swami Vivekananda had emphasized the need to engage new and fresh talents and to have the ability and wisdom to listen to them. His teachings then are valid today. Do we have the ability and the humility to listen? Only time can tell.
You might be the best captain on the ship, but in a tsunami you will always lose the battle on the coasts. There are too many good agents in the IAS system, but they may not be well equipped to handle public health issues–a prerogative of public health professionals.
Therefore, it is now very necessary to bring in competent public health secretaries from the government or a deputy secretary from the department or ministry.
Standing Committee on Public Health
The judiciary should order the state and central government to create a permanent commission for public health, where commission members have a three-year term and tangible results to meet.
Alternatively, visionary governments of the day can put this in place and champion community development in a structured way by integrating public health into all policies through the standing committee. This is a small investment that will yield 100 times the rewards over the years. After all, life is all about planting trees in the shade of which we can never sit. Right?
Bring back Indian medical services
I mentioned this many years ago and a video to this effect remains on my YouTube channel. But I would like to reiterate it to break us from the lethargy that drives us. Bring back the Indian medical services that existed in British India and let all district health offices and the Department of Health be defended by such cadres.
If, after decades of midday meal programs, we still haven’t eradicated malnutrition, it’s not a flaw in the stars, but glaring flaws in our approach, strategy and persuasion to innovate. and dissociate the clutches of caste and oppression. who still reigns supreme.
If the maternity policy is killing mothers today, it is a public health problem. If years of development are wiped out by disaster, it is a public health problem. For this and more, we must act now.
Train new recruits at the IAS in specialized executives
Civil servants come from different backgrounds. It is a celebration of diversity and democracy at the highest level. What we need to do is help them select the sectors of their choice, which have a ministerial supervisory value, and train, strengthen skills and have two or three departments where they are rotated for lack of importance. natural administrative. Imagine, if I received as a doctor the Ministry of Textile or Finance, what would I do? Imagine also a mechanical engineer turned public servant who now heads the ministry of health or of women and children. The answer lies in the questions I raised.
These initiatives, if taken with the utmost seriousness, will put India on the right track and secure the generations to come after us. The time for implementation has come.
The author is a community health physician and CEO of CHD Group