I have some of the finest friends in the bureaucracy across Karnataka and at the national capital and those flying our flags around the world. I admire them and have a fond affection for them. While we all at large must be grateful to them for holding the complex fort of our noisy politics and yet delivering results, albeit snail-paced at times, the bureaucracy has done a good job.
However, I also feel public health is too large a problem to be managed by the Indian Administrative Services. COVID-19 has exposed the hiccups that the civil service has stumbled upon, much because the nation is run by bureaucracy not trained in public health and by politically close doctors of all disciplines other than community medicine and public health qualifications. I would recommend in broad strokes a three-pronged solution to this problem. Mind you this is going to get worse from here and the Indian Administrative Service will not be able to hold guard. India faces a cascading risk emerging from natural disasters, extreme weather events, climate change, pandemic of futuristic importance and the public health consequences of this nature will be beyond comprehension of the bureaucracy.
Give it a thought, a bureaucrat who moves from department to department can only grasp as much as you and I can. A secretary in shipping, moves as secretary to finance and then as women and child or as Secretary to the top boss. How can you establish competency and creativity? A jack of all trades, but master of none model ! Here’s what we must do:
Create lateral entries in the Ministry of “Public Health”
Identifying new and emerging talent, voices and thoughts than sticking to old guards will inject fresh energy into the national veins. Swami Vivekananda had stressed upon the need to engage new and fresh talent and have the ability and wisdom to listen to them. His teachings back then, hold good today. Do we have the ability and humility to listen? Only time can tell.
You may be the best captain of the ship, but in a tsunami you will still lose the battle to the shores. There are too many good officers in the IAS system, but they may not be able to handle public health problems which remains the prerogative of public health professionals.
Therefore bringing in public health competent Secretaries to Government / Joint Secretary to the department or Ministry is much necessary now.
Permanent commission for public health
Since everyone wants to have a share in the pie, I would like to float an independent idea to the Hon’ble High Court and Hon’ble Supreme Court to direct the state and central government to establish a permanent commission for public health where members to the commission will have a 3-year term and tangible outcomes to meet. If a detailed note is necessary to this idea, I am happy to provide it to the Courts.
Alternately, visionary governments of the day can set this up and champion community development in a structured manner by bringing public health in all policies through the permanent commission. This is a small investment that will reap 100X rewards over the years. After all, life is all about planting trees under whose shade we may never sit. Right?
Bringing back Indian Medical Services
I spoke about this many years ago and a video to this effect remains on my YouTube channel. But I would like to re-enforce this lethargy that drives us. Bring back Indian Medical Services which existed in British India and let all District Health Offices and Ministry of Health be championed by such cadres. If after decades of mid-meal programmes, we still haven’t eradicated malnutrition, it is not a fault in the stars, but the glaring fault-lines of our approach, strategy and persuasion to innovate and de-link clutches of caste and oppression that still reigns supreme. If politics of motherhood kills mothers today, it is a public health problem. If years of development get wiped out with a disaster, it is a public health problem. For this and much more, we need to act.
Train new recruits to IAS into specialized cadres
Civil servants come in from different backgrounds. This is the celebration of diversity and democracy at the highest levels. What we must do is to help them to select their sectors of their choice, which have line ministerial value and train them into only such a stream. Build their competence and have 2-3 departments only where they will be rotated for want of natural administrative importance. Imagine, if I as a doctor are to be given Ministry of Textiles or Ministry of Finance, what would I do? Also imagine a Mechanical Engineer turned civil servant now running Ministry of Health or Ministry of Women and Child? The answer lies in the questions I raised. These initiatives if pursued with utmost seriousness, will set India rolling on the right path and secure generations that will come after us. The time to implement is now.