Need for Decentralised Management

LG Manoj Sinha is a well-meaning person who, as head of the state administration, wants to take people-friendly measures and confront various issues head-on rather than brushing them under the carpet. A number of measures announced by him under the SACAM (Saksham) scheme to ameliorate the people’s sufferings due to the pandemic have received widespread appreciation. The affected categories are eagerly awaiting the executive orders to implement the various welfare measures. It is hoped that adequate application of mind will be ensured so that the executive orders do not leave any ambiguities and immediate benefit can be given to the desired beneficiaries.

 

Despite the Government’s best efforts to successfully fight the pandemic; there is widespread criticism of the management of pandemic and large mortality rates, particularly in the Jammu region. There are complaints of lack of requisite facilities and lack of medical care of the patients. Unfortunately, the Health & Medical Education (H&ME) Department, the nodal department for the fight against Covid has failed to live up to the people’s expectations. Starting from preparing for the phase two to management of covid facilities, provision of necessary equipment and infrastructure and patient care, there have been mistakes galore. It has happened despite no change at the helms of affairs of the department for nearly three years, providing much-needed continuity. There is no denying the fact that to err is human. But repeated erring requires investigation and intervention because it cannot be allowed to become a habit.

 

The list is long, which is why there is a growing public demand for the audit of the H&ME Department. Numerous articles in the media and debates in social media have questioned and raised fingers on the functioning of the department. The list includes non-payment to the firm contracted for installation and maintenance of ventilators, failing to implement High Court orders regarding regularization of employees, timely purchase and installation of oxygen plants, ignoring deficiency of trained manpower, favouritism, utilizing the services of MOs and specialists on administrative duties when there is a hue and cry about the shortage of doctors, Adhoc recruitment for DRDO hospitals and failure to ensure the visit of senior doctors to the Covid wards.

 

Many decisions indicate a lack of strategic thinking, professional analysis and a short-sighted approach. In all fairness, the Government decisions under question may have been taken in good faith and in the public interest. However, drawing benefit from hindsight, it appears that the decisions would have proved more beneficial if the detailed analysis would have been done of the expenditure involved in these decisions and better utilization of that amount under the prevailing circumstances.

 

The Government has decided to extend the service of all retiring medicos from May onwards till December 2021. If the normal routine had continued, about 50 senior doctors on the cusp of their sixties and drawing an approximate monthly salary of 2.5 lakh would have retired. Most of these senior doctors who have been retained in service also suffer from co-morbidities and hence avoid visiting Covid wards. This is evident from the directive issued by the Financial Commissioner H&ME to the Principal GMC and the duty rosters issued by her. Despite that, the usual complaints of senior doctors not visiting the Covid patients continue to surge. The Government would incur a total expenditure of nearly 7.5 crores for the retention of these doctors. However, their retention is not contributing towards better management of Covid as anticipated by the government. On the other hand, 7.5 crores would have been better utilized to recruit young and fresh doctors at a much lower stipend in larger numbers as well as hire more nursing care staff. This option would have contributed immensely towards better covid patient care and achieved a higher satisfaction level

 

Many decisions indicate a lack of strategic thinking, professional analysis and a short-sighted approach. In all fairness, the Government decisions under question may have been taken in good faith and in the public interest

Take the case of World Bank-funded 30 manifold oxygen plants being purchased and installed through ERA. A scrutiny of the locations where these are proposed to be installed (15 each in Jammu and Kashmir Divisions) would reveal that they are being installed at places located along the highways and easily accessible. What about those far-flung areas which are not easily accessible? Is the population in those areas not required to be provided oxygen nearest to those locations by the government? None of the Jammu Division is planned along the Old Dhar-Udhampur Road, while the majority are planned along the NH.

 

In fact, there is no need to distribute everything mathematically between the two divisions. While the population of the two regions is almost equal, the Jammu region is backward in existing infrastructure and connectivity. Leaving aside these 30 plants, soon there will be 57 OGPs in Kashmir in an area of 15,948 sq km and 41 in Jammu, covering an area of 26,000 sq km. Kashmir would already enjoy an advantage over Jammu with one OGP per 280 sq km compared to Jammu with one OGP per 634 sq km. There is a definite need to augment the oxygen resources in Jammu. In that case, where is the justification for the mathematical distribution of an additional 15 each to both the regions?

 

Keeping the accessibility and connectivity factor in mind Jammu region definitely needs more oxygen plants than Kashmir. The backwardness and difficulty of travel or ease of accessibility should have been factored in if proper application of mind was made. Jammu requires to mix large and small oxygen plants to increase the OGP penetration to far-flung areas in Kishtwar, Doda, Ramban, Reasi, Poonch, Kathua and Udhampur districts.

 

There is an urgent need to involve the newly emerging democratic system of three-tier Panchayati Raj in Jammu & Kashmir in decision making. The decisions taken by bureaucrats lack local flavour and ignore local needs. With the change at the highest level in bureaucracy, it is expected that things would improve for the better. There is a lot of scopes for the administration to review its functioning and make it people-friendly. It would not be out of place to expect the new Chief Secretary to tackle the ailing H&ME Department on red hot priority so that the fight against covid can be taken to its logical conclusion.