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India heading for comprehensive healthcare crisis: Amartya Sen

The Medical Council of India (MCI), which aims to provide quality medical care to all Indians through promotion and maintenance of excellence in medical education, Sen blames the organisation for not only failing to perform its duties but also for its designated role of looking after medical colleges.

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Amartya Sen

India spends just a little over one per cent of its GDP on healthcare and this is leading the country into “a comprehensive healthcare crisis”, according to Nobel laureate and noted economist Amartya Sen, who has called for greater allocation on healthcare in India and highlighted what he calls “three general failures” in the country’s healthcare segment.

“The fact that India allocates only a little over 1 per cent of its gross domestic product on public healthcare contrasts sharply, for example, with nearly three times as much by China. We reap as we sow, and cannot expect to get what other countries achieve by allocating much more resources — as a proportion of their respective levels of the gross national product– to healthcare,” Sen writes in his elaborate foreword to “Healers or Predators? Healthcare Corruption in India”, which will be launched here on Thursday.

Sen, a recipient of the Bharat Ratna in 1999, further claims that the entire organisation of Indian healthcare has become “deeply flawed”, leading the country into “a comprehensive healthcare crisis”.

“Despite being one of the fastest growing economies in the world, India ranks among the poorest achievers of good health. The shortfall of India’s health achievements compared with those of, say, China or Thailand is large and has been growing larger. Even within South Asia, Bangladesh and Nepal have overtaken India in health accomplishment, including in life expectancy.

“If India’s bad record in healthcare is not much discussed in the Indian press, this neglect does not indicate the presence of a tolerable level of healthcare in India, but reflects instead the narrow reach of the Indian news media, with its traditional neglect of elementary education and healthcare,” writes the 84-year-old economist.

Sen has extensively written on welfare economics and social justice and in the given book, he also highlights the plight of patients suffering at the hands of “private caregivers”.

He says private clinics “will not budge” without “the promise of payment”. Noting that even though some public services are offered freely, Sen highlights that many critically important services are denied unless the patient can cough up demanded sums, which can be “unaffordable” for many underprivileged Indians.

Taking a dig at the Medical Council of India (MCI), which aims to provide quality medical care to all Indians through promotion and maintenance of excellence in medical education, Sen blames the organisation for not only failing to perform its duties but also for its designated role of looking after medical colleges.

“In particular, in the use of the power — and responsibility — to set up new private medical colleges, there seems to be clear evidence of fairly straightforward corruption,” he claims.

He ends the over 1,500-word foreword to this “splendid, if depressing, book” with what he calls “three general failures” in India’s healthcare segment — “the amazing neglect of primary healthcare compared with health interventions needed at later stages”; “India’s hasty and premature reliance on private healthcare, which goes hand in hand with neglect of public healthcare”; and the deficiancy of “informed public discussion on healthcare” in the country.

Published by Oxford University Press, “Healers or Predators? Healthcare Corruption in India” has been edited by by Samiran Nundy, Keshav Desiraju and Sanjay Nagral.

“This hard-hitting volume”, according to the publisher, “shows a mirror to the society and, more specifically, to those associated with the health sector — on how healers, in many cases, are shifting shape to becoming predators”.

(Saket Suman can be contacted at [email protected])

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Lakhs of towels, bedhseets missing from AC coaches – passengers are suspects

Besides, the Railways found 56,287 pillows and 46,515 blankets missing from the AC coaches in this period.

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Indian Railway Bed Rolls

New Delhi, Nov 15 : Affluent AC passengers are the prime suspects as over 21 lakh towels, bedsheets, blankets and other items went missing from air-conditioned coaches during 2017-18 an official said.

The passengers are suspected to have made off with precisely 21,72,246 “bedroll items” — including 12,83,415 hand towels, 4,71,077 bedsheets and 3,14,952 pillow covers — from trains across the country in the last fiscal.

Besides, the Railways found 56,287 pillows and 46,515 blankets missing from the AC coaches in this period.

“Together, the missing items are estimated to cost over Rs 14 crore,” a senior Railway Ministry official told IANS.

While the theft of toilet mugs, taps, flush pipes and mirrors are also reported on a regular basis, the missing bedroll items in substantial numbers has posed a challenge for the Railways, which is trying to provide better amenities to upper class passengers.

Currently, about 3.9 lakh sets of linen are provided daily — this comprises two bedsheets, a towel, a pillow and a blanket for each passenger in the AC classes.

“The maximum number of items stolen are towels, followed by bedsheets, as reported by coach attendants at the end of each journey,” the official said.

In the light of the thefts, especially of towels, the Railways has decided that the face towels given to passengers travelling in air-conditioned coaches will be replaced with cheaper, smaller, disposable, takeaway napkins, said the official.

The Railways has already started changing the cover of blankets in some sections while the frequency of washing is being increased from monthly to fortnightly and weekly.

There is also a move to increase the frequency of washing of blankets to begin with and replacing the existing ones with the newly designed lightweight blankets made of soft fabric in a phased manner.

The plan envisages improvement of linen management with the aim of providing clean, hygienic and good quality linen to passengers travelling in AC classes, the official said.

Among the 16 zones of Indian Railways, the Southern zone alone accounted for the theft of 2,04,113 hand towels, 29,573 bedsheets, 44,868 pillow covers, 3,713 pillows and 2,745 blankets.

In the missing list, South Central zone has registered 95,700 towels, 29,747 pillow covers, 22,323 bedsheets, 3,352 blankets and 2,463 pillows.

In the Northern zone, 85,327 towels, 38,916 bedsheets, 25,313 pillow covers, 3,224 pillows and 2,483 blankets were found missing.

In the East Central zone, 33,234 bedsheets, 22,769 pillow covers, 1,657 pillows, 76,852 towels, and 3,132 blankets were stolen last year.

In the Eastern zone, 1,31,313 towels, 20,258 bedsheets, 9,006 pillow covers, 1,517 pillows and 1,913 blankets were reported missing by attendants after the end of the train journey.

The East Coast railways has registered 43,318 towels, 23,197 bedsheets, 8,060 pillow covers, and 2,260 blankets as missing.

(Arun Kumar Das can be contacted at [email protected])

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Lakhs of towels, bedhseets missing from AC coaches – passengers are suspects

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indian-railways

New Delhi, Nov 15: Affluent AC passengers are the prime suspects as over 21 lakh towels, bedsheets, blankets and other items went missing from air-conditioned coaches during 2017-18 an official said.

The passengers are suspected to have made off with precisely 21,72,246 “bedroll items” — including 12,83,415 hand towels, 4,71,077 bedsheets and 3,14,952 pillow covers — from trains across the country in the last fiscal.

Besides, the Railways found 56,287 pillows and 46,515 blankets missing from the AC coaches in this period.

“Together, the missing items are estimated to cost over Rs 14 crore,” a senior Railway Ministry official told IANS.

While the theft of toilet mugs, taps, flush pipes and mirrors are also reported on a regular basis, the missing bedroll items in substantial numbers has posed a challenge for the Railways, which is trying to provide better amenities to upper class passengers.

Currently, about 3.9 lakh sets of linen are provided daily — this comprises two bedsheets, a towel, a pillow and a blanket for each passenger in the AC classes.

“The maximum number of items stolen are towels, followed by bedsheets, as reported by coach attendants at the end of each journey,” the official said.

In the light of the thefts, especially of towels, the Railways has decided that the face towels given to passengers travelling in air-conditioned coaches will be replaced with cheaper, smaller, disposable, takeaway napkins, said the official.

The Railways has already started changing the cover of blankets in some sections while the frequency of washing is being increased from monthly to fortnightly and weekly.

There is also a move to increase the frequency of washing of blankets to begin with and replacing the existing ones with the newly designed lightweight blankets made of soft fabric in a phased manner.

The plan envisages improvement of linen management with the aim of providing clean, hygienic and good quality linen to passengers travelling in AC classes, the official said.

Among the 16 zones of Indian Railways, the Southern zone alone accounted for the theft of 2,04,113 hand towels, 29,573 bedsheets, 44,868 pillow covers, 3,713 pillows and 2,745 blankets.

In the missing list, South Central zone has registered 95,700 towels, 29,747 pillow covers, 22,323 bedsheets, 3,352 blankets and 2,463 pillows.

In the Northern zone, 85,327 towels, 38,916 bedsheets, 25,313 pillow covers, 3,224 pillows and 2,483 blankets were found missing.

In the East Central zone, 33,234 bedsheets, 22,769 pillow covers, 1,657 pillows, 76,852 towels, and 3,132 blankets were stolen last year.

In the Eastern zone, 1,31,313 towels, 20,258 bedsheets, 9,006 pillow covers, 1,517 pillows and 1,913 blankets were reported missing by attendants after the end of the train journey.

The East Coast railways has registered 43,318 towels, 23,197 bedsheets, 8,060 pillow covers, and 2,260 blankets as missing.

IANS

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India’s higher education system needs drastic changes to address tech-induced challenges

Further, India’s GER for the male population is 26.3 per cent and 25.4 per cent for females. The GER also varies across different social groups — 21.8 per cent for the Scheduled Castes and 15.9 per cent for the Scheduled Tribes.

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education

As the world stands on the brink of the Fourth Industrial Revolution, powered by a wide range of new technology breakthroughs such as Artificial Intelligence (AI), Machine Learning (ML), advanced robotics, Internet of Things IoT), Cloud computing and 3D printing, major changes are expected in the labour market globally.

There will be reduced demand for middle-skilled workers doing repetitive tasks and increased demand for more highly-skilled workers — and also low-skilled workers doing non-routine work. While many developed countries, such as the US and Japan, as also several European economies, are already experiencing this polarisation, the labour market is also hollowing out in many developing countries, although at a rate slower than the developed world.

In the case of India, this polarisation can be seen in the organised manufacturing sector, where the share of high-skilled occupations in total manufacturing employment increased by more than three percentage points, while the share of middle-skilled jobs decreased by 6.3 percentage points from 1993-94 to 2011-12. Looking at the impact of technological progress on various manufacturing industries, the capital-intensive industries, such as automobile manufacturers, have a greater probability of adopting advanced automation and robotic technologies, compared to labour-intensive manufacturing industries such as textile, apparel, leather and footwear, and paper manufacturers.

Further, in the services sector, particularly in the IT sector, e-commerce, banking and financial services and health care services, there is a huge potential for automation technologies, which would increase the demand for skilled workers and reduce the demand for middle-skilled workers.

However, in India, over 80 per cent of the working population is engaged in low-skilled jobs in the unorganised sector. These low-skilled workers aspire to join the middle-skilled workforce in the organised sector to raise themselves from poverty. However, the changing nature of work due to technology advancements in the organised sector prevents their upward labour mobility and any improvement in their incomes.

Addressing these challenges requires reforms in India’s higher education system. The institutes of higher learning should shun dated teaching methodologies and redesign the course curriculum by understanding key market transitions amidst the technological advancements. This would enable the country to create a workforce which could be placed in the positions demanded by the companies in the digital era and thus bridge the skill gap in the labour market.

However, looking at the current state of higher education in India, one can see that it is not just the quality of the system which needs to be improved. There is also much to be done in terms of the number of students enrolled in the institutes of higher learning. The Gross Enrollment Ratio (GER) in tertiary education in India is 26.9 per cent, which is lower than that of China (48.4 per cent), Indonesia (27.9 per cent) and the Philippines (35.3 per cent), among others.

Further, India’s GER for the male population is 26.3 per cent and 25.4 per cent for females. The GER also varies across different social groups — 21.8 per cent for the Scheduled Castes and 15.9 per cent for the Scheduled Tribes.

There are also wide variations in the number of colleges for higher education across different states in India, with the lowest number of seven colleges in Bihar for every 0.1 million of eligible population to 51 in Telangana and Karnataka. The top eight states in terms of highest number of colleges are Uttar Pradesh, Maharashtra, Karnataka, Rajasthan, Andhra Pradesh, Tamil Nadu, Gujarat, and Madhya Pradesh, which have 28 or more colleges per 0.1 million of the population. The disparity in the distribution of the colleges is also seen across different districts in these states, with the top 50 districts having about 32.6 per cent of the colleges.

In addition to the inequalities existing in the access to institutions for higher education, another issue is that a majority of the students are enrolled in undergraduate level programmes, compared to the Masters and the Doctoral programmes. Moreover, at the undergraduate level, there is a low pass-out rate — out of 2,90,16,350 students enrolled at undergraduate level, only 6,419,639 passed-out in 2017.

It is imperative for the country to address these issues given that the Indian system of higher education faces multiple challenges of low gross enrollment in its colleges and universities, with predominance of students settling on undergraduate studies, along with various socio-economic inequalities existing in access to higher learning. Further, emphasis must be placed on increasing the number of students who pass out of the colleges/universities, along with increasing enrollment numbers.

The technology-induced skill gap which the Indian economy is facing across different sectors is bound to widen with the current higher education system. Change has to be brought from outside the existing constructs. Improvement in the teaching methodology from the traditional lecture courses, accreditation of online courses, along with redesigning the course curriculum to be more industry relevant are some of the ways the technology-led changes in the labour market can be dealt with.

(Amit Kapoor is chair, Institute for Competitiveness, India. The views expressed are personal. He can be contacted at [email protected] and tweets @kautiliya. Deepti Mathur, senior researcher at large, Institute for Competitiveness has contributed to the article)

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