The outdated nature of bureaucracy
Why in News
- In the 21st century, democratic countries are still relying on traditional bureaucracies to perform public policy formulation and implementation roles.
- These bureaucracies have outlived their relevance.
- Weberian bureaucracy still prefers a generalist over a specialist. A generalist officer is deemed an expert and as a result, superior, even if the officer works in one department or ministry today and in another tomorrow.
- Specialists in every government department have to remain subordinate to the generalist officers. The COVID-19 pandemic has exposed this weakness.
- Traditional bureaucracy gives preference to leadership of position over leadership of function.
- Leadership of function is when a person has expert knowledge of a particular responsibility in a particular situation. Whereas Weberian bureaucracy prefers leadership based on position.
- Weberian bureaucracy prefers leadership based on position. Bureaucracy has become an end in itself rather than a means to an end.
- Rigid adherence to rules has resulted in the rejection of innovation.
- This as a reform movement promotes privatization and managerial techniques of the private sector as an effective tool to seek improvements in public service delivery and governance.
- It renders the state a bystander among the multiple market players with accountability being constantly shifted, especially during a crisis.
- The most appropriate administrative reform suggested by author is the model of new public governance.
- It is based on collaborative governance in which the public sector, private players and civil society, especially public service organisations (NGOs), work together for effective public service delivery.
- During the pandemic, civil society playing a major role in saving lives. As part of new public governance, this role has to be institutionalized.
- It needs a change in the behavior of bureaucracy, needs flexibility in hierarchy, a relook at the generalist versus specialist debate, and an openness to reforms such as lateral entry and collaborations with a network of social actors.
- All major revolutions with huge implications on public service delivery have come through the collaboration of public bureaucracy with so-called outsiders. Theses includes Green Revolutions, the White Revolutions, Aadhar-enabled services and the IT revolution.
- Thus, New public governance is the future of governance, especially public service delivery.
The fault line of poor health infrastructure
Why in News
- As the second wave of the COVID 19 pandemic ravages India, many bitter home truths and fault lines have been starkly exposed.
- The World Bank data reveal that India had 85.7 physicians per 1,00,000 people in 2017 (in contrast to 98 in Pakistan, 58 in Bangladesh, 100 in Sri Lanka and 241 in Japan).
- It also reveals that there are only 53 beds per 1,00,000 people (in contrast to 63 in Pakistan, 79.5 in Bangladesh, 415 in Sri Lanka and 1,298 in Japan).
- India has only 7 nurses and midwives per 1,00,000 people (in contrast to 220 in Sri Lanka, 40 in Bangladesh, 70 in Pakistan, and 1,220 in Japan).
- The situation is a direct result of the appallingly low public health expenditure.
- The latest data narrative from the Centre for Economic Data and Analysis (CEDA), Ashoka University, shows that this has been stagnant for years: 1% of GDP 201314 and 1.28% in 201718 (including expenditure by the Centre, all States and Union Territories.
- Health is a State subject in India and State spending constitutes 68.6% of all the government health expenditure. Because the Center is the key player as major bodies like ICMR etc. are under its control so the onus lies on centre.
- CEDA has prepared an interactive graphic that allows users to see the interState variation in per capita healthcare expenditure in 21 major States and how this has changed from 201011 to 201920.
- Kerala and Delhi have been close to the top in all the years.
- Bihar, Jharkhand and Uttar Pradesh, States that have been consistently towards the bottom of the ranking in all years, are struggling to cope with the pandemic.
- Odisha is noteworthy as it had the same per capita health expenditure as Uttar Pradesh in 2010, but now has more than double that of Uttar Pradesh. This is reflected in its relatively good COVID-19 management.
- India has among the highest out-of-pocket (OOP) expenditures of all countries in the world.
- The World Health Organization estimates that 62% of the total health expenditure in India is OOP, among the highest in the world.
- Uttar Pradesh, Bihar, Madhya Pradesh, Jharkhand and Odisha have a high ratio of OOP expenditures in total health expenditure.
- Thus, the most vulnerable sections, are the worst victims of a health emergency.
Government’s role critical
- The inter-State variation in health expenditure highlights the need for a coordinated national plan at the central level to fight the pandemic.
- The Centre tightens the major decisions of health, including additional resources raised specifically for pandemic relief, PM CARES Fund.
- CEDA has shown that the first round of vaccinations, where the vaccines were procured by the Centre and distributed to the States, was marked by considerable interState variation, which was neither explained by the case load nor by the share of eligible (45+) population.
- Centre can bargain vaccines for a good price from vaccine manufacturers in its capacity as a single large buyer and benefit from the economies of scale in transportation of vaccines into the country.
- These could be distributed across States equitably in a needs-based and transparent manner.
- Distribution of constrained resources (medical supplies, financial resources) can internalize the existing disparities in health infrastructure across States.
- According to the author, the decentralized management exacerbates the inter-state inequalities as the richer states can compete better in procuring resources.
A policy briefs
- In April 2020, CEDA came out with a policy brief, where among other measures.
- It recommended the following:
- Creation of a “Pandemic Preparedness Unit” (PPU) by the central government, which would streamline disease surveillance and reporting systems.
- Coordinate public health management and policy responses across all levels of government,
- Formulate policies to mitigate economic and social costs, and communicate effectively about the health crisis.
- The central government needs to deploy all available resources to support the health and livelihood expenses of COVID-19-ravaged families immediately.
- After this wave, bolstering public health-care systems has to be the topmost priority for all governments: The Centre as well as States.