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Perpetual Dance Of Democracy: ONE NATION, ONE POLL, ANYONE?, By Poonam I Kaushish, 19 March 2024 Print E-mail

0Political Diary

New Delhi, 19 March 2024

Perpetual Dance Of Democracy

ONE NATION, ONE POLL, ANYONE?

By Poonam I Kaushish 

Its’ party time folks as India readies for its greatest nautanki of democracy: General elections April-May. Amidst the bugle sounding BJP’s rallying cry for ‘Ab ki baar 400 paar’ and Congress President Kharge warning it could well be the last election and death knell for federalism, Ex-President Kovind Committee’s 320-pages report recommending a two-step electoral process: Lok Sabha and Assemblies elections followed by municipal and panchayat polls within 100 days has caught the zeitgeist this week.

Including the suggestion that once the appointed date to bring into force provisions for transition to simultaneous polls is fixed, “tenure of all State Assemblies constituted in any election after the appointed date would come to an end on expiry of Lok Sabha’s full term irrespective of when an Assembly was constituted.” Moreover, Constitutional amendments to this effect would not need ratification by States.

Questionable are we moving to ‘One nation, One Election?’ Specially as the country has witnessed 400 polls to Lok Sabha and State Assemblies till date. And given Law Commission had thrice — 1999, 2015 and 2018 — argued for simultaneous elections to “free citizens, Parties and Government from encumbrance of asynchronous elections.

Ditto Parliamentary Committee 2016 which said holding simultaneous elections would reduce massive expenditure incurred in holding polls, underscored by Election Commission pegging cost of holding simultaneous elections at Rs 4,500 crore.

Undeniably, simultaneous elections could be economically viable and a big saving for exchequer. Welcome, as it would help avoid disruptions in governance and policy paralysis due to frequent polls as once a Party is elected and Government formed it can get down to work, take hard decisions in public interest and concentrate on delivering good governance without worrying  about its impact on vote banks.

Think. Several good initiatives are dumped due to electoral considerations lest it upset a caste, community, religion or region. All, becoming victims of policy shutdown, mismanagement and poor implementation.

Let’s face it. Post 2019 Lok Sabha elections, we witnessed 35 State Assembly polls. Now alongside Lok Sabha we have Odisha, Andhra, Arunachal and Sikkim followed by Maharashtra-Haryana October, Jharkhand November. February 2025 Delhi and December Bihar goes to polls. 

With 15 Parties opposing the report, challenge is the procedural details and Government’s disregard of citizens’ right to removing non-performing Governments. Besides, fear it militates against the federal structure of multiple diversities and Constitution’s spirit along-with complex legal procedures that Kovind report proposes for bringing Constitutional amendments which needs to be weighed carefully to allay fears of “infringing federalism.”

More. Opposition perceives one-nation-one-poll as imposition of BJP;s political agenda and extension of its ideological preference for homogeneity and uniformity vis-à-vis faith, customs, language, dress and diet given federal relations are fraught in rival ruled States. And it hinders political accountability and performance scrutiny.

Recall, post Independence, elections to Lok Sabha and State Assemblies were conducted simultaneously October 1951-May 1952 until Nehru Cabinet blotted the copybook by dismissing CPI-led Government in Kerala 1059. But with political instability gaining ground in the sixties, the cycle of simultaneous elections got disrupted.

While Punjab, Bihar and UP couldn’t complete their tenures on three occasions between 1967-1980, Odisha Assembly witnessed five elections during that period and West Bengal Assembly four elections 1967-1972. Resulting in many unstable Governments at Centre and States, leading to early dissolution of Lok Sabha or Assemblies whereby India could never go back to holding simultaneous elections again.   

Moreover, expenditure spiralled, doubling to over Rs 23 crores in 1980, further doubling to Rs 54 crores 1984 and Rs 154 crores 1989. In 1991expenses shot up to Rs 359 crores, 1999 to Rs 880 crores, 2004 Rs 1300 crores, 2014 Lok Sabha elections Rs 30,000 crores and staggering Rs 60,000 crores in 2019.

However, the legal and Constitutional position on Lok Sabha/ State Assembly term is challenging and requires amendments, including ratification by States to avoid future legal confrontation. An example: Article 83(2) and 172(1) aver Lok Sabha/ State Assembly term respectively should be for five years from date of its first sitting. 

But, both do not have a fixed term and can be dissolved earlier. Further, the provisos allow extension of Parliament/Assembly's term for six months at a time following a ‘proclamation of emergency.’ 

Besides, Article 356 allows Centre to bring a State under President's rule by prematurely dissolving its Assembly. But, the Anti-Defection Act, 1995 and Supreme Court placed several safeguards to prevent misuse of this power. 

Kovind’s proposal is not finding takers among INDIA Parties. Why should we agree to truncated tenure of our State Government, is a common refrain. They believe Government’s motive of simultaneous elections is to bridge BJP’s weakness in Southern States where it is hampered byt linguistic sub-nationalism and ideology. 

“It is motivated by political considerations, as when concurrent elections are held voters tend to vote for the same Party. BJP knows it has unparalleled dominance at national level. Also, poll issues at Centre and States are different which would create confusion. A Party could be deserving of support at the Centre for its policies and performance at the national level. Yet, it could be deserving of popular punishment and defeat for its policies and performance at State level. Also, this fractious process would strain our federal fabric,” said a Congress leader. 

Some argue a fixed term for Lok Sabha/ State Legislatures goes against Parliamentary democracy’s basic tenets. What happens if after simultaneous polls, an Assembly’s five-year term is interrupted by political realignments? Clearly, this would help the dominant national Party at the Centre and disadvantage the regional player.

What happens if a Government falls at the Centre or State mid-term? Or if a Government enjoying people’s mandate is voted out, it would continue to hold office or be replaced by another Government, which might not necessarily enjoy the popular mandate?

Plainly, a Government which lacks the confidence of the House would be foisted on people, with no say in the matter. Smacking, of de facto dictatorship or monarchical anarchy, an idea which translates into unrepresentative governance. It would impose artificial fixity on legislatures terms at Centre and States which is at odds with a system given its staggering diversity. 

To avoid this EC suggests a no-confidence motion against a Government must come alongside a confidence motion for another Government and Prime Minister and voting for both motions done simultaneously. Ditto in State Assemblies. 

As and when India ushers in ‘One Nation, One Election’ it will not be the first country to do so. In Germany, Bundestag (Lower House), Landtags (State Assembly) and local elections are held simultaneously. Philippines, too conducts simultaneous elections every three years, though it has a Presidential form of Government. 

True, there are cogent arguments on either side: Development vs accountability? Electoral expenses vs political choices? Governance vs electoral fairness?  Given how elections have an almost talismanic power in the country’s democracy the stakes couldn’t be higher. 

Remember, elections are the bedrock of our democracy, we should avoid polls duplication. With States perpetually in election mode, managing Government is akin to running with the hare and hunting with the hound. India’s democracy should not be reduced to a tu-tu mein-mein between Parties all the time. ---- INFA

 (Copyright India News & Feature Alliance)

 

 

 

 

 

Electoral Bonds Shear Rs 29 Tr: BANKS, ECONOMY IN TURMOIL, By Shivaji Sarkar, 18 March 2024 Print E-mail

Economic Highlights

New Delhi, 18 March 2024

Electoral Bonds Shear Rs 29 Tr

BANKS, ECONOMY IN TURMOIL

By Shivaji Sarkar 

The Indian economy may or may not have matured, it has specialised in its murky Bombay stock operations. It did not crash alone on Wednesday. Two days earlier, on Monday, too the chinks were noticed in the State Bank of India shares in the wake of the Supreme Court’s firmness on submission of details on electoral bonds (EB). In two months, the market has dumped a huge loss of Rs 29 lakh crore. The small caps also took a hit of Rs 30,246 crore portraying far from a glowing picture. 

The losses are the biggest since Covid-19. On March 11, the market lost, Rs 3.15 lakh crore mostly hitting the SBI, followed by Rs 13.9 lakh crore losses across the board, including the Adani group, on March 14. In two sessions the market lost Rs 17.05 lakh crore or almost 30 per cent equivalent of the total central budgetary amount. It tanks over 900 points on Wednesday and on Monday it loses 617.75 points. Together it is a bigger loss than March 13, 2020, when the fall was estimated at minus 14.2 per cent. 

Not to forget that in the wake of the Hindenberg disclosures, the stock market crashed by 1168 points or almost Rs 12 lakh crore on January 23, 2024, the biggest in recent times. Most hits were taken by the groups of Adani, Zee and IRCON. In just about two months, the market has jolted the country with a Rs 29 lakh crore wipe out. The 2024-25 budget is of Rs 47.65 lakh crore. 

Complicating the issue, the retail traders as a new phenomenon are also suffering. Volumes in retail trades multiplied since 2019, when it overtook the US. Murkier operations are in sight. An index of small-cap stocks lost more than Rs 30,246 crore in market value in less than two weeks through March 13. In 2023, Indian investors traded 85 billion in small cap, according to SEBI, in which 90 per cent of active traders lost. 

In 2021-22, investors lost $ 5.4 billion, or $ 1468 apiece, a big sum, for a country with per capita GDP of $2300. This happens through dream cyber kiosks that mushroomed of Whatsapp, Facebook, Telegram and Instagram. The online media carry advertisements by CEOs of top companies alluring to multiply Rs 500 investments. As per SEBI these are mere traps. 

Are the electoral bonds the big shakers? Perhaps. Investors are wary of disclosures of their identities at election time. The way foreign portfolio investors withdrew from the market faintly indicates this. There have been many MoUs with houses in West Asia and other countries. 

Some days back, SEBI Chairman Madhabi Puri Buch had raised concern over ‘frothiness and bubbliness’. On Thursday, Uday Kotak of the Kotak group also says there is ‘frothiness’. The jargon does not say much except that the regulators’ awareness of murkiness and their inability to check it. 

In its statement to the court the SBI says that of the 22, 207 electoral bonds, 22,030 were purchased. The remaining were deposited in the Prime Minister’s relief fund. Two documents were filed with the Election Commission of India, one mentioning names of political parties and the other detailing the bonds redeemed by them. The other set contains the details of electoral bonds purchasers. The total amount has not yet been disclosed though the EC announced that the list has been uploaded on its website. 

It is interesting to note that the Delhi High Court had declared the election donations illegal just prior to the 2014 elections. On 29 March 2014, the court observed that both the Congress and BJP broke laws by accepting cash from companies owned by London-listed Vedanta group (Vedanta Resources) between 2004 and 2012. Sterlite Industries India and Sesa Goa, two companies then registered in India but whose controlling shareholder was Vedanta, donated Rs 87.9 million in total to the Congress between 2004 and 2012. Sesa Goa donated Rs 14.2 million to the BJP, according to the Association for Democratic Reforms (ADR) and presented it in the court. 

An agency report says that a Prudent Electoral Trust has raised $272 million since its creation in 2013, funnelled “roughly 71 per cent of that to BJP. The trust donated $20.6 million to the Congress as well”. It mentions that eight business groups donated to the trust. Nobody has denied receiving corporate funding. The controversy is limited to the factor whether their names and total funding to the parties be disclosed or not. 

On February 15, the Supreme Court struck down the Electoral Bond scheme or anonymous donations to political parties, as unconstitutional, violating right to information under Article 19(1) A of the Constitution. The court also quashed the amendments made to the Income Tax Act and the Representation of People Act, which made the donations anonymous. 

During the last 10 years, electoral trusts reportedly disbursed about Rs 2557.74 to various political parties. Donations are stated to have 360 per cent growth. The growth of donations was phenomenal from 2018 to 2022. Political parties received Rs 9191.41 crore through electoral bonds, with the ruling parties always receiving higher funding. 

The court held that the scheme cannot be justified by saying that it would help curb black money in politics. Instead, it said that transparency in political funding cannot be achieved granting absolute exemptions and feared that such fundings could have a quid pro quo. The top court’s actions rattled the market as such dealings create crisis of credibility and confidence. 

The stock market is not an indication of economic growth. A small fall in the market capex, however, severely impacts the health of the banks. Since the Harshad Mehta scam in 1992, a number of Indian banks and FIs collapsed or merged and now the SBI, Indusind and some other banks are in disarray. The market may recover, but the banking process takes a severe beating. 

This also raises questions about high electoral expenses. The court did have this in mind like the petitioner, ADR. Besides, travel costs have increased, which is owed to the artificially high pricing of petroleum, natural gas, coal and now even electricity. It is also linked to unnecessary toll on highways jacking up inflation to over 5.5 per cent despite low international crude cost. Favours for construction contracts of projects are also questionable, not to forget that rising costs have a cascading effect. 

Market regulators need severe course correction. Losing such huge amount of money in just two months is a serious jolt to the economy and the banking sector. And it may not be the last of such national trauma. Undoubtedly, it would be interesting to watch how it impacts the elections. ---INFA 

(Copyright, India News & Feature Alliance)

 

India-FTA Trade Pact: A REAL BREAKTHROUGH, By Prof. (Dr.) D.K. Giri, 15 March 2024 Print E-mail

Round The World

New Delhi, 15 March 2024

India-FTA Trade Pact

A REAL BREAKTHROUGH

By Prof. (Dr.) D.K. Giri

(Secretary General, Assn for Democratic Socialism) 

The signing of Trade and Economic Partnership Agreement (TEPA) on 10th March between India and EFTA (European Free Trade Association) countries is a real breakthrough for India on building trade relations. This is because India has been negotiating an EFTA with European Union (EU) since 2007, which is yet to conclude. In the meantime, India managed to sign it with four EFTA countries which are small in population but strong in economy. These countries participate in European Single Market of EU and part of the Schengen area. The countries are Switzerland, Iceland, Norway and Liechtenstein. 

Negotiations for a trade agreement began with EFTA in 2008, one year later than that with EU. And it has been concluded earlier. The negotiators of EFTA felt that the agreement signifies success as it precedes any such agreement with the EU or any developed economy. The Indian side was led for the last 10 years by Minister of Commerce and Industry, Food and Consumer Affairs and Textiles, who sounded euphoric about the agreement. He said, “TEPA is a model and ambitious trade agreement”. 

It has created a couple of firsts. For the first time, India is signing an FTA with four developed countries which constitute a powerful economic bloc in Europe. “For the first time in history of FTAs binding commitment of 100 billion USD investment and 1 million direct jobs in the next 15 years has been given. The agreement will give a boost to Make in India and provide opportunities to young and talented workforce. The agreement will provide a window to Indian exporters to access large European and global markets”. 

Beginning in 2008, negotiations covered 13 rounds and then were put on hold in November 2013. They were resumed after gap of 10 years last year in October. And in less than six months, the TEPA was signed. Prime Minister Narendra Modi commended the agreement in a written message, “Despite structural diversities in many respects, our economies possess complementarities that promise to be a win-win situation for all nations”. This feeling was reciprocated by one of the top negotiators, Swiss State Secretary for Economic Affairs, Helene Budliger Artieda, “There was a sense that we could really have a fair and balanced deal, which would the win-win …. five times win for all five parties.” (four EFTA countries plus India). 

The agreement consists of 14 chapters. It focuses on market access related to goods, rules of origin, trade facilitation, technical barriers to trade, investment proportion, market access to services, intellectual property rights, trade and sustainable development and many other legal provisions. Significantly, the agreement will see considerable tariff reduction, increase in market access and simplification of customs procedure. Most of all, the investment of 100 billion USD is the highlight of the agreement which provided the breakthrough moment. 

Prime Minister Modi noted that the global leadership of EFTA countries in innovation and R&D across diverse sectors like digital trade, banking and financial services and pharma will open up new doors of collaboration. Investment in these sectors will open up great opportunities for India. This is the second such full-fledged FTA signed after India’s agreement with the United Arab Emirates.

Indian industries have welcomed the trade agreement. The Director General of Confederation of Indian Industry opined that the agreement will yield multi-dimensional gains to Indian industries. He said, “It will elevate trade, promote technology, knowledge transfer, and encourage investment”. He added that improved market access in EFTA countries for Indian goods will boost India’s export potential and greatly expand employment opportunities. 

As noted, the negotiations concluded in a fast-track mode and the deal was signed just a few days, ahead of the announcement of dates for Lok Sabha elections in India. However, the political-electoral angle in the negotiations could not be attributed to EFTA countries although the incumbent Union Government could dangle it to the electorate as a prize they have secured. A question was asked to the Swiss State Secretary by an Indian journalist, “Did you think this deal would happen before Indian elections?” Her answer was candid. She said that one can never be 100 per cent sure in such negotiations involving five countries. “But I really felt sincere interest, trust and friendship between India and EFTA negotiators”. She pointed out that the agreement on investment chapter was a breakthrough moment. 

According to TEPA’s Chapter 7 that deals with investment promotion and cooperation, both sides are agreed that first tranche of 50-billion USD will be invested within 10 years and another 50 billion in the next five years. The EFTA side clarified in terms of riders that it is not the states that make the investment; it is the companies which do. Norwegian Trade Minister said in a press conference that, “It is about creating the right environment, speaking to our companies and then tracing and tracking development. It is also recorded that if the investment is not made within 15 years with a three-year grace period and another two years in negotiations, India will be entitled to withdrawing some of its trade concessions. 

It is the investment that will define the parameters of success. India should do everything possible to facilitate that investment. Many investors know that India is a big market but are equally aware of the bottle necks. It is for New Delhi to clear such impediments and make it investment friendly. Likewise, India’s export regime has to improve. Timely clearance of goods by the Indian Custom Department is necessary. The timelines for delivery have to be adhered to by the Indian companies. The quality check is another issue that Indian exporters must be wary of. In my research on India-EU trade, these issues were pointed out by EU officials. 

The agreement will come into force after the ratification by EFTA countries expected by the end of this year. Switzerland, the biggest of the four, will possibly bring the agreement for ratification by Swiss Parliament in the autumn session. So, by the end of the year, the agreement should come into force. Other countries which have a different time span for ratification process would also complete it by the end of the year. 

The agreement is indeed a momentous occasion for Indian trade despite the murmur on timing of the agreement which is just before the elections. It is an achievement that Indians should be happy about. This will perhaps open up of the possibility of such agreements in general with other developing countries and hasten the process with the EU in particular. New Delhi should set an example by successfully implementing the TEPA.---INFA 

(Copyright, India News & Feature Alliance)

CAA, Simultaneous Polls: AMMO FOR OPPOSITION STATES, By Insaf, 16 March 2024 Print E-mail

Round The States

New Delhi, 16 March 2024

CAA, Simultaneous Polls

AMMO FOR OPPOSITION STATES

By Insaf 

The timing of the CAA notification and Ram Nath Kovind panel’s report recommending ‘one nation, one election’, other than details of electoral bonds, has further ignited the poll arena for Battle 2024. Opposition-ruled states have upped the ante against BJP and Modi team, though it remains to be seen whether it will fire up the voter. Chief Ministers of West Bengal, Kerala, Tamil Nadu and Delhi have resolved to oppose it, accusing the BJP of resurrecting the ‘divisive’ Act, four years since it was passed only to manipulate religious sentiments for political gains. Specifically, Kerala Cabinet has decided to move the Supreme Court by asking Advocate General to initiate action against it without further delay. The firm No says Chief Minister Vijayan is because it treats Muslim minorities as second-class citizens. In West Bengal Mamata Didi warns the Act could be a precursor to implementation of the NRC across the country and must be opposed. In BJP-ruled Assam, protests are hotting up with police warning of strict action. Union Home Minister Amit Shah is at pains to say, ‘Indian Muslims needn’t worry as CAA won’t impact their citizenship…Modi has delivered on his promise.’ Will the top court allow him to fulfil it?   

‘One nation, no election…’ Congress’ reaction to the report recommending holding of simultaneous polls in the country, may turn out to be good campaign material. Here too, Opposition parties are in sync voicing serious concern since Thursday last, since the report was submitted to President Murmu. “The prime minister’s objective is very clear. He’s going around asking for a clear majority, 23rd majority, 400 seats…They want to completely dismantle Constitution’, says the grand old party. It’s ally in Maharashtra, Shiv Sena (UBT) asserts the concept was a move towards dictatorship; the AIMIM termed the bid a “…frequent elections keep governments on their toes… they will no more have to worry about people’s fury for five years…It (the move) will convert India into a one-party state.” In UP, SP said “in a country like ours, ‘one nation, one election’ seems impossible’. 

The AAP warns it would ‘marginalise regional parties, encourage dominance of national parties, and result in a presidential form of government”. The BJP is among 32 other parties, mostly its NDA partners supporting the recommendation, as it will help save resources, spur development and social cohesion..’ In the first stage, elections for LS and all state assemblies can be held together and in the second, civic polls and panchayats will be synchronised with these within 100 days. Critically, term of Assemblies elected after the first sitting of newly-elected Lok Sabha will be cut short till the next general elections to ensure the cycle is not disturbed! Worrisome for regional players as the recommendations could just as well come into force in five years—2029!   

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Haryana’s Surprise

Haryana springs a big surprise. On Tuesday last, Chief Minister Manohar Lal Khattar suddenly resigned with his entire Cabinet, by evening he was replaced by Nayab Singh Saini and 24 hours later BJP government comfortably won the trust vote in Assembly. Clearly, the change of guard was orchestrated with an eye on ensuing elections, both in the State and Centre, with the anti-incumbency factor weighing against Khattar’s 2-term leadership. The BJP also took serious note of Congress’ OBC thrust and thus chose Saini, an OBC to counter its opponent. This apart, it opted for dumping Dy Chief Minister Dushyant Chautala and his JJP, which with its 9 MLAs had helped form the alliance government after a fractured verdict in 2019. This, as JJP was asking for two seats for LS polls, whereas big brother was willing to give only one. However, the parting of ways doesn’t quite gel, as JJP issued a whip asking its MLAs to remain ‘absent’ during the trust vote! Said Congress: “We used to hear a whip issued by a party asking its MLAs to ensure their presence during a voting. It’s first time we are hearing a party has issued a whip to its members to remain absent… A fixed match is being played by both BJP-JJP”. The INLD response was on similar lines. Be that as it may, BJP has plans for Khattar as he’s given a Lok Sabha ticket and that it can shift gears to remain on the road to victory.   

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Tripura U-Turn

For or against the tribals, is a question doing the rounds in Tripura. Tipra Motha chief and royal scion-turned-politician Pradyot Kishore Manikya Debbarma has stirred a hornet nest by joining BJP-IPFT alliance, four days after he signed a tripartite pact with Centre and state government and a month after he was talking to Congress to cobble an anti-BJP coalition! Expectedly, Congress and CPM accuse him of ‘playing with tribals’ as all along he’s been demanding a Greater Tipraland state for tribals but instead signed a ‘bogus piece of paper’ (agreement) which tries to sell Tiprasa (tribals of Tripura) and looks after his own interests. Pradyot hits back: both these parties neglected tribals’ rights while in government, didn’t lend support during anti-CAA protests and ‘it’s they who prioritised political interests over tribal welfare.’ He also explains his joining government is to ‘ensure proper implementation of accord’; two of his MLAs shall join Cabinet; and importantly, his sister, who he managed to get a BJP ticket for East Tripura ST-reserved constituency ‘she shall be needed in Delhi to further its progress.’ Time will tell. 

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Bengaluru’s Water Woes

Don’t use of potable water for cleaning vehicles, gardening, building construction, fountains, swimming pools, entertainment purposes other than as drinking water in cinema halls and malls, is Bangalore Water Supply and Sewerage Board’s warning to residents in IT hub Bengaluru. Else, pay a fine of Rs 5,000 in case of violation. Indeed, the Karnataka government is busy grappling with water woes as concerns grow over Cauvery water supply and depleting groundwater levels. Steps include, ordering huge tankers from adjoining towns; take over private borewells (50% of borewells have dried up); fill up the drying lakes with 1,300 million litres per day of treated water to replenish groundwater sources; install filter borewells and construct water plants using an innovative technology near the restored lake beds to supply water after testing, etc. Too little too late, may be a right reaction. Undoubtedly, it’s the unplanned urbanisation and over concretisation in the city which needs to be dealt with. Blaming climate change doesn’t hold water! ---INFA

(Copyright, India News & Feature Alliance)

Hospital Treatment Rates: SC BALM FOR COMMON MAN, By Dhurjati Mukherjee, 13 March 2024 Print E-mail

Open Forum

New Delhi, 13 March 2024

Hospital Treatment Rates

SC BALM FOR COMMON MAN

By Dhurjati Mukherjee 

That health is a neglected sector in India has been echoed by experts over the years, but the government has not taken adequate measures to ensure that benefits reach all sections of society. It is, in this connection, that the very recent Supreme Court order merits special attention. The order directed “all hospitals and clinical establishments must display rates charged for each type of service provided and facilities available for the benefit of patients at a conspicuous place in the vernacular as well as in the English language and charge rates for each type of procedure and service within the range of rates determined and issued by the Centre from time to time, in consultation with the state government”. 

The bench of Justices BR Gavai and Sandeep Mehta, hearing a PIL by the NGO ‘Veterans Forum for Transparency in Public Life,’ boldly stated, “If the Union government fails to find a solution, then we will consider the petitioner’s plea for implementing CGHS-prescribed standardised rates.” The PIL sought clarity on medical expenses and urged the Centre to determine the fee chargeable to patients based on Rule 9 of the Clinical Establishment Rules 2012 on which the judgment would stand out to be a landmark order. 

It is indeed distressing to note that health has become big business in the country and the private nursing homes charge rates that even the middle class finds difficult to pay. There is no regulation by the state governments and the Centre is totally indifferent to the continued fleecing of the population. The political class has never said anything regarding the matter and there are virtually no protests as the nursing homes owners are rich and powerful. 

Though some of the state governments have given land at subsidised rates to these nursing homes – some also call them hospitals – they are supposed to reserve some beds for the poor and the economically weaker sections, but this is not done, and the state governments do not check whether these health centres actually treat the poor. It has to be accepted that the ruling dispensation at the Centre favours the rich, but this is also true of most state governments. 

The question that comes up is how will the poor get proper treatment? There is no survey undertaken in the country to determine how many poor people are not properly diagnosed and, as such, treatment is not received by them. Moreover, costs of treatment in the private sector are quite high, specially of life-threatening diseases. But though these are considered life-threatening in the country, this is not so in the Western world as also in the emerging economies. 

It is a well-known fact that the conditions of rural health centres and hospitals run by the government are in a pitiable state of affairs with very few specialists and even general doctors not being able to give proper attention to the huge number of patients. Moreover,equipmentis lacking and specialised treatment, in most cases, is not possible. 

Some experts question that there is no proper survey to find out how much people from the lower segments of society have to spend to get proper treatment, how many of them can really afford this treatment, how much they have to travel to avail of this treatment? It has been found that poor people have been found to sell their fixed assets like land, even part of building, apart from jewellery etc. and taking huge loans at high rates of interest, mostly from moneylenders.   

Though such order for standardisation of rates should have been taken decades back to prevent health being treated as a source business, the present order, if acted on seriously, would greatly benefit the common man. One cannot deny that health facilities must improve in all parts of the country, specially in the backward districts, and this can only happen when facilities are available at affordable rates. 

It is worth referring to a World Health Organization (WHO) report which rightly highlighted the fact that with countries reducing investments in health after the Covid outbreak does not augur well as health security is complementary to economic security. To address gaps and prepare for the next pandemic, the regional director of Southeast Asian region of WHO stressed on investments and strengthening six pillars of health systems –service delivery, health workforce, access to medical products, vaccines and technologies, health information systems, and financing backed by political commitment. 

The government proposal of setting up hospitals in PPP mode in select underserved districts has not been implemented as business houses are not interested to set up such centres in remote rural areas. It was envisaged that medical colleges would be attached to district hospitals in PPP mode to address shortage of qualified medical doctors. However, the Indian Medical Association (IMA) expressed concerns by public health experts that inviting the private sector to manage public hospitals was tantamount to backdoor corporatisation of civil hospitals and this would not help the poor as the mass would not get benefits at affordable rates. 

A recent development that should be welcomed is the initiative by the insurance regulator to allow subscribers to avail cashless treatment at any private hospital or nursing home, irrespective of whether it is part of an insurer’s network or not. Earlier to get treated in such a nursing home, which was not part of an insurer’s network of facilities, patients had to pay the full amount and go through the cumbersome process to claim reimbursement. This would undoubtedly help a major section of the middle class, specially the salaried who have such insurance facilities. 

It goes without saying that health is critical to human well-being and, as such, there is need to look into the whole issue and evolve an effective solution in the matter. The judiciary has done the right intervention though this was needed much earlier. Now it is the prerogative of the Centre to direct the states to check the functioning of private nursing homes and hospitals and ensure not just standardisation of rates but see to it that at least 20 percent of beds are reserved for the poor from whom just the actual costs of surgery and minimum doctor’s fees are recovered. 

Only talking of ‘health for all’ has no meaning unless effective steps are taken by the Centre and the states. Maybe some time, the judiciary will also intervene and direct the states to ensure that the poor citizens of the country are not deprived of basic health facilities. As socio-economic development is intrinsically linked to better health, the present landmark order, if adhered to, will bring about a drastic change in the functioning of private health centres.---INFA

(Copyright, India News & Feature Alliance)

 

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