Chanakya's New Manifesto: To Resolve the Crisis Within India (33 page)

5.14  As already stated, a major growth in the labour-intensive manufacturing sector should go hand in hand with a revolution in our agricultural sector in order to attack poverty effectively. The goal outlined in the new National Manufacturing Policy announced by the government, namely 100 million additional jobs, and the manufacturing sector increasing its share of the economy from the current 16 per cent to 25 per cent by the year 2021-22, must become a reality. The goal is ambitious but not unachievable if treated as a priority.

5.15  The government must immediately put in place a special regimen of facilitation and incentives to encourage investment in this area. Experts believe that India, by leveraging its cheap labour, can become a world manufacturing hub, and take on any country in the world in the area of labour-intensive industries. Several economically developed nations, like Japan, the US and South Korea, would be glad to take advantage of this initiative were it to happen. For this reason, labour intensive manufacturing must be opened up to FDI. Labour rights are important, but our labour laws are outdated; they foster inefficiency and inhibit modern managerial practices and must be urgently reviewed. Industries require land; this land has to be acquired; given the population density in most states, the acquisition of land is a contentious issue. Therefore, the Land Acquisition Bill must receive urgent attention. Industries, like agro-processing, which have an obvious synergy with agriculture, must be given priority. A Special Purpose Vehicle (SPV), or an independent authority, needs to be created to fast-track proposals in this sector.

5.16  Education and health are two vital components of any inclusionary agenda. Both are victims of gross neglect, mismanagement and corruption. Government schools, where an overwhelming bulk of our children study, have to be made to function better. Admittedly, this is not an easy task, but the challenge has to be taken up.

5.17  A new policy which creates partnerships with civil society must be considered. NGOs could be harnessed to monitor the implementation of government policies, such as the Sarva Shiksha Abhiyan, and audit the functioning of schools; To give only one example of civic activism, Teach For India, a project of the international agency Teach To Lead, is a nationwide movement of outstanding college graduates and young professionals who have committed two years to teach full-time in under-resourced schools and who will become lifelong leaders working from within various sectors towards the pursuit of equity in education. There is no reason why, with the right government policies, such instances of non-governmental support cannot be multiplied. In addition, civic groups and corporate houses could be encouraged to adopt schools and be provided with tax incentives to do so. For instance, the government’s indication that 2,500 ‘model’ schools would be set up on the PPP model could become the beginning of the structured involvement of NGOs and the corporate sector with government to improve the quality of schools.

5.18  As we have seen, our track record on health deliverables is abysmal. India has spent only about one per cent of its GDP on health in the last five years. Even more inexcusably, it now plans to increase this spending by only another 0.5 per cent. The Twelfth Plan for the next five years (2012-17) allots only 1.58 per cent of GDP to health. The budget allocation for health must increase substantially.

5.19  Moreover, even the paltry amount currently allocated has been used in a hugely sub-optimal manner. The Planning Commission itself admits that in 2011 the government-run health care system was short of doctors by 76 per cent; there were less than half the number of nurses required; only 12 per cent of specialists had been employed; and laboratory technicians were in short supply by around 80 per cent. The number of primary health centres, community health centres and district hospitals that had been set up were also behind target. This was the situation after the government had spent 70 per cent of the budget of the National Rural Health Mission (amounting to over
50, 000 crore).

5.20  It is also worrying that while our higher education infrastructure has expanded, the infrastructure that exists for medical education is lagging far behind. The country needs 12 lakh doctors and 36 lakh nurses to match WHO norms; however, we have only 5.5 lakh doctors and only 4 lakh nurses. In 2011, China admitted 8 lakh students to medical institutions; our figure was an unbelievably low 42,000.

5.21  To overcome the shortage of doctors, medical education must be expanded on a priority basis. With a strong regulator to ensure standards, the government must allow greater private-sector investment in this area. The pending Foreign Education Institutions Bill, which allows foreign investment in the education sector, must become a reality. If China has improved the quality of its health care it is because it can deploy sixteen times more doctors than India. Nursing colleges and institutions for technicians such as radiographers and pathologists also need to increase dramatically. Here, too, since the government is short of resources, private investment is the answer. What is required is a focused policy that seeks to create the required human resources within a concrete timeline, not an ad hoc drift.

5.22  As a transitional measure, the MBBS degree course must mandate that medical students work for a year in rural areas. This recommendation is likely to be opposed, but the bulk of medical students receive a highly subsidized education, and given the huge shortage of doctors, this is a service they need to provide to their country. They could be given a stipend to ease their passage through the period of rural service. It is important to ensure any such scheme does not degenerate into tokenism.

5.23  The quality and reach of health services is a life and death issue for the poor. This sector needs to be drastically revamped, in terms of funding, long-term planning, and strategies of implementation. The government’s track record in meeting the health requirements of the poorest sections of our society is disappointing but there is nobody else who can do it. There is no other solution except for the government to perform better. The recommendations contained in the earlier chapter on governance, and the measures detailed to combat corruption, must be followed to ensure this.

5.24  However, when it comes to managing very large public health schemes, it is clear that the government cannot deliver on its own. The government must forge partnerships with civil society, with NGOs and other voluntary bodies to better implement its health schemes. Such agencies can be harnessed to monitor government programmes, adopt primary and community health centres, and become partners in implementation strategies.

5.25  The government has almost never tried to partner with nongovernmental agencies to implement its welfare programmes. But the few attempts that have been made have succeeded beyond all expectations. K. Anji Reddy, the founder chairman of the Naandi Foundation and Dr Reddy’s Laboratories Ltd, moots the idea of what he calls ‘post-reform development services enterprises’. ‘These will be run by passionate, young professionals who will use the best of management principles with a focus on efficiency and outcomes. They will partner with the government for one-time subsidies for capital investment or for tapping budgetary allocations’ in order to get deliverables to the poor. He cites several examples where this is working very well. Partnering with the government, and with the support of corporate donations, these entrepreneurs are efficiently running kitchens in urban areas and remote drought-hit regions which have brought the mid-day meal scheme to five million children. The Haryana and Punjab governments have also taken the initiative to float tenders to provide safe drinking water to villages at a fixed price. ‘These post-reform development entrepreneurs,’ says Reddy, ‘got a one-time subsidy from the state governments for the capital cost, and run their enterprise with the efficiencies reaped in management and service delivery mechanisms.’
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When the Andhra Pradesh government outsourced water treatment plants to tackle the rampant problem of fluorosis, a thousand micro-entrepreneurs responded, leading to a near-complete eradication of the disease. Reddy argues that since such enterprises run with small margins, the government can encourage greater participation with tax incentives. What is important is to explore new avenues which ensure deliverables at cost-effective rates, something government agencies on their own have not been able to do.

5.26  Modern India needs to resurrect the notion of paropkar. So-called realists, hardened by the selfish cynicism which has become the hallmark of modern India, will scoff at the idea. While it is true that appeals to our better nature may not get us very far, if an enlightened policy framework is created, and the right incentives and entrepreneurial opportunities are provided, the philanthropic impulse is likely to be catalyzed. It is essential, therefore, that shedding its previous hostility and reservations, the government comes out with a new policy wherein the inclusionary agenda is opened up to nongovernmental partners through the right mix of competence evaluation, tax incentives and outsourcing.

5.27  Non-governmental actors—be they citizens’ groupings, welfare associations, NGOs, or corporates—can contribute to the welfare agenda in three principal ways. First, they can partner with the government to ensure that deliverables reach the intended beneficiaries; second, they can partner in providing those deliverables; and third, they can, as independent stakeholders, provide those deliverables themselves.

5.28  The logical question to ask is whether such non-governmental actors constitute a sufficient critical mass to partner with the government or take independent initiatives in furthering the welfare agenda. Their numbers may not be adequate now, but there is no reason why the right policies cannot encourage a substantial number of new players. A 2009 study estimated that India has 3.3 million registered NGOs; a great many of them are involved in development work, and a sizeable proportion of the rest should be encouraged to do so. It is true that several of these NGOs benefit from foreign funding. By some estimates a sum of
110 billion comes from outside the country to assist roughly 20,000 organizations. Foreign funding is not by itself subversive, nor is such funding an India-centric phenomenon. International charities and foundations look for partners to further their goals, and India provides enough legitimate avenues for such partnership. Each application must be judged on merit, and if a hidden agenda that is inimical to India’s interests is discovered it should be dealt with appropriately. However, a generalized and reflexive hostility towards the foreign funding of NGOs is unnecessary.

5.29  The existing official regimen in India to encourage philanthropy, NGOs and non-profit organizations is woefully inadequate. This has been recognized by several task forces and commissions appointed by the government itself but, as usual, the correctives proposed have not been acted upon. A comprehensive report for the Planning Commission in 2004
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bluntly states that a multiplicity of laws and agencies, cumbersome procedures, unjustified delays, the unhelpful attitude of officers, and corruption are all responsible for the tardy growth of philanthropic activity in the country. The myriad arms of the government are responsible for oversight and incompetent functioning in this area. ‘The Voluntary Action Cell for overall policy coordination is under the Planning Commission; the income tax agencies (which grant exemptions) are under the finance ministry; the Registrar of Companies (Section 25 of the Companies Act deals with nonprofit companies) is under the Department of Company Affairs and Company Law; the Charities Commissioner in Maharashtra and Gujarat report to the Legal Department, and the Registrar of Societies is under the Cooperative Department or under the Home department.’
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In the absence of a nationwide enabling milieu, such a fragmented administrative structure, rife with corruption and apathy, is hardly designed to incentivize an individual or entity predisposed to volunteerism. On the contrary, the regimen is designed to discourage paropkar, with such absurd requirements as making it compulsory for any trust with an annual income of
1,500 per annum to submit annual audited accounts! The cost of the audit would be more than the income. In fact, the report commissioned by the Planning Commission itself points out that, unfortunately, ‘charity or volunteerism comes way down in the priority list of governments—both at the Centre and state level.’
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