Fixing healthcare: (Indian Express, Editorial)
More than 60 per cent of the population cannot afford private healthcare because of the following reasons:
- Private health service routinely excludes a large poor population, overcharges and reduces many to penury.
- Private healthcare is often without regulation and even tenuous attempts at implementing the Clinical Establishment Act have not been made.
- They are confined to cities and urban areas.
- Comparatively, private hospitals facilitate profit-maximisation with impunity.
What are the problems government hospitals are facing?
Shortfall of doctors
- Lack of accountability, absenteeism, trade unionism and underfunding in government hospitals.
- Health services in government hospitals are quasi-public goods or merit goods.
- Drug supply by the government is not reliable.
- Missing of budget: There is hardly any budget to buy new gadgets and hospital equipment. Most devices are therefore outdated. As soon as they stop working they cannot be replaced by new ones.
- Lack of infrastructure like insufficient laboratory systems, beds, electricity, toilets etc.
- There is a scarcity of skilled manpower. Even if they are they are mostly located in urban areas. A significant portion of doctor are under qualified
- Low public expenditure: Though there has been an improvement in the expenditure still India’s health expenditure is one of the lowest in the world.
- Irregularities like non-availability of medicines and unethical practices by doctors
- Lack of resources: Lack of resources/funds often means diagnostic instruments are not in working condition, forcing doctors to ask patients to get tests done from private laboratories.
- High workload: Acute shortage of manpower hence, they are not able to attend to all the patients, resulting in long queues and delays
- False charges of negligence: People come to the government hospital as a last resort, after trying to get treatment in local nursing homes or doctors, by which time, in most cases, the patient’s condition is critical.
What strategies should be followed to deal with these issues?
- Providing good working environment to the young doctors.
- Providing secure working environment for women doctors and other staffs.
- Increasing funding of health sector
- Improving the public transport in government hospitals.
- Increasing the infrastructure such as more hospital, adequate equipments, adequate staff etc.
- Efficiency is must for public health system but co-existing with private players in the same premises is not the best solution
- Increasing the budget to 3 per cent of GDP will be a welcome step but may be the only one that is required
- Revamping the existing ecosystem to deliver better service.
What are the Government initiatives in the field?
- The Union Government launched Pradhan Mantri Surakshit Matritva Abhiyan (PMSMA) to provide free health check-ups to pregnant women at government health centers and hospitals.
- Mission Indradhanush programme aims at reducing maternal and child mortality by reaching out to each and every child under two years of age and all pregnant women who have been left uncovered under routine immunisation programme. Its focus is on improving immunization coverage in select districts and cities to ensure full immunization to more than 90% by December 2018.
- E-Health: In July 2015, the Prime Minister launched his Digital India campaign, and E-Health was one of the initiatives launched with the campaign.
- The government is finalising a draft law on passive euthanasia called ‘The Management of Patients With Terminal Illness – Withdrawal of Medical Life Support Bill’.
- This bill is under review by the Law Commission of India and recommends that life support can be withdrawn for patients in persistent vegetative state (PVS) or suffering an irreversible medical condition.
What is euthanasia? What is Passive euthanasia?
- Euthanasia is the practice of intentionally ending a life to relieve pain and suffering. There are different euthanasia laws in each country.
- Euthanasia is categorized in different ways, which include voluntary, non-voluntary, or involuntary.
- Voluntary euthanasia is conducted with the consent of the patient.
- Non-voluntary euthanasia is conducted when the consent of the patient is unavailable. It is illegal worldwide.
- Involuntary euthanasia is conducted against the will of the patient. This is also illegal.
- Passive euthanasia is the subdivision of Voluntary, non-voluntary and involuntary euthanasia.
- Passive euthanasia involves the withdrawing of treatment or food that would allow the patient to live.
Passive euthanasia in Indian context:
- In March 2011, the Supreme Court of India passed a historic judgement-law permitting Passive Euthanasia in the country.
- The Supreme Court specified two irreversible conditions to permit Passive Euthanasia Law
- The brain-dead for whom the ventilator can be switched off and
- Those in a Persistent Vegetative State (PVS) for whom the feed can be tapered out and pain-managing palliatives are added.
- After the case of Aruna Shanbaug’s euthanasia, the Supreme Court laid the following guidelines:
- A decision has to be taken to discontinue life support either by the parents or the spouse or other close relatives, or in the absence of any of them, such a decision can be taken even by a person or a body of persons acting as a next friend.
- Even if a decision is taken by the near relatives or doctors or next friend to withdraw life support, such a decision requires approval from the High Court concerned.
- When such an application is filled the Chief Justice of the High Court should forthwith constitute a Bench of at least two Judges who should decide to grant approval or not.
Aruna Shanbaug’s euthanasia:
- Aruna Shanbaug was a nurse working at the King Edward Memorial Hospital, Parel, Mumbai.
- On 27 November 1973 when she was strangled and sodomized by, a sweeper.
- After the incident, she has been treated at KEM since the incident and is kept alive by feeding tube.
- On behalf of Aruna, her friend Pinki Virani, a social activist, filed a petition in the Supreme Court arguing that the continued existence of Aruna is in violation of her right to live in dignity.
- The Supreme Court court rejected the plea to discontinue Aruna’s life support but issued a set of broad guidelines legalising passive euthanasia in India.
- Euthanasia has been a controversial topic of discussion throughout ages.
- It is believed that country’s weak rule of law and the large gap between the rich and the poor, which might lead to the exploitation of the elderly by their families.
- India and Britain meet focuses on concrete measures to take forward their defence partnership by next year.
- The meeting of the two leaders is widely expected to take place at the Commonwealth Heads of Government meeting in London in April 2018.
Talks of co-operation
- India’s Defence Secretary Sanjay Mitra in his three-day visit met with Michael Fallon, Ministry of Defence(U.K) to hold meetings of the Defence Consultative Group.
- The visit consolidates India-UK defence cooperation in the framework of the Defence and International Security Partnership (DISP), agreed in November 2015.
- The defence partnership will encompass cooperation in the defence industry, stronger military to military engagement, including training and joint exercises.
- The renewed engagement will place capability and technology development at its core and use the private and public sectors to develop defence solutions for use in home and shared export markets.
- The Defence ministers will continue to coordinate policies across a range of global security challenges, especially those intended to eliminate international terrorism.
- The ministers agreed to further strengthen their naval interactions, including enhanced Maritime Domain Awareness (MDA) to exchange information to track terrorists and pirate vessels. This is key to the DISP.
- The two ministers recognised the potential for further cooperation in defence manufacturing between the UK and Indian companies under ‘Make in India’.
- Recent announcements were made including the MOU between Bharat Dynamics and Thales UK on technology transfer opportunities for missile systems. And to develop an Advanced Hawk jet trainer jointly by the BAE Systems and Hindustan Aeronautics Limited (HAL).
- Both nations will explore establishing a secure communications method to share classified material.
- The two ministers recognised the need for stronger R&D cooperation, including access to Defence R&D training.
Make in India push
- India puts the defence sector as one of the major areas where the bilateral partnership could be expanded around the “Make in India” campaign.
- During Mr. Modi’s visit in 2015, the two sides agreed to move towards a new Defence and International Security Partnership that would “intensify cooperation on defence and security, including cybersecurity, and maritime security” pushing for joint working in key strategic areas.
- India is hoping that U.K. firms participate in ‘Make in India’ process thus strengthening the strategic partnership exercise between the two countries.
India- UK relation in the present day context:
- India and the United Kingdom share a modern partnership bound by strong historical ties.
- The bilateral relationship that was upgraded to a strategic partnership in 2004, was further strengthened during the tenure of British Prime Minister David Cameron to India who visited India thrice in his first term.
- The successful visit of Prime Minister Modi to the UK in November 2015 gave further impetus to the bilateral relationship.
- Interactions at the highest political level have continued as is reflected from UK Prime Minister Theresa May’s latest visit to India in November 2016, her first overseas bilateral visit after assuming office in July 2016.
India – U.K Defence Cooperation
- Cooperation in defence sector is another important pillar of bilateral cooperation.
- At all the three services level, joint exercises and wide ranging exchanges between the three services are conducted regularly.
- The last Army Joint Exercise ‘Ajeya Warrior’ was held in the UK from 7-28 June, 2015.
- The Indian Air force participated in the Exercise ‘Indradhanush-IV’ in the UK from 21 July – 1 August, 2015. The Joint Navy Exercise ‘Konkan 2017’ was held in May 2017 at Plymouth in the UK that witnessed participation by INS Tarkash.
- During Prime Minister’s visit to UK in November 2015, the two countries agreed to elevate their Defence relationship by establishing capability partnerships in strategic areas through which we will work together across the spectrum of doctrine, training and other elements upon which military effectiveness depends.
- The institutionalized dialogue to discuss defence cooperation viz. Defence Consultative Group Meeting, is held annually at Defence Secretary level. The 17th DCG meeting was held on 15-16 November 2016 in New Delhi.
- The Securities and Exchange Board of India (SEBI) has allowed exchanges established in GIFT City to introduce crude oil futures contracts, trading in which is set to commence later this month.
What is the GIFT City?
- GIFT is conceptualized as a global financial and IT services hub, a first of its kind in India, designed to be at or above par with globally benchmarked financial centers such as Shinjuku, Tokyo, Lujiazui, Shanghai, La Defense, Paris, London Dockyards
- GIFT is planned as a financial Central Business District (CBD) between Ahmedabad and Gandhinagar as a Greenfield development.
- GIFT is designed as a hub for the global financial services sector. More particularly, state-of-the-art connectivity, infrastructure and transportation access have been integrated into the design of the city.
What are the various objectives through which GIFT can be accomplished?
- To develop a new format for globally benchmarked Integrated City
- To propose a road map for fast track development and implementation
- To make the city scalable in each & every aspect for a distant future
- To derive the city format from fast changing lifestyles & new technologies
- To achieve an image of Global city, that keeps pace with modern technologies
What is IFSC?
- International Financial Services Centre caters to customers outside the jurisdiction of domestic economy, dealing with flows of finance, financial products and services across borders
- London, New York and Singapore can be counted as global financial centres.
What are the services an IFSC can provide?
- Fund-raising services for individuals, corporations and governments
- Asset management and global portfolio diversification undertaken by pension funds, insurance companies and mutual funds
- Wealth management
- Global tax management and cross-border tax liability optimization, which provides a business opportunity for financial intermediaries, accountants and law firms.
- Global and regional corporate treasury management operations that involve fund-raising, liquidity investment and management and asset-liability matching
- Risk management operations such as insurance and reinsurance
- Merger and acquisition activities among trans-national corporations
What is the significance of the incursion of crude oil in IFSC?
- There is a high demand for crude oil contracts globally and the launch of such contracts in GIFT City will boost the liquidity
- Crude oil is the highest traded commodity on Multi Commodity Exchange of India (MCX)which is the country’s largest commodity bourse in terms of market share.
- The inclusion of crude oil contracts at the International Financial Services Centre (IFSC) was one of the main demands by market participants to trade in the global commodity in dollar terms, with the added advantage of lower trading costs and also longer trading hours on Indian shores.
- BSE’s India INX and the NSE IFSC are the two operational bourses in the special financial zone in Gujarat.
- India INX would offer two contracts — one with Brent crude as the underlying, and the other with WTI crude.
The wrong options: (The Hindu, Editorial)
GST and Demonetisation are not the structural reforms that will boost the economy
What is GST?
- GST is an indirect destination based tax levied on the supply of goods and services. GST Law has replaced many indirect tax laws that previously existed in India.
- Level playing field for small traders in any part of the country.
- More efficient neutralization of taxes to make our exports more competitive internationally.
- It will create a unified common National market.
- It will make India a manufacturing hub.
- Reduction in multiplicity of taxes now leviable on goods and services, leading to simplification.
- Increased costs due to software purchase
- GST will mean an increase in operational costs
- GST came into effect in the middle of the financial year
- GST is an online taxation system
- SMEs will have a higher tax burden
What is demonetization?
- Demonetisation is withdrawal of a particular form of currency from circulation. Notes of a particular denomination cease to be legal tender. In other words, the notes lose their value as a currency.
- Direct tax collections rose 19% in April-July of FY18 as more individuals have come into the tax net.
- The digitalization of money transactions has gone up substantially in the past few months, following demonetisation.
- Demonetisation has improved transmission in the banking system and led to the greater financialization of savings.
- Cash crunch
- Economic slow down
- Corruption at different levels
- Recalibration of ATM
What do the critics of these reforms say?
- Demonetisation was a temporary demand shock that brought the wheels of commerce to a halt. It failed to achieve its primary objective of mass confiscation of illegal wealth.
- GST, is a fiscal programme to increase the government’s ability to tax more citizens in the large informal economy, which also manages to kill the scope of tax competition between States.
- Both GST and demonetisation are measures to increase, rather than reduce, the role of the government in the economy.
- It is not the lack of sufficient tax revenues that has held back India, rather it is simply the lack of economic freedom which impedes ordinary individuals from seeking to improve their economic status without any interference from the state.
- What India needs is not increased tax compliance among citizens, but pro-market reforms that will make the country a free and competitive marketplace.
- A government should allows free competition, without favouring special interest groups, either through pro-business or pro-poor policies, will also be sowing the seeds for improved living standards.
New Pattern Of Urban Terror: (Indian Express, Editorial)
- After the sniper attack, which recently took a heavy toll of innocent lives in Las Vegas, India too must prepare for a changing security threat and challenge.
What is lone-wolf attack or terrorism?
- A lone wolf, lone-wolf terrorist, or lone actor, is someone who prepares and commits violent acts alone, outside of any command structure and without material assistance from any group.
- He or she may be influenced or motivated by the ideology and beliefs of an external group and may act in support of such a group.
What are the measures in India to control Lone Wolf Attack?
- India is not as vulnerable as some of the countries that have faced this threat in the recent past. Some of its major measures taken are as follows:
- In 2015, Intelligence bureau started Operation Chakravyuh to monitor the internet for the activities of the youth who are in touch with Islamic State operatives or viewing the material posted.
- The National Security Guard (NSG) was set up in 1984 as a Federal Contingency Deployment Force to tackle all facets of terrorism in the country.
- The NSG is trained to conduct counter terrorist task to including counter hijacking tasks on land, sea, and air; Bomb disposal (search, detection and neutralization of IEDs); PBI (Post Blast Investigation) and Hostage Rescue missions.
What are the further measures to be taken in India to control Lone Wolf Attack?
- Following are the further steps to be taken in order to be more vigilant about Lone wolf attacks in India:
- The approach must follow the sequence of awareness of the contagion, detection of potential and existing recruits and finally remedial action.
- There is a need to focus attention on potential target groups through monitoring and infiltration of social media sites that are the principle source of radical propaganda.
- Big data analytics must be used to discern the level of radicalisation of potential recruits, their networks and sources of information, funding and leadership in order to help unravel the roots of radicalisation.
- Raising the strength of our police stations and posts in cities needs to be stepped up.
- Communication to the nation about the need to understand security threats has to be carried out.
A new industrial policy for Bharat: (Live Mint, Editorial)
The Department of Industrial Policy and Promotion, Ministry of Commerce and Industry initiated the process of formulation of a new Industrial Policy recently.
- Since the last Industrial Policy announced in 1991, India has transformed into one of the fastest growing economies in the world. With strong macro-economic fundamentals and several path breaking reforms in the last three years, India is equipped to deploy a different set of ideas and strategies to build a globally competitive Indian industry.
- The new Industrial Policy will subsume the National Manufacturing Policy.
- A Task Force on Artificial Intelligence for India’s Economic Transformation has also been constituted which will provide inputs for the policy.
Why there is need for new industrial policy?
- A recent report by Deloitte LLP pointed out that India’s young population will drive its economic growth to overtake China and other Asian tigers in the next few decades.
- The potential workforce in India is set to increase from 885 million to 1.08 billion in the next 20 years.
- In this context the discussion paper on Industrial Policy 2017, released recently by the Department of Industrial Policy and Promotion (DIPP), becomes relevant.
- The new industrial policy aimed at building a globally competitive Indian industry equipped with skill, scale and technology.
- It is proposed that the new Industrial Policy will aim at making India a manufacturing hub by promoting ‘Make in India’.
- It will also suitably incorporate the use of modern smart technologies such as IOT, artificial intelligence and robotics for advanced manufacturing.
- The Economic Survey 2016-17 pointed out that he richer peninsular states in India will witness a sharp increase in working age populations, followed by a sharp decline.
- It is an opportunity to address the problems of low Research & Development spending and tough competition from cheap Chinese imports
- Micro, the small and medium enterprises sector facing tough competition from cheap imports from China and other countries with which India has free trade agreements
- It recognizes the need to gainfully employ a growing workforce
What needs to be done?
- For India to realize its economic potential, it is this young population which needs to be tapped and provided opportunities.
- Significant migration in search of better sources of livelihood is also being witnessed from such areas towards urban centres, which needs to be carefully managed.
- A new industrial policy for India must necessarily discuss ideas for creating jobs for and in Bharat.
- There is need to promote competition, enhancing the competitiveness of domestic industry, and strengthening global linkages and value chains.
- Any design of industrial policy must appreciate its linkages and interaction with agriculture and services policies
- It is important to institutionalize such a whole-of-government approach and authorize a powerful nodal department in the prime minister’s office to ensure coherence through coordination with different departments and related stakeholders, and enable swift decision making within predetermined time frames.
- Any industrial policy design must note its linkages with agriculture and services policies at a granular level, and with trade and competition at a broader level.
- India’s new industrial policy must focus on improving overall competitiveness and avoid the lure of protectionism.
A new forward-looking industrial policy for India must have Bharat as its soul. It must prioritize the creation of livelihoods in rural and semi-urban areas, and should recognize the importance of growth in the rural non-farm and agriculture-allied economy for industrial development.
A long-term view needs to be taken on competition and trade-related issues, and the industrial policy should avoid the temptation of short-term benefits of over-protectionism.
- The World Health Organization (WHO) has released new guidelines on how trained professionals can better identify youngsters in need of help.
- These new guidelines are updates for the Integrated Management of Childhood Illness (IMCI).
World Health Organization (WHO):
- The World Health Organization (WHO), established on 7 April 1948, is the body of the United Nations (UN) responsible for directing and coordinating health.
Its current priorities include managing:
- communicable diseases, the mitigation of the effects of non-communicable diseases,
- sexual and reproductive health, development, and ageing,
- nutrition, food security and healthy eating,
- occupational health; substance abuse and
- driving the development of reporting, publications, and networking.
What are the guidelines to manage obesity in children provided by the World Health Organisation?
- The WHO guidelines is entitled as “Assessing and managing children at primary healthcare facilities to prevent overweight and obesity in the context of the double burden of malnutrition”.
- The guideline aims to support the efforts to achieve a host of goals such as, the Sustainable Development Goals, the global targets set by the Comprehensive implementation plan on maternal, infant and young child nutrition, and the Global strategy for women’s, children’s and adolescents’ health 2016–2030.
The guidelines of WHO are as follows: an overview:
- WHO has issued guidelines to support primary healthcare workers and identify and manage children who are overweight or obese.
- Where infants and children are identified as overweight, WHO recommends providing counselling to parents and caregivers on nutrition and physical activity.
- This can be done by a health worker at primary health-care level, if adequately trained, or at a referral clinic or local hospital.
- WHO recommends that all infants and children aged less than 5 years presenting to primary health-care facilities should have both weight and height measured.
- WHO also recommends not to provide formulated supplementary foods on a routine basis to children who are moderately wasted or stunted.
What are the causes of obesity in children?
- Children become overweight and obese for a variety of reasons. Some of them are as follows:
- The most common cause is genetic factors,
- lack of physical activity,
- unhealthy eating patterns,
- overweight caused by a medical condition such as a hormonal problem and
- psychological issues may also lead to obesity in some children.
- As a matter of fact, although weight problems run in families, not all children with a family history of obesity will be overweight.
Why is it important to control obesity at an early age?
- Children who are obese have a higher risk of developing health problems. Thus it becomes important to control it at the initial stage. Some of the potential threats involved are as follows:
- Children and adults who are overweight are more likely to develop type 2 diabetes.
- Diabetes can lead to eye disease, nerve damage, and kidney dysfunction.
- High cholesterol and high blood pressure raise the risk of future heart disease in obese children.
- Asthma is chronic inflammation of the lung’s airways and obesity is the most common comorbidity.