Fatal indifference

Dinesh Trivedi,minister of state for health and family welfare,vented his frustration with his own officials for red-tapism,and wished aloud for a younger,more limber and technology-friendly support staff. The crux of the confrontation was a web-portal recommended by the Knowledge Commission that Trivedi threw his weight behind,but the ministry failed to release funds. Trivedi felt his concept had been sidelined, say ministry officials. Back-and-forth over the merits of Trivedis proposal aside,the ministers rant definitely serves a useful purpose: it directs long-overdue attention at the functioning of the health ministry. The ministry is possibly the most unreformed in government today. It has served less as help and more as hindrance in the implementation and spread of the National Rural Health Mission,for example. They have not been held accountable for not meeting targets which are frequently opaque and woolly in the first place.

The culture of impunity that surrounds this establishment was brought out with startling clarity when the Medical Council of Indias president Ketan Desai was arrested for corruption. But the trouble reaches further into the past. Meant to regulate the MBBS programme,set ethical standards and provide expert advice to the government,the MCI strayed into the more profitable realm of postgraduate education,while failing its own mandate. It created an artificial scarcity of medical institutions,constrained the supply of professionals and creating dangerous skews in our healthcare. It held back innovation,like the training of nurse practitioners and nurse obstetricians.

The health ministry has known all this for years,and yet it excused the regulators venality on life-and-death matters,saying that the MCI was a self-governing body of professionals. The fact that they had to be dragged kicking and screaming to reform the MCI only invites the charge of vested interest on the ministry as well. India,with its vast unmet needs and its unevenly spread facilities,needs imaginative regulation and an active,reformed,accountable ministry. Meanwhile,once the indignation subsides,one can only hope that the ministers tirade rouses his bureaucracy out of its torpor.