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Seven Health Secretaries in Seven Years - Where Is the Accountability? -K Sujatha Rao

-TheWire.in

The government should keep the secretary of the health department unchanged for three years for him/her to be able to show results. But that has not been happening.

The NDA government had promised good governance and policy stability. Yet we have a fourth secretary in the health department in the last three years – the seventh in the last seven years. Since both the outgoing and the incoming officers have sterling reputations, the reason for this mid-course change is unclear.

Why it matters

Health is a complex sector, and a highly contentious one, with several stakeholders working at cross purposes, requiring focused leadership, undistracted by the noise – something similar to the journey of Odysseus when he was tied to the ship’s mast to keep himself from being distracted by the lovely music of the sirens and in the process wreck the ship on the rocks. But such focused leadership requires knowledge of the purpose of the journey, the direction to take, the end to reach. And such clarity comes with years of engagement, absorbing the nuances, developing an intuitive grasp of matters and most importantly, building a team and assessing the political environment within which to steer policy. It is for this reason that the Second Administrative Commission suggested that the tenure of Secretary should be three years. Every change at the top then means a loss of a few months till new equations are formed, trust developed, and understanding gained.

Matters of importance

In line with predecessor governments, the NDA too accorded lukewarm priority to health. It sacked a knowledgeable minister, wound up the National AIDS Control Organisation, that had a global reputation of being a best practice, stopped the reform process of the Rashtriya Swasthya Bima Yojna, shifting it instead to the already overburdened Ministry of Health, and reduced central funding to states in real terms. Instead of swift action to reform the Medical Council of India, in response to the scathing report of the Parliamentary Standing Committee on Health, a Committee was constituted. Two years later, the draft bill is still awaiting action.

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