TO BE FIGHTING FIT :-
Issue in the news :-
- Vice-Chief of Army Staff Lt. Gen. Sarath Chand’s interaction with the parliamentary standing committee on defence hopes dashed by budget.
- Whereas the govt spokespersons talked about how the government had worked to strengthen the military while the Opposition accused them of paying inadequate attention to the forces.
What is the reality? As usual, it lies somewhere between the two extremes.
International Agency Favours Indian Defence Budget :-
- According to a recent report by Stockholm International Peace Research Institute, India was the largest arms importer in the last five years, accounting for 12% of global imports.
- The Indian defence budget has now overtaken that of the U.K. to become the fifth largest in the world.
Against the Budget Allocation :-
Despite this, as the Vice-Chief of Army Staff pointed out to Parliament’s standing committee on defence :-
- The current capital allocation is insufficient even to cater for “committed liabilities”, which is payments for equipment under contractual obligation.
- Also, 68% of the Army’s equipment is under the ‘vintage’ category and the situation is unlikely to improve in the near future.
- Equally worrying is the adverse impact on infrastructure development and strategic roads where there is a severe shortage of funds.
How Insufficient Budget Impacts the defence system ?
- An insufficient defence budget impacts not only modernisation but also the current operational readiness of the force.
- Reduction in revenue allocation means cutting down on training requirements and routine replacement of items like surveillance and protective equipment.
Contradictions between Army and govt :-
Regular strategic consultations between the political and military leadership are rare, and when they do take place it is generally for crisis-management, not long-term strategy. But the security challenges, both internal and external, facing the country have to be squarely addressed. The government and the military need to quickly come together and be on the same page.
What steps need to be taken by Govt so Army and govt can be on the same page on security challenges ?
- Govt needs to order a comprehensive strategic review of the future threats to India. This will provide a clear picture to the political leadership, and also directions to the military on its doctrine and force structures. A long-term capability development plan can then be prepared by the military and approved by the government. This will form the basis for the defence budget. The annual bickering over the mismatch between what the military demands and the actual allocations made will be avoided.
- The government must also take a holistic look at all border-guarding forces — the Army, Assam Rifles, the Border Security Force and the Indo-Tibetan Border Police (ITBP). A comprehensive and an integrated approach to border management could result in considerable savings.
The military’s challenge :-
- Military Capability :-
The Military must stop talking in terms of numbers, of squadrons, ships and divisions, and focus on capability because it confronts us with the crucial issue of defining the type of capability that India needs for future warfighting. It will force us to search for the new and the unexpected, and to look at technologies such as robotics, autonomous systems and artificial intelligence to enhance our military capability.
- Integration of Three Defence Services :-
There is a crying need to move towards greater integration among the three services and with the Ministry of Defence (MoD). The luxury of each service running its own training, administrative and logistics system is no longer affordable. An internal report prepared late last year by Minister of State for Defence Subhash Bhamre pointed out that only 8-10% of 144 proposed deals in the last three financial years fructified within the stipulated time period. Greater integration could improve efficiency.
Civil-military differences over defence budgets are an inevitable part of any democracy. However, these differences can be minimised if there is a common understanding of the contours of a national security strategy, and of the genuine requirements of the military for putting this strategy into effect. On its part, the military must focus on capability for future warfighting, not mere numbers.
Mains Level :- There is need to know the differences between the Military & Civil over budget & strategic issues. Both sides are lacking somewhere on their part & How can we resolve those issues so Army & Govt can be on the same page whether its about strategic issues or security challenges.
FIRST STEP IN LONG JOURNEY :-
Article 47 of the Constitution makes it clear that the state is duty-bound to improve public health, but India continues to face a health crisis, with an absolute shortage of and an inequitable presence of doctors and over-burdened hospitals.
Present Challenges :-
- Although India has 10 lakh medical doctors, it needs 3,00,000 more in order to meet the World Health Organisation standard of the ideal doctor-population ratio.
- There is an 81% shortage of specialists in community health centres (CHC), the first point of contact for a patient with a specialist doctor. Those most affected by this are poor and rural patients who are then forced to consult quacks.
- Another fact is that 82.2% of providers of “modern medicine” in rural areas do not have a medical qualification.
- Rural India, which accounts for 69% of the population, faces another issue — only 21% of the country’s doctors serve them.
- The quality of the health-care experience too needs attention.
The NMC Bill, among other things, seeks to address these problems.
Commercialisation of Health System Under Indian Medical Council Act :-
- The insertion of Section 10A in the Indian Medical Council Act was followed by an exponential rise in the number of private medical colleges. This was encouraged as there was, and still is, a shortfall in the number of medical practitioners. the high capitation fees have been charged by these colleges
- With corruption in the issuing of licences and regulatory requirements, many such academic institutions have a faculty of questionable standards, with obvious repercussions on the quality of education imparted.
Bill On To Prevent Health System of commercialisation :-
- The Bill puts in place a mechanism to assess and rate medical colleges regularly, with a high monetary penalty for failure to comply with standards. Three such failures will result in the de-recognition of a college.
- There is also an enabling provision for the government to regulate the fees of up to 40% seats in private medical colleges.
- The Bill goes a step further with a relaxation of the criteria for approving a college in specific cases. Currently, there is a blanket standard for establishing a medical college in India, which disregards the contextual realities in some areas such as difficult terrain or a low population density. For instance, Arunachal Pradesh, Mizoram, and Nagaland do not have a single medical college.
Three Tire Public Health Care System :-
India has a well-thought-out, three-tier public health-care system which rests on a base of
- Sub-centres (SC)
- Primary Health Centres (PHCs) which take care of common ailments.
- Patients in need of specialist consultations go up the chain to secondary centres (CHCs) , or tertiary centres, which are district hospitals (DHs) or medical colleges.
However, because of a poor vanguard, patients who can be treated at the “base” (SCs or PHCs), go straight to the “apex” (CHCs or DHs).
NMC Bill on Strengthening Primary Centres :-
Strengthening primary centres can ensure that the pyramid rests on its base again. With the government now planning to revamp 1,50,000 sub-centres into health and wellness centres by 2022, there is need for an equivalent number of mid-level providers. For this, India’s 7,70,000 AYUSH (Ayurveda, Yoga and Naturopathy, Unani, Siddha and Homoeopathy) practitioners can be tapped.
- The Bill has facilitated this by providing for a bridge course for AYUSH/non-allopathic doctors. This course, to be designed by a joint sitting of all medicine systems, will ensure that non-allopathic doctors are trained to prescribe modern medicines in a limited way, within the scope of primary care.
- An added measure in the Bill prevents “cross-pathy” or the unqualified cross-over of health-care providers from one system to another.
- The Bill provides for two separate national registers – allopathic doctors, and AYUSH doctors who complete the bridge course, respectively.
Mains Level :- Need to know about about issues & features of National Medical Commission Bill (NMC Bill) and so we can ensure how this bill can change the future of Indian Public Health Care system.