Dissent and democracy

Full text: 'NGOs are not anti-national just because they differ with government on some matters'

Dozens of NGOs ask Prime Minister Modi to review restraints and to amend rules regarding foreign contributions to make them more transparent.

Even as the New York Times  noted in an editorial on Thursday said that the government's crackdown on the Ford Foundation and other NGOs "smacks on political payback", 200 representatives of several civil society organisations have urged Prime Minister Narendra Modi to "put an end to coercive actions" against activist outfits and donors "without reasonable cause or due process".

In a letter released on Friday, they also urged him to "review all orders placing restraints on organisations, and revoke such orders where due process has not been followed by the government, no redress mechanism is clearly stated, and grounds are vague, subjective or flimsy"

The NGOs that been treated unfairly, the letter said, include the Indian Social Action Forum or INSAF, Peoples Watch, Sabrang Trust, Greenpeace India, Ford Foundation, HIVOS and ICCO.

Last month, the Modi government cancelled the licenses of nearly 9,000 NGOs that received foreign funds, claiming that they had not filed their tax returns. It also froze the accounts of the environmental NGO Greenpeace, which has conducted several high-profile anti-mining campaigns. The government claimed that Greenpeace had "prejudicially affected the economic interests of the state".

Over the past few month, Teesta Setalvad's Sabrang Trust, which has been instrumental in pursuing cases involving victims of the Gujarat riots of 2002, when Modi was the state's chief minister, has also faced a barrage of inquiries about its funding. The Gujarat police have claimed that Setalvad and her husband, Javed Anand, misappropriated funds and have moved court to interrogate them in custody, claiming that the couple have not been cooperating with the investigation. Setalvad say that she was already submitted all the documents demanded by investigators ‒ some 20,000 documents in all.

Here is the full text of the letter, which has been signed among others by Poonam Mutttreja of the Population Foundation of India, Enakshi Ganguly of the Haq Centre for Child Rights, Biraj Patnaik and others.
Dear Mr. Prime Minister,

We write to you today as members and representatives of Indian civil society organizations and, most importantly as Indian citizens, to express our deep concern at how civil society organizations in general and their support systems, including donors, are being labeled and targeted.

Funds are being frozen, intelligence reports are being selectively released to paint NGOs in poor light, disbursal of funds are being subjected to case-by-case clearance, and their activities are reportedly being placed on ‘watch lists.’ As a result several NGO projects have shut down, donors are unable to support work, and there is an overall atmosphere of State coercion and intimidation in India’s civil society space.

Today, standing in solidarity with India’s most marginalized communities, with the NGO sector and donors who support us, affirmed by the guiding principles of our Constitution – justice, equality and liberty – we address you through an open letter.

As you are aware, NGOs work both in the welfare sector and in empowering people to be aware of and enforce their rights as enshrined in our Constitution. Such action may include questioning and protesting decisions taken by government in many areas. This work is both our right and our responsibility as civil society actors in a democratic nation. Indeed the Indian government acknowledged this. At the Universal Periodic Review of India at the UN Human Rights Council in 2012, the Government spoke of "…the Government’s active association with civil society and the increasing and important role that civil society and human rights defenders are playing in the area of human rights.’"Government of India further said that, "The media, civil society and other activists have helped the Government to be vigilant against transgressions."

Many of us receive both Indian and foreign donations in compliance with laws and carry out activities intended to help those marginalized in India’s development. Many of us have partnered with Government, both at State and Central levels, towards many goals – achieving universal education, access to health care, women’s empowerment, and providing humanitarian relief in times of tragedy such as the recent earthquake. We have also worked in pilot projects – some over the years have been scaled up, and others have richly contributed to the policy framework of the Government of India. It should be a matter of pride for any government and a sign of robust people-centric engagement that NGOs and citizens have impacted State policy.

On other issues, your government and indeed previous governments may or may not agree with some of our views. These may include the issue of nuclear power plants, acquiring tribal and other lands, upholding Dalit rights, protecting rights of minorities against the scourge of communalism, protecting rights of sexual minorities, or campaigning for the universal right to food. Yet, we expect that Government protect our right to work and express our views.  It does not behoove the Government to label any and every conflicting voice on these issues as "anti-national","‘against national security" or "donor driven" and seek to create a public atmosphere that justifies “a crack down on NGOs.” These very words shame any society. "Watch lists” and “crack-downs” belong in another age and have no place in a modern democracy.

Your government has raised the issue that some NGOs may not have complied with the Foreign Contribution Regulation Act, the law governing receipt of foreign donations in India. We state categorically that we stand fully for transparency and accountability in both government and NGO practice, and it is in fact civil society actors who have fought hard for these principles to be enshrined in all areas of public life. So let us constructively ensure transparency and legal compliance across the vast NGO sector, including societies, trusts and a range of public and private institutions. However, such efforts cannot be capricious, selective or based on flimsy grounds. At the moment it seems that ‘compliance’ is serving as a garb to actually target those organizations and individuals whose views the government disagrees with, and indeed to monitor and stifle disagreement itself.

There is irrefutable documentary evidence that State action against select organizations has been arbitrary, non-transparent, and without any course of administrative redress. The effect has been to harm important work being done by NGOs at the grassroots and send a signal of threat to civil society. Our concern includes the manner in which many Indian NGOs and  international partners have been targeted for different reasons. Thus, civil society organizations in India today find themselves in a situation where the only avenue of redress appears to be through the judiciary. Mr. Prime Minister, this kind of coercive domestic environment being created under your watch does not augur well for the worlds largest democracy that professes aspirations to being a global leader in promoting freedoms and democratic values.

Further, in an increasingly globalized world, where even business interests freely collaborate across national boundaries, to label any individual or NGO that engages with international forums or any donor who supports such NGOs, as "anti-national" is illogical. India is signatory to international conventions and treaties and seeks to adhere to the highest international standards of democracy, liberty, justice and human rights. The Government of India regularly reports at these forums. It is accepted practice that NGOs and civil society actors also present their views at these forums, often disagreeing with the views of their respective governments. Many of us, signatories to this letter, engage in active advocacy at international forums. This upholds the best traditions of global democratic debate, and the right to seek a more just nation and more just world. It is not anti-national to do so. We do not believe that any government can claim that it alone has the prerogative to define what is ‘national interest’. The citizens of this country, who elect the Government into power, are the ultimate stakeholders, and must be allowed to define, articulate and work towards their idea of ‘national interest’ too, whether or not it concurs with the views of the Government.

Mr. Prime Minister, it does your Government no credit to use its power to stifle the rights of individuals or NGOs to legally and freely associate, to work with communities, to receive donations to do such work, and to express their views on a range of issues that directly affect our country and its people. An atmosphere of hostility against civil society actors in a democracy, and the uncertainty and insecurity created among communities across the country, can only be to the detriment of our society and the Government.

We therefore ask the Government to:

1. Put an end to coercive actions against NGOs and donors, without reasonable cause or due process, or seek to cripple the ability of these organisations to carry on their legitimate and sanctioned work.

2. Urgently review all orders placing restraints on organizations, and revoke such orders where due process has not been followed by the government, no redress mechanism is clearly stated, and grounds are vague, subjective or flimsy. Those we are currently aware of include, among others, INSAF, Peoples Watch, Sabrang Trust, Greenpeace India, Ford Foundation, HIVOS and ICCO.

3. Initiate an immediate dialogue between the NGO sector and Government to address our concerns going forward. Amend the presently opaque FCRA rules and regulations; ensure complete clarity and transparency on provisions and processes, as well as forums and mechanisms of redress; remove all provisions that are amenable to subjective interpretation; ensure their uniform application to all NGOs, trusts, foundations, and societies.

We look forward to your response and action on these vital issues of national interest.


We welcome your comments at letters@scroll.in.
Sponsored Content BY 

What hospitals can do to drive entrepreneurship and enhance patient experience

Hospitals can perform better by partnering with entrepreneurs and encouraging a culture of intrapreneurship focused on customer centricity.

At the Emory University Hospital in Atlanta, visitors don’t have to worry about navigating their way across the complex hospital premises. All they need to do is download wayfinding tools from the installed digital signage onto their smartphone and get step by step directions. Other hospitals have digital signage in surgical waiting rooms that share surgery updates with the anxious families waiting outside, or offer general information to visitors in waiting rooms. Many others use digital registration tools to reduce check-in time or have Smart TVs in patient rooms that serve educational and anxiety alleviating content.

Most of these tech enabled solutions have emerged as hospitals look for better ways to enhance patient experience – one of the top criteria in evaluating hospital performance. Patient experience accounts for 25% of a hospital’s Value-Based Purchasing (VBP) score as per the US government’s Centres for Medicare and Mediaid Services (CMS) programme. As a Mckinsey report says, hospitals need to break down a patient’s journey into various aspects, clinical and non-clinical, and seek ways of improving every touch point in the journey. As hospitals also need to focus on delivering quality healthcare, they are increasingly collaborating with entrepreneurs who offer such patient centric solutions or encouraging innovative intrapreneurship within the organization.

At the Hospital Leadership Summit hosted by Abbott, some of the speakers from diverse industry backgrounds brought up the role of entrepreneurship in order to deliver on patient experience.

Getting the best from collaborations

Speakers such as Dr Naresh Trehan, Chairman and Managing Director - Medanta Hospitals, and Meena Ganesh, CEO and MD - Portea Medical, who spoke at the panel discussion on “Are we fit for the world of new consumers?”, highlighted the importance of collaborating with entrepreneurs to fill the gaps in the patient experience eco system. As Dr Trehan says, “As healthcare service providers we are too steeped in our own work. So even though we may realize there are gaps in customer experience delivery, we don’t want to get distracted from our core job, which is healthcare delivery. We would rather leave the job of filling those gaps to an outsider who can do it well.”

Meena Ganesh shares a similar view when she says that entrepreneurs offer an outsider’s fresh perspective on the existing gaps in healthcare. They are therefore better equipped to offer disruptive technology solutions that put the customer right at the center. Her own venture, Portea Medical, was born out of a need in the hitherto unaddressed area of patient experience – quality home care.

There are enough examples of hospitals that have gained significantly by partnering with or investing in such ventures. For example, the Children’s Medical Centre in Dallas actively invests in tech startups to offer better care to its patients. One such startup produces sensors smaller than a grain of sand, that can be embedded in pills to alert caregivers if a medication has been taken or not. Another app delivers care givers at customers’ door step for check-ups. Providence St Joseph’s Health, that has medical centres across the U.S., has invested in a range of startups that address different patient needs – from patient feedback and wearable monitoring devices to remote video interpretation and surgical blood loss monitoring. UNC Hospital in North Carolina uses a change management platform developed by a startup in order to improve patient experience at its Emergency and Dermatology departments. The platform essentially comes with a friendly and non-intrusive way to gather patient feedback.

When intrapreneurship can lead to patient centric innovation

Hospitals can also encourage a culture of intrapreneurship within the organization. According to Meena Ganesh, this would mean building a ‘listening organization’ because as she says, listening and being open to new ideas leads to innovation. Santosh Desai, MD& CEO - Future Brands Ltd, who was also part of the panel discussion, feels that most innovations are a result of looking at “large cultural shifts, outside the frame of narrow business”. So hospitals will need to encourage enterprising professionals in the organization to observe behavior trends as part of the ideation process. Also, as Dr Ram Narain, Executive Director, Kokilaben Dhirubhai Ambani Hospital, points out, they will need to tell the employees who have the potential to drive innovative initiatives, “Do not fail, but if you fail, we still back you.” Innovative companies such as Google actively follow this practice, allowing employees to pick projects they are passionate about and work on them to deliver fresh solutions.

Realizing the need to encourage new ideas among employees to enhance patient experience, many healthcare enterprises are instituting innovative strategies. Henry Ford System, for example, began a system of rewarding great employee ideas. One internal contest was around clinical applications for wearable technology. The incentive was particularly attractive – a cash prize of $ 10,000 to the winners. Not surprisingly, the employees came up with some very innovative ideas that included: a system to record mobility of acute care patients through wearable trackers, health reminder system for elderly patients and mobile game interface with activity trackers to encourage children towards exercising. The employees admitted later that the exercise was so interesting that they would have participated in it even without a cash prize incentive.

Another example is Penn Medicine in Philadelphia which launched an ‘innovation tournament’ across the organization as part of its efforts to improve patient care. Participants worked with professors from Wharton Business School to prepare for the ideas challenge. More than 1,750 ideas were submitted by 1,400 participants, out of which 10 were selected. The focus was on getting ideas around the front end and some of the submitted ideas included:

  • Check-out management: Exclusive waiting rooms with TV, Internet and other facilities for patients waiting to be discharged so as to reduce space congestion and make their waiting time more comfortable.
  • Space for emotional privacy: An exclusive and friendly space for individuals and families to mourn the loss of dear ones in private.
  • Online patient organizer: A web based app that helps first time patients prepare better for their appointment by providing check lists for documents, medicines, etc to be carried and giving information regarding the hospital navigation, the consulting doctor etc.
  • Help for non-English speakers: Iconography cards to help non-English speaking patients express themselves and seek help in case of emergencies or other situations.

As Arlen Meyers, MD, President and CEO of the Society of Physician Entrepreneurs, says in a report, although many good ideas come from the front line, physicians must also be encouraged to think innovatively about patient experience. An academic study also builds a strong case to encourage intrapreneurship among nurses. Given they comprise a large part of the front-line staff for healthcare delivery, nurses should also be given the freedom to create and design innovative systems for improving patient experience.

According to a Harvard Business Review article quoted in a university study, employees who have the potential to be intrapreneurs, show some marked characteristics. These include a sense of ownership, perseverance, emotional intelligence and the ability to look at the big picture along with the desire, and ideas, to improve it. But trust and support of the management is essential to bringing out and taking the ideas forward.

Creating an environment conducive to innovation is the first step to bringing about innovation-driven outcomes. These were just some of the insights on healthcare management gleaned from the Hospital Leadership Summit hosted by Abbott. In over 150 countries, Abbott, which is among the top 100 global innovator companies, is working with hospitals and healthcare professionals to improve the quality of health services.

To read more content on best practices for hospital leaders, visit Abbott’s Bringing Health to Life portal here.

This article was produced on behalf of Abbott by the Scroll.in marketing team and not by the Scroll.in editorial staff.