Letters to the editor

Readers' comments: 'This government and the prime minister no longer deserve our trust'

A selection of readers' opinions.

Flip flops

Given that most of the demonetised currency is making its way back into the system, the government appears to be desperate to salvage some pride by forcibly keeping at least a small part of it outside (“I trusted the prime minister’: The explanation Indians are giving for delay in depositing old notes”). Either that, or it considers every Indian to be a potential hoarder of black cash and therefore deserving of further inquisition and harassment at the hands of bank officials. Either way, this government – and specifically, this prime minister – no longer deserve our trust, nor the guardianship of this nation. – Arnab

***

The government’s back-to-back policy reversals have destabilised the monetary climate of the Indian economy and has deeply shaken consumer confidence in the banking system. These continuous flip-flops and the whimsical manner in which the finance ministry and the RBI are dealing with demonetisation have serious socio-economic ramifications.

Changes such as imposing restrictions on weekly basis or demanding explanations for an amount as minuscule as Rs 5,000 are ridiculous at best. Far from easing people’s lives, it has increased the red-tape. Moreover, it has bestowed too much power into the hands of a bank clerk, who has his own personal interpretation of these weekly diktats. – Gaurav Singhal

Real trouble

Those who are not daily wage earners will not understand the impact of demonetisation (“Why the chattering classes can’t fathom the vast support for demonetisation”). The vegetable vendors I have spoken to have admitted that they are just making a third of what they usually would. In Amritsar, the hosiery, lock-manufacturing and footwear industries have been thrown into disarray. The pictures of those labourers going back to their villages also makes us question the wisdom of the demonetisation move.

Modi, to cover up his alleged involvement in a bribe case, indicated in the Sahara-Birla papers, has embroiled the whole country in the mess of demonetisation. The media is complicit in the cover-up.

The media has not spoken much about this revelation. When the most corrupt man talks of eradicating corruption and black money, you know it is just hollow talk. – Onkar Singh

Clean sweep

I cannot understand how a heavily cash-dependent and technology poor rural sector can be converted to a cashless one in one go (“In Andhra Pradesh villages, demonetisation has deprived the elderly of their pensions”). There is also the question of mindset. I was a former chairman of NABARD and many of us, when in public service, were sometimes prone to relying on theoretically attractive models without complete understanding of the constraints on the ground. While every sector has an inherent capacity to absorb change, the rate at which the change is internalised varies vastly. If a scooter engine is revved to simulate that of a Bullet motorcycle, it cannot but break down. One hopes fervently that the government has intuited the pace of absorption empirically. It would be unwise to test the proverbial patience of the rural poor beyond a point. – Dr YSP Thorat

Crushing blow

Many thanks to Neha Bhatt for picking up a most interesting aspect of the impact of demonetisation (“How demonetisation has hit book sales (and what might happen at next month’s book fairs”). Her article raises the question of the caste-differentiated effect of demonetisation – has the move benefited our upper and moneyed classes at the expense of the majority of our country’s population? I would love to see any analysis which answers this question.

In our intensely-competitive economy, in which the winner takes it all and the losers get nothing, it could be that demonetisation will further disadvantage the lowest castes and classes in our country as it makes it difficult for them to invest in books, paper, lighting, travel, etc – thereby providing an advantage to upper castes and classes who can continue to afford these?

It was thanks to Dr Ambedkar’s contribution to our Constitution that our lowest castes and classes were being (gradually) uplifted. Could demonetisation be a thinly-disguised attack by the Sangh Parivar against the liberation of our lowest classes and castes? – Prabhu Guptara

Token gesture

For the past many decades, Muslims have been fulfilling their religious obligations without any problem (“Namaz break for Uttarakhand employees: It’s back to Muslim tokenism for the Congress”). Civil servants have rules that have been followed. Why change them now except for some publicity? – CM Naim

Anger management

What baffles me is that no such articles appeared when our honourable prime minister won the elections (“How online comments on US news sites helped created a hateful electorate”). The Gujarat model was proved to be a sham by several economists. In fact, immediately after the 2012 North East exodus from Bengaluru based on rumours that people from that region would be singled out and attacked, there were a few stories claiming it to be a false flag operation by those in the Sangh Parivar camp. However, these conveniently disappeared. India too needs to address the blatant lies being propagated as news. Vivan Eyben

Soft targets

More than 60 people are said to have died since demonetisation was announced on November 8, as per media reports (“Note demonetisation: 86% of Indian currency has been frozen overnight”). The number of unreported deaths may be even higher.

The main aim of the demonetisation was to tackle and choke black money, in the process making the rich and corrupt suffer, but till now it has been amply clear that the sole sufferers of this convoluted process are the poor, who I am sure do not have any black money.

Meanwhile, India’s neighbour and rival, China, is also struggling to tackle corruption. However, their method to tackle it does not entail making life miserable for the poor. China goes only after the corrupt and not the entire population. One of the best examples of this was the death sentence given to a former Chinese railway minister Liu Zhijun for embezzlement and bribery in 2013, which was later commuted to life imprisonment.

On average, China executes around 2,000 people a year, of which a majority faced charges of corruption, including embezzlement and bribery. This is something unheard of in India, which rarely sees ministers in particular facing the music for corruption.

While China’s is not the best example, at least it is indicative of seriousness in rooting out corruption by going after the rich and powerful. I am not a proponent of the death penalty but instilling fear in the minds of corrupt is surely a deterrent. – Sid

Cyber safety

The cyber security challenges in India have increased, particularly post demonetisation (“Over past three weeks, conmen snared 12 in the Capital with offers to beat demonetisation”). The absence of robust cyber security laws in India is a major threat to the country’s dream of becoming a cashless economy. Instances like the massive security breach of 32 lakh debit cards just months before demonetisation are a strong indication that the country is yet to develop an efficient cyber-security system. The lack of infrastructure will be a strong impediment to going digital. India should not hesitate to build its proactive cyber capabilities. A dedicated cyber security law – a techno-legal framework – is the need of the hour. – Nikhil Chopra

Cash overhaul

Honestly, I did not read the entire article, but the tone and tenor was enough to tell me what to expect (“Phones as wallets: Three reasons why Modi’s cashless drive will not happen in a hurry”). It’s just lies and statistics. If even four metro cities and all state capitals adopt a “less cash” approach, half the battle will be won. Most of the urban areas are reasonably well connected.

This is the proverbial chicken and egg question. Obviously, the chicken came first. and the egg followed. The government has created the chicken, as in the incentive to go cashless, the infrastructure shall follow. – Balasubramanian Ramaswamy

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Your money is yours was the assurance given by the prime minister when he announced the decision of demonetisation on November 8. Asking people to bear with the inconvenience up to December 30, he emphasised the activity was needed to shun the two devils that has haunted our economy – black money and corruption. People instantly extended their support.

However, just a week before the deposit window closes, media reports say that Rs 12 lakh crore deposits have come into the system out of the Rs 15 lakh crores currency in circulation. This leads to the suspicion that the government has been misled on the issue of black money. So, it seems as though the misery on common people was unwarranted.

Even as the entire exercise appears to be a failure, the government is hastily experimenting with cashless transactions, ignorant of the ground reality in the lower strata of society. Government should come up with unambiguous assurance to remove the apprehensions of innocent citizens. – Ganesan P

Going south

Being anti-establishment seems to be fundamental to reporting, but when it comes to Tamil Nadu, this website appears to have an antipathy (“With falling standards in healthcare, education and employment, Tamil Nadu is losing its sheen”). Whatever problems the state faces are not peculiar to it and many of these are global phenomena.

Tamil Nadu, in my opinion, fares much better than others in the country. The establishment in the state definitely has the drive to makes things better for people. The instances of non-delivery are possible even under the best circumstances. Scroll.in need to spread out its coverage and should not restrict itself to urbanised regions. – Karthik G

Contesting claims

It is with deep regret that I acknowledge that German National Socialists have used Hindu scriptural authorities to further their political aims (“Writings of French Hindu who worshipped Hitler as an avatar of Vishnu are inspiring the US alt-right”). Their claims were not noticed by the traditional theologians. Savitri Devi’s views are contrary to what I think and practice as a Hindu. I request the writer of this article, Blake Smith, to contact American Sanskrit academics for a formal reply to Devi’s work, to expose the fallacies therein, lest they draw proponents of racial superiority within Hinduism. Alternatively, the Hindu council of the United States could be contacted to speak on behalf of Hindus, to confirm racial equality. I look forward to a reply by Mr Blake, perhaps, in the form of another article. – Narasimha

Finding hygge

As someone born and living in Denmark, I find two notions on the concept of hygge often repeated in the English press quite odd (“Why ‘hygge’ is the go-to concept for happiness that has spawned an entire publishing genre”). The first misconception is that hygge is somehow insular, a way of bonding not extended to or open to non-Danes. That makes absolutely no sense in the Danish context, where you can perfectly well “hygge” with complete strangers, including refugees. The only thing hygge requires is a common understanding of enjoying the good things in life in good company. But if you’re not familiar with this kind of grounded experience, it may not work for you, of course.

The other odd notion is that hygge is somehow a winter phenomenon. That is also a complete misunderstanding. You can also hygge on a summer’s day by the beach. If you want to give emphasis to a hygge situation being a winter state of mind, you can call it vinterhygge (winter hygge).

A final footnote would be that we have had populists in Danish politics for at least four decades and have learnt to deal with, or accommodate, such upsurges. For that reason there is likely to be no Danish equivalent of Brexit or a Trump vote of any magnitude. And despite the harsh rhetoric from some quarters in Danish politics, Denmark accepted more asylum-seekers in 2015 (per capita) than any other European nation (except Sweden, Switzerland and Malta). Over the past year, populist parties have actually lost ground according to the polls, which indicates that the Danes are dealing with reality without losing their head or foothold. – Kim Wyon

Smooth sailing

Captain Sanjeev Kumar has expressed very well the fatigue of on-board personnel (“How all work and little sleep have left the Indian navy fatigued and stressed”). I am sure Capt Sanjeev Kumar would have done the same while he was serving and I do not blame him at all because it is very difficult to change the system unless the orders come from the top.

It is necessary that the chief of naval command, chief of naval staff and other flag officers make a start and try solving this problem.

Some recommendations are: ships should return to the harbour on Friday evening and the weekend should be absolutely free, ships should be painted once a year, during which period they should be offloaded and managed by the Dockyard, no paint to be supplied to ships and while sailing, two hours every day, preferably in the evening, should be kept for recreation. A welfare committee, heading by a flag officer, should look at several other suggestions. – Tejinder Gill

We welcome your comments at letters@scroll.in.
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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.