Building alliances

Opposition’s formula to stop a runaway BJP ahead of 2019: Reduce its strength by 100-plus seats

But much will depend on whether they can set aside their egos and rivalries to forge a secular front well before the general elections.

The contours of the likely face-off between a resurgent Bharatiya Janata Party and the proposed broad-based national secular front of Opposition parties for the 2019 Lok Sabha elections is emerging gradually.

If the BJP’s strategy is to retain the Lok Sabha seats it won in 2014 and focus on 120 seats where the party does not have a presence, the Opposition’s aim will be to work unitedly to reduce the saffron party’s strength by 100-plus seats and ensure it is not allowed to expand its base.

The BJP had won an impressive 282 seats in the last general elections. By the Opposition’s calculations, it will not be possible for the BJP to retain all these seats as there is bound to be anti-incumbency against MPs. It is believed that if the Opposition parties can form a joint front well before the next Lok Sabha polls, it should be possible to dent the BJP and bring down its numerical strength.

Uttar Pradesh and Bihar

For instance, Janata Dal (United) leaders maintain that the BJP and its allies will not be able to retain the 31 Lok Sabha seats they won in Bihar if the grand alliance (mahagathbandhan) forged for the 2015 Assembly polls remains in place in the next general elections. The grand alliance comprised the Janata Dal (United), Rashtriya Janata Dal and Congress. As witnessed in the state election, the caste combination of the three allies will be hard to beat, especially if Bihar Chief Minister Nitish Kumar’s image remains untarnished. It is the same in neigbhouring Jharkhand. The Opposition is convinced that if the Janata Dal (United), Rashtriya Janata Dal, Jharkhand Mukti Morcha and Congress work out a viable seat-sharing formula, the BJP will face an uphill task in the state where it won 12 of the 14 Lok Sabha seats in 2014.

Similarly, it could be tough going for the BJP in politically-crucial Uttar Pradesh, despite the fact that it swept the February-March Assembly polls and won 73 of the state’s 80 Lok Sabha seats in 2014. Ironically, Congress and Samajwadi Party members in the state, who maintain that their last-minute alliance proved disastrous for both parties in the Assembly polls, are now pitching for larger Opposition unity that includes Mayawati’s Bahujan Samaj Party.

Though the Samajwadi Party and the Bahujan Samaj Party have been sworn enemies for over two decades, both have shed their antagonism towards each other and have publicly declared their willingness to work together after their disastrous performance in the Assembly elections. Since the proposed partnership – the Samajwadi Party, Bahujan Samaj Party and the Congress – is envisaged on the same lines as the grand alliance in Bihar, the Opposition is confident that their combined strength can halt the BJP juggernaut.

In BJP-ruled states

The Opposition’s optimism is also based on its understanding that the BJP will not fare as well as it did in 2014 in Gujarat, Rajasthan, Madhya Pradesh, Haryana and Chhattisgarh, where Modi magic had dealt a crushing blow to the saffron outfit’s political opponents. For instance, there are doubts whether the BJP will succeed in winning all the seats in Gujarat and Rajasthan or retain its strike rate in the other states in the northern belt. The BJP has reached saturation point in this region and its strength should come down, according to the Opposition camp. At the same time, regional parties like Mamata Banerjee’s Trinamool Congress in West Bengal and the Naveen Patnaik-led Biju Janata Dal in Odisha will have to work doubly hard to hold on to their bastions, which are currently ripe for the taking by the BJP. “If we manage to reduce the BJP’s strength by 100-120 seats, its allies and other smaller parties will be encouraged to look around for greener pastures,” said a Rashtriya Janata Dal leader who did not wish to be identified.

However, all these calculations are based on the premise that the disparate parties in the Opposition will be able to set aside their egos and state-level political rivalries to forge a broad-based secular front well before the 2019 elections. “If this coalition is to succeed, the Opposition parties must arrive at an understanding well before the next general election and work out its seat-sharing harmoniously,” remarked a senior Janata Dal (United) leader. But, more importantly, the Opposition will have to work out a common minimum programme as distinct from that of the BJP-led National Democratic Alliance. “We should not be seen to have come together only to defeat the BJP or to consolidate the Muslim vote,” said a senior Congress leader. “We will end up strengthening Modi if this perception prevails.”

Role of the Congress

The Opposition parties are depending on the Congress to take the central role in forging this alliance. As the largest party with a pan-Indian presence, the Congress is being viewed as a rallying force for other Opposition parties that have a limited presence. There is a section in the Congress that is opposed to coalition politics as it believes that as the larger party, it will have to cede space to regional forces, which will restrict its growth. On the other hand, it is argued that since the Congress is in no position to take on the BJP on its own, it needs the support of other parties, failing which it could well disappear.

Party president Sonia Gandhi has taken the lead in this direction as she has personally spoken to most Opposition leaders to forge a consensus on fielding a common candidate for the presidential election in July. This could well pave the way for the formation of an anti-BJP secular front for the 2019 general elections. As a first step, the Opposition parties will showcase their combined strength when they converge in Chennai on June 3 for Dravida Munnetra Kazhagam stalwart M Karunanidhi’s birthday celebrations.

BJP not sitting idle

However, the Opposition has a long way to go before it firms up a viable alliance. While it is still getting its act together, the BJP is racing ahead with its poll planning. Well aware that it may not be able to retain the seats it won in 2014, BJP president Amit Shah has chalked out an exhaustive plan to expand the party’s base in states where it had little or no presence. He is learnt to have identified 120 constituencies in states like West Bengal, Odisha, Kerala and Telangana which, he believes, can be won. Central ministers and senior BJP leaders are being despatched to these states to communicate the achievements of the Narendra Modi government and hold meetings with party workers in preparation for 2019.

Amit Shah on a visit to West Bengal in April in preparation for the 2019 general elections. (Credit: Samir Jana / HT)
Amit Shah on a visit to West Bengal in April in preparation for the 2019 general elections. (Credit: Samir Jana / HT)

In addition to normal political activities, the BJP is said to be using other methods to contain its rivals. A number of Opposition leaders from the Congress, Trinamool Congress and Rashtriya Janata Dal are being investigated for various corruption offences by investigative agencies.

Realising that the alliance comprising the Janata Dal (United), Rashtriya Janata Dal and Congress in Bihar can pose a formidable challenge in the 2019 polls, the BJP is also making strenuous efforts to create fissures between the allies and build pressure on Nitish Kumar to walk out of the coalition. The BJP is particularly keen that the Bihar chief minister break away from his allies as such a move would derail the ongoing unity moves among Opposition parties. But most importantly, the BJP does not want Nitish Kumar to emerge as the face of the united Opposition front because it wants to avoid a Modi versus Nitish Kumar contest in 2019. The BJP would rather have Congress vice-president Rahul Gandhi as its main adversary as the Nehru-Gandhi scion compares poorly with the prime minister while Nitish Kumar has the potential to hold his own against Modi.

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.