Opinion

Opinion: An article by Rajiv Kumar shows that there is still confusion about Niti Aayog’s role

The column by the new Niti Aayog vice-chairman in Dainik Jagran also shows that he has flip-flopped on important policies.

On Monday, shortly after Rajiv Kumar was appointed Niti Aayog vice-chairman, the economist wrote a column in Dainik Jagran in which he described his vision of a swadeshi patriot-technocrat.

In the article, Kumar lamented the “Anglo-American” influence on Indian policy making. He gave examples of former Reserve Bank of India chairman Raghuram Rajan and his own predecessor at Niti-Aayog, Arvind Panagariya, claiming that these kinds of people had several failings. They do not understand the Indian ground realities and are not committed enough, so tend to run away from responsibilities before their tenures end. Besides, he claimed, the policies they frame spring from their ideological baggage rather than any real need.

While Kumar’s decision to advocate an insular idea that has little relevance in today’s world is worrying, that seems to be the smallest of the problems. Worryingly, his column reflects his willingness to alter his opinions to suit the prevailing ideological climate. More alarming, it indicates that both the government and Kumar are yet to define the role Niti Aayog ought to play as a premier government think-tank.

A change of mind

These early signals of Kumar’s intellectual flexibility are a cause for concern, considering that he is going to head an institution meant to provide intellectual rigour to policy making.

In the Dainik Jagran piece, he strongly opposes the privatisation of the health sector, primary education and other basic services. He says leaving these functions to the private sector will increase inequality and lead to looting by some at the cost of public welfare. He described this as the Reagan-Thatcher-International Monetary Fund model.

However, only the week before, he seemed to have held a completely different view. In an article in Swarajya magazine, he wrote: “An innovative approach would be to hand over the management of primary health centres and even district hospitals to private providers on the basis of a carefully drawn contract that is strictly monitored and enforced. The central government could design such a model contract for adoption by the states.”

This is exactly what the Niti Aayog had prescribed under Panagariya. But this push for privatisation of health care had drawn loud condemnation from the Swadeshi Jagran Manch, an organisation that Rajiv Kumar now seeks to align with.

Anglo-American admiration

That isn’t the only instance of Kumar reversing his position. As journalist Sunit Arora recollected on his blog, Kumar had in 2013 advised India to seek help from the International Monetary Fund during the economic trough that year. This is quite in contrast to his newly-adopted criticism of the World Bank, the International Monetary Fund and other Anglo-American’ influences.

In April 2015, too, he flipped from commending Prime Minister Narendra Modi for trying to amend the land laws through central fiat and then, a few months later in August 2015, went on to congratulate him for backing off and leaving it to the states as a federal concern . One can only hope that in coming days he will either show greater cohesion of thought or explain the reasoning behind his change of views. Else, he will strengthen the impression that his intellectual elasticity is a result of political expediency.

What is Niti Aayog?

The article raised questions about more than just Kumar’s intellectual positions. The article creates doubts over the future of Niti Aayog as government’s premier think tank. Rajiv Kumar’s own earlier thoughts on this might be useful for Prime Minister Narendra Modi to mull over.

In 2015 Kumar wrote, “As one foreign observer quipped, Professor Arvind Panagariya could hardly be expected to give up his University of Columbia professorship for anything short of regular and intensive interaction with the PM and his senior officials.”

In the same article he explained how that anecdote reflected the uncertain role of Niti Aayog:

“My fear is that, given the lack of statutory authority and the absence of well-defined rules of business, it [Niti Aayog] could continue to be perceived as a fifth wheel by both state government and central government agencies. Its role in government policy formulation would then be restricted to the personal access that the vice-chairman and two full- time members enjoy with the PM and his Cabinet colleagues... I am left wondering at the rational and strategic approach that has underpinned the design and mandate of the Niti Aayog.”

Kumar has repeatedly thought aloud about the confusion over the role of Niti Aayog. He has written several articles imagining various roles for the institution. In January 2015, Kumar, while discussing the nature of the new organisation, lamented that Prime Minister Narendra Modi has taken small incremental steps that add up to a good beginning. But he added: “These [steps] need to be broadcast much better to remove the perception that his government is suffering from hubris”. In the same article he notes, “One could, therefore, justifiably argue that this government, with its record of delivery, new initiatives and reliance on civil servants did not really require an independent body comprising primarily of professionals and domain experts.” He also suggests that taking over administrative roles from other ministries may not be a good idea for the think tank.

Even to function as a useful think-tank that can shape public policy, the Aayog requires clarity about its space in the government and not just a broad brush-strokes of ideas as guidance. For example, it would be valuable to consider if Niti Aayog is an agency that details and coordinates implementation of the ideas emanating principally from the executive across ministries, agencies and states – such as Skill India? Or it could work as a think-tank at arm’s length to provide the government with out-of-the-box ideas? The latter format allows the government some latitude to adopt ideas that work within the party-in-power’s political-economic goals and disown others as that of the think-tank.

Clear brief essential

Once this role is clear, the government needs to draw clear brief for staffing the institution. It is not just about the top rung. Other layers of the staff have a great deal to do with the deep drill and fleshing out of policy prescriptions that brings ground reality to bear upon big ideas. They are assisted by a host of non-government institutions, besides government officials at the Centre and in the states. Potential technocrats can come in all flavours after all and from all corners of life. Their intellectual moorings should not be dismissed as ideological baggage but valued for providing different perspectives and approaches.

The Bharatiya Janata Party-led government did well to dissolve the Planning Commission and the command-and-control ideology it represented, shortly after coming to power in 2014. But it will take a lot more to shape an alternative institution, which unlike its predecessor, does not draw powers only from personal proximity of its top rung to the prime minister and one that does not act as the government’s advertising agency.

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

Putting the patient first - insights for hospitals to meet customer service expectations

These emerging solutions are a fine balance between technology and the human touch.

As customers become more vocal and assertive of their needs, their expectations are changing across industries. Consequently, customer service has gone from being a hygiene factor to actively influencing the customer’s choice of product or service. This trend is also being seen in the healthcare segment. Today good healthcare service is no longer defined by just qualified doctors and the quality of medical treatment offered. The overall ambience, convenience, hospitality and the warmth and friendliness of staff is becoming a crucial way for hospitals to differentiate themselves.

A study by the Deloitte Centre for Health Solutions in fact indicates that good patient experience is also excellent from a profitability point of view. The study, conducted in the US, analyzed the impact of hospital ratings by patients on overall margins and return on assets. It revealed that hospitals with high patient-reported experience scores have higher profitability. For instance, hospitals with ‘excellent’ consumer assessment scores between 2008 and 2014 had a net margin of 4.7 percent, on average, as compared to just 1.8 percent for hospitals with ‘low’ scores.

This clearly indicates that good customer service in hospitals boosts loyalty and goodwill as well as financial performance. Many healthcare service providers are thus putting their efforts behind: understanding constantly evolving customer expectations, solving long-standing problems in hospital management (such as long check-out times) and proactively offering a better experience by leveraging technology and human interface.

The evolving patient

Healthcare service customers, who comprise both the patient and his or her family and friends, are more exposed today to high standards of service across industries. As a result, hospitals are putting patient care right on top of their priorities. An example of this in action can be seen in the Sir Ganga Ram Hospital. In July 2015, the hospital launched a ‘Smart OPD’ system — an integrated mobile health system under which the entire medical ecosystem of the hospital was brought together on a digital app. Patients could use the app to book/reschedule doctor’s appointments and doctors could use it to access a patient’s medical history, write prescriptions and schedule appointments. To further aid the process, IT assistants were provided to help those uncomfortable with technology.

The need for such initiatives and the evolving nature of patient care were among the central themes of the recently concluded Abbott Hospital Leadership Summit. The speakers included pundits from marketing and customer relations along with leaders in the healthcare space.

Among them was the illustrious speaker Larry Hochman, a globally recognised name in customer service. According to Mr. Hochman, who has worked with British Airways and Air Miles, patients are rapidly evolving from passive recipients of treatment to active consumers who are evaluating their overall experience with a hospital on social media and creating a ‘word-of-mouth’ economy. He talks about this in the video below.

Play

As the video says, with social media and other public platforms being available today to share experiences, hospitals need to ensure that every customer walks away with a good experience.

The promise gap

In his address, Mr. Hochman also spoke at length about the ‘promise gap’ — the difference between what a company promises to deliver and what it actually delivers. In the video given below, he explains the concept in detail. As the gap grows wider, the potential for customer dissatisfaction increases.

Play

So how do hospitals differentiate themselves with this evolved set of customers? How do they ensure that the promise gap remains small? “You can create a unique value only through relationships, because that is something that is not manufactured. It is about people, it’s a human thing,” says Mr. Hochman in the video below.

Play

As Mr. Hochman and others in the discussion panel point out, the key to delivering a good customer experience is to instil a culture of empathy and hospitality across the organisation. Whether it is small things like smiling at patients, educating them at every step about their illness or listening to them to understand their fears, every action needs to be geared towards making the customer feel that they made the correct decision by getting treated at that hospital. This is also why, Dr. Nandkumar Jairam, Chairman and Group Medical Director, Columbia Asia, talked about the need for hospitals to train and hire people with soft skills and qualities such as empathy and the ability to listen.

Striking the balance

Bridging the promise gap also involves a balance between technology and the human touch. Dr. Robert Pearl, Executive Director and CEO of The Permanente Medical Group, who also spoke at the event, wrote about the example of Dr. Devi Shetty’s Narayana Health Hospitals. He writes that their team of surgeons typically performs about 900 procedures a month which is equivalent to what most U.S. university hospitals do in a year. The hospitals employ cutting edge technology and other simple innovations to improve efficiency and patient care.

The insights gained from Narayana’s model show that while technology increases efficiency of processes, what really makes a difference to customers are the human touch-points. As Mr. Hochman says, “Human touch points matter more because there are less and less of them today and are therefore crucial to the whole customer experience.”

Play

By putting customers at the core of their thinking, many hospitals have been able to apply innovative solutions to solve age old problems. For example, Max Healthcare, introduced paramedics on motorcycles to circumvent heavy traffic and respond faster to critical emergencies. While ambulances reach 30 minutes after a call, the motorcycles reach in just 17 minutes. In the first three months, two lives were saved because of this customer-centric innovation.

Hospitals are also looking at data and consumer research to identify consumer pain points. Rajit Mehta, the MD and CEO of Max Healthcare Institute, who was a panelist at the summit, spoke of the importance of data to understand patient needs. His organisation used consumer research to identify three critical areas that needed work - discharge and admission processes for IPD patients and wait-time for OPD patients. To improve wait-time, they incentivised people to book appointments online. They also installed digital kiosks where customers could punch in their details to get an appointment quickly.

These were just some of the insights on healthcare management gleaned from the Hospital Leadership Summit hosted by Abbott. In over 150 countries, Abbott 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.