air pollution

The Daily Fix: Supreme Court's ban on firecrackers in Delhi reflects failure of pollution board

Everything you need to know for the day (and a little more).

The Supreme Court on Monday extended the suspension on all licences that permit sale of firecrackers in Delhi and surrounding areas to November 1, implicitly effecting a ban on their sale for the upcoming Diwali festival on October 19. Bursting crackers has become an integral part of the celebrations, a reason why the order received sharp responses from the likes of writer Chetan Bhagat, who questioned the court’s impartiality.

Bhagat’s claims were partly sensational and were in the manner of communalising a primarily health and environment issue. After all, bursting firecrackers for Diwali is a fairly recent phenomenon and has very little support in ancient Hindu scriptures. But given the campaign by Hindutva groups in recent years against any attempt to take firecrackers out of Diwali, even Union Environment Minister Harsh Vardhan was not spared on Monday when he tweeted welcoming the court order. He later took the tweet down following angry responses.

Screen grab: Dr. Harsh Vardhan/Twitter
Screen grab: Dr. Harsh Vardhan/Twitter

However, the Monday order did showcase the court’s inconsistency. It was only in September that the Supreme Court relaxed the ban it originally effected in November 2016. Last month, while lifting the total ban on licences for sale of crackers, the court said:

“Unfortunately, neither is it possible to give an accurate or relative assessment of the contribution of the other identified factors nor the contribution of bursting fireworks to the poor air quality in Delhi and in the NCR. Consequently, a complete ban on the sale of fireworks would be an extreme step that might not be fully warranted by the facts available to us.” 

On Monday, the Supreme Court entertained interlocutory applications from petitioners (three infants) opposing firecrackers, and said having a ban in place between Diwalis and not during the festival may not help test the efficacy of such a move. The court wanted to have one cracker-less Diwali and see what effect it has on the pollution levels.

While under most circumstances a court-ordered ban is never considered the best way of bringing a systemic change, the Supreme Court’s hands were forced in this matter by the utter apathy shown by the Central Pollution Control Board and other governmental agencies in handling this environment and health crisis. While crackers are not the only contributors to the pollution menace in the Capital, it is an indisputable fact that ambient air quality deteriorated by over three times the average levels the morning after Diwali in 2016. And Delhi’s average air quality levels are higher than prescribed limits on most days of the year. This was one of the primary reasons for the suspension of sale licences the Supreme Court brought into force in November last year.

For many years, standards in manufacturing and sale of crackers have been violated with disdain. The court noted in September that fireworks contain many elements which the pollution board has neither studied nor has established any standards for. In fact, in a stunning commentary on the pollution board’s inefficiency, the court showed no trust in its claim that it will set the standards by September 15 and then extended the deadline voluntarily to September 30. It is not clear if the pollution board at least kept to this extended deadline. The court also asked the board to study the effect of firecrackers on health, something it is expected to complete by December 31. On the other hand, those who hold temporary licences for sale of crackers had consistently violated the provisions of the new Explosives Rules which came into effect in 2008. Stunningly, they appeared before the court asking for one more year to adhere to the rules, showing how a law, which contains crucial regulations to avoid major fire accidents, had largely remained only on paper.

While courts have been criticised for assuming the role of the executive and making policies by using special powers given under the Constitution, in matters such as the firecrackers case, the government clearly has itself to blame as it has ceded ground through its inaction. Instances such as these erode the executive’s credibility and make it difficult for the government to resist real judicial overreach.

The Big Scroll

  • The air over North India during 2016 Diwali was the worst in the world – and worse than 2015 too. 
  • How Delhi residentsstarted petitions and protests in an attempt to breathe following last year’s Diwali. 


  1. Manish Sabharwal in Indian Express says the relationship between entrepreneurs, banks, bankruptcy is being reworked to end culture of impunity.
  2.   Responsive social and care systems for mental health issues must be pursued relentlessly, writes Vandana Gopikumar in The Hindu. 
  3. Actor Deepika Padukone on why it is important to accept depression than feeling ashamed about it. 

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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.

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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 marketing team and not by the editorial staff.