Losing touch: Whatever happened to Narendra Modi’s optimism?

Candidate Modi of 2014 who offered a vision of national greatness has been replaced by Prime Minister Modi who campaigns on paranoia.

In 2014, Narendra Modi ran for, and achieved, the prime ministership as the candidate of aspiration. There were many other aspects to his campaign and many factors in his victory. But aspiration was central both to how he wished to be perceived and how he actually was perceived across the country and in the Indian diaspora.

He embodied aspiration in his own life story, as the son of a backward caste chaiwalla who had never had anything handed to him and had achieved high office through drive and ingenuity; in the way he promised strong, decisive leadership; and, above all, aspiration in his vision for the country. Elect Modi and India would be a developed country by 2022; one crore new jobs would be created every year; Make in India would transform us into an East Asia-style manufacturing economy; the Ganga would be cleaned up by 2018; India would be recognised around the world as a major economic and military power.

There were aspects missing from this aspirational vision. Notably, there was little talk of the moral aspiration of rooting out caste and gender discrimination, of the idea that we could be a better society as well as a more prosperous one. And the Bharatiya Janata Party’s campaign benefited from plenty of tactical caste and religious polarisation. But Modi’s own rhetoric and energy were overwhelmingly positive. His core slogans – Sabka Saath, Sabka Vikas and Achhe Din – spoke to a sunny, inclusive optimism.

Modi’s optimism, his sense of possibility for himself and for the country, was infectious. Newspaper columnists with no time for Hindutva pronounced it a moral imperative to vote for Modi so that India could become a great power. Young voters responded with particular enthusiasm. Modi’s principal opponent, Rahul Gandhi, is two decades his junior, but in 2014, Modi made a mockery of Gandhi’s attempts to position himself as the leader of India’s youth.

Three and a half years later, a very different Modi has been leading his party’s campaign in Gujarat. To be sure, many aspects of the BJP’s campaign are typical of state elections in general and Gujarat in particular. There was no shortage of anti-Muslim rhetoric in the Gujarat elections of 2002 and 2007. Nor is there anything new or noteworthy about the Congress’s belated attempts at “soft Hindutva”. As for ad hominem attacks and dirty tricks: the Hardik Patel “sex CD”, and fraudulent claims that Rahul Gandhi is not a Hindu and Ahmed Patel the Congress’s chief ministerial candidate are contemptible but of a piece with modern Indian electoral politics.

What is new, and striking, is the change in the prime minister himself. His optimism, his sense of embodying aspiration, and his ability to set and control the political narrative are nowhere to be seen. In 2014, the Gujarat Model of development was supposed to be the prototype for Achche Din. Now the BJP is a three-year incumbent at the Centre and a 22-year incumbent in Gujarat. Where is the robust defence of its record and the optimistic vision of what they can offer in the future?

Loss of control

It is not that Modi omits all talk of development in his speeches. But a better future – for Gujarat, India, and young people – no longer provides the narrative foundation. Instead, the prime minister is reactive, touchy, and uncertain about his own record. He established the last of these when he declared, in Gandhinagar on October 16, that the Congress had been an “equal partner” on the Goods and Services Tax; far from claiming credit for his government’s principal economic reform, he looked to share the blame.

Two repeated tropes embody Modi’s diminished optimism and loss of narrative control. His complaints about the Congress’s personal attacks are more than hypocritical; they suggest that, for the first time, Rahul Gandhi has managed to get under his skin. Modi and the BJP have pursued personal abuse as political strategy to greater effect than any of their rivals. To elevate Rahul Gandhi and the Congress in this way is not a sign of confidence. Steve Waugh’s Australian cricket team did not whine about opposition sledging.

The repeated invocation of Pakistan, above all in the allegations about the now-infamous dinner hosted by Mani Shankar Aiyar, speak to paranoia and desperation rather than the effective use of nationalist rhetoric. If, as it appears thus far, Modi is unable to substantiate his claims, he will have sacrificed one of his most important achievements as prime minister. He restored authority to the office of prime minister after 10 years of back-seat driving from Sonia Gandhi as the Congress president. A prime minister who wildly implies that his predecessor has been conspiring to commit treason, and then fails to back it up, is even less commanding than one who takes orders from his party chief.

What has caused the disappearance of Modi’s optimism? And what might it mean for our politics over the next 18 months? In part, this is simply the common story of a politician who achieves power through extravagant promises and then struggles when confronted with the challenge of incumbency. Some credit, too, should go to Rahul Gandhi and the Congress. After three years of drift, Rahul Gandhi’s coronation as the party president has given the Congress some degree of focus and energy – for now. And the appointment of Divya Spandana as head of social media has sparked a hugely successful overhaul of the party’s digital strategy, one for which the BJP was unprepared and has failed to counter.

But Modi’s central problem is one specific to him. As prime minister, he is unable to run with any confidence on his own record. For one thing, he has made limited to negligible progress on most of his aspirational promises of 2014. Make in India is little more than a slogan; the three crore jobs have not materialised; his Ganga clean-up has been as ineffectual as Rajiv Gandhi’s. And his government’s two signature economic measures – demonetisation and GST– are now seen as liabilities, as his attempt to implicate the Congress in GST shows.

This means that while Modi remains personally popular, including with young voters, he can no longer credibly be the candidate of aspiration. The Congress’s revival in Gujarat has, almost certainly, come too late to prevent the BJP rule in that state being extended for another five years. But one exit poll that predicts a BJP victory, by India Today-Axis, had a remarkable finding: in their sample, voters aged 18-25 actually prefer the Congress to the BJP. It is one poll and may have little significance. But it would have been unthinkable only three years ago. Modi cannot take young voters for granted. If he wants to win a renewed majority in 2019, he needs to convince them, and perhaps himself, that he remains the best vehicle for their aspirations.

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Getting the best from collaborations

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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.