Category: Uncategorized

Women / Senior Citizens – Immediate & Important steps that needs to be taken


To: Dr.Manmohan Singh, Rahul Gandhi, Sonia Gandhi , Sushma Swaraj, Meira Kumar , Dr.Murli Manohar Joshi via email.

Dear Dr.Singh,

Please pardon me for raising this issue ( this is the only issue for which i have not down much ground work !! ), but i am solely moved to raise this issue , seeing the plight of women passengers squeezed between males across towns in public transport .

I was in Bangalore last week, and when my cab passed by a public transport bus , i could see how we respect our women !! Reservation for women is a good step . But first let’s address the basics

  • Ask all the state governments to start special busses for Women passengers / senior citizens in all towns . You can probably have common buses for Women / Senior citizens
  • The local licenses for toddy ( local fermented drink ) should be banned

I am sure that women being in key positions in India ( President , Chairperson UPA , Leader of Opposition , Speaker of Lok Sabha ) could make this happen sooner than later

Best wishes

Rajendra Pratap Gupta

Email : office@rajendragupta.in

3G & the high speed downfall of the Telco’s


3 G spectrum has been over-sold . Keeping in mind the fact that,  the average yearly penetration of 3 G users has been highest at 5 % in developed countries like Japan. It took them 7 years to increase the penetration of 3G services to 35 %. India is a country with 150- 220 million middle income people , and not everyone requires 3G !!

In India , do we need high speed internet in our daily lives ? We are pretty okay with Blackberry,  emails and voice calls- Just 70 million internet users !!

Industry has perhaps gone overboard to pay “Obnoxious” sums for 3G spectrum.

To ensure profitability , 3G players will have to invade few sectors to make it viable ( trust me , it is a big challenge for immediate future  ). The sectors that need to be invaded are HEART ( Healthcare , Education & Entertainment , Agriculture ,  Rural India & Travel & Tourism , Telemedicine )

People have wrongly understood the first wave of telecom revolution . The first wave came because of the following

  1. Before the cell phones were launched , getting a land line from the government “monopoly” ( BSNL /MTNL ) was difficult – wait times was uncertain & services pathetic even after bribing the lineman the things would not work !
  2. ‘Rich’ people could afford the luxury of a ‘Cordless’ phone, that would have a coverage of 10 or 20 Feet . Suddenly , with a cell phone , people could roam with a phone across India or the world !! I think people in the telecom sector have believed that the craze for 3G would be the same as the first wave for cell phones !! But believe me , it will never happen . I have used cell phone since 1996 , when it was launched and paid an “Airtime’ of Rs.16.40 per minute + normal call rates !!
  3. The actual number of cell phone users are still as per what i call  the 1/3rd Rule ( we just have approximately 200 million cell phone users and not 654 Million, what the Telco’s & the government talk about  )
  4. Handsets to use the features of the 3G are not evolved as yet

Overall, paying and bidding for 3G was a lot easier than to manage the profits out of the networks using 3G. This will leave only two players doing something worthwhile ( Vodafone & “may be” , Mukesh Ambani ). Rest will have to work hard to avoid “Consolidation” of the industry

May be , some players will use 3G airwaves to enhance the voice quality

MNP ( Mobile number portability ) : MNP was delayed for obvious reasons !! But once the system is operational, it will crash due to the overload of the people applying for the same . There is a lot of anger amongst users for poor service quality . People will change the provider not for better service but to vent out anger at the existing service provider.  Some Telco’s will lose millions of users in months ( who gains in the long run is going to be a billion dollar question )  Time to wake up and take corrective action,  and innovate the services !!

Two big challenges 3G & MNP – Head ache of CEO’s of all Telco’s

3G might become the high speed to downfall – Thanks to the myopic government policies and over excitement of the bidders. May be , that’s the reason why MNC’s stayed out of the bidding. Perhaps, they will wait for some companies to bleed, and then, buy them out

Rajendra Pratap Gupta

Email : office@rajendragupta.in

UID & PDS – Will wipe out each other’s value proposition


I have been seeing that there is a lot of Hype & Hoopla around the fact that UID will weed out corruption , and that the poor will get their share of monthly grain & Kerosene quota

Let’s examine some hard facts :

PDS system runs on corruption , systemic loot and  injustice to the needy card holders. Else, why will a person take a ration shop and run it for distributing sub-standard grains to the poor with so low a margin!!

The margins are barely anything to even recover the rents & other incidental costs !! It is like the fuel stations around the country, the margin of  Rs.1.22 per litre of petrol and .64 Rupee on a litre of diesel is barely anything to cover the bribes to inspection authorities , rents and salaries ( few fuel pumps could be an exemption !! ). But most of the fuel stations run on ‘Adulteration’ & ‘Lesser quantities’ dispensed per every litre of fuel.

So UID has a value proposition which will make the business of PDS ( Ration shops ) business unviable for its licensees.  So while the poor will have UID card , but no shops to dispense the ration !! I am not mentioning about electricity in rural India etc.etc…for reading the UID card and other related issues w.r.t implementation

Also , UID on paper is very good. Believe me,  that about 300 million people in India still think that Indira Gandhi is the Prime Minister of the country !! The reason i write this is, because , parts of our country still live in 1847 ( grossly neglected ), parts live in 1947 ( plans on paper ) and about 300 Million live in 2000 ( have had an impact of ‘time bound’ growth ).

For people who don’t have shelter to sleep , clothes to wear , where will they keep the UID Card ? What will they understand of UID when they cannot even read and write , & when they know that ‘Government establishment’ is meant for either the people in government service or the corrupt !! One must study the ‘High tech’ ideas before taking it to the people who barely have 5-6 meals per week !! Remember , 7000 children die every day due to malnutrition in India

We must also understand that corruption never started because of lack of technology , but because of wrong leadership at the top,  absence of a feedback mechanism & corrupt machinery at all levels, that has never taken action . So i believe that, the powerful people in the rural India will mislead the poor and keep their UID cards or the poor will spoil them due to mishandling of the cards . Also , UID does not have the techniques to turn stock hoarders and swindlers into honest PDS contractors !! Either the rot will continue after the UID or will wipe out the PDS shops by making them non-lucrative businesses .

Time to address the real issues. UID is a good idea , whose time is yet to come !!

Rajendra Pratap Gupta

Email : office@rajendragupta.in

Wrong Economic priorities ,lop sided growth & flawed statistics


This is the follow up blog on my views dated 15th June 2010 & 27th June 2010 on the topic of “High GDP but low GDP per capita”.
Focussing on statistics , in April-May 2010, IIP witnessed a decent growth of 14 % but this did not cover some vital sectors . Only one sector , machinery and equipment , alone contributed 37 % to this high growth.  Transport equipment , metal products and mining contributed another 32 % to IIP growth. This implies that around 70 % growth of IIP was a result of high growth in just 4 out of a total of 19 sectors . Also , that these growth rates have an important factor ‘Low base effect’ . Like manufacturing sector achieved one of the highest growth rates of 19.4 % in April 2010 over a low base of 0.4 % in 2009. Similarly,  Capital goods sector’s high growth of 72.8% in April 2010 was over  a negative base of 6 % in 2009.
Time to balance out. Else , we will blame Greece, Italy , Europe , China , poor rainfall etc. Etc. for all our ills, forgetting that we never looked at “REAL India” for growth
Get the priorities right and actions STRAIGHT
BJP must be focussed more on right issues than routine struggles !!
Rajendra Pratap Gupta
Email : office@rajendragupta.in

National Council for Human Resources in Health -NCHRH


Date : June 30th , 2010.

Mr. Debasish Panda

Joint Secretary

Ministry of Health & Family Welfare

Government of India

Nirman Bhawan , New Delhi 110108

Ref: D.O. V.11025/10/2009-ME(P-1) dated 8th June 2010

Dear Mr.Panda,

Thanks for the invite for the regional consultation on NCHRH . Unfortunately,  I could not attend the meeting at Mumbai on 18th June due to a prior commitment at Bangalore for the India Innovation Summit on the same date.

I had sent you an email on the NCHRH with two recommendations. Since then, I have dwelled on the issue at length and wish to submit some recommendations for your kind consideration

Before I start on the specific recommendations, let us consider a few important points that need to be kept in mind for the National Council for Human Resources for Health – NCHRH

  • India has 1.2 Billion population out of which about 1/3rd is illiterate population
  • In the next 10 years, India will add 120 million people in the working age category
  • Currently, India has about 2/3rd of the population below 35 years in age
  • Currently , 2/3rd of India lives in rural India and probably, in that category, healthcare does not figure in the list of priorities
  • 2/3rd of India does not have adequate access to healthcare
  • Awareness and sensitization about healthcare is missing . People will go and splurge money on dining outside , but will not spend a fraction in wellness .
  • India believes more on religion , spirituality and charity than wellness
  • Healthcare professionals  available are not willing to work in the so called rural India . At max, they are willing to work in semi urban India
  • The incidence of diseases is not vastly different in rural India from that of urban India for most of the ailments
  • Status of urban poor is deplorable when it comes to healthcare
  • PPP’s in healthcare are not going to work in rural India
  • Those who study for healthcare in urban areas, majority of them are not willing to adjust to the rural lifestyle for professional or family reasons . Gives us a reason to think to start medical colleges in rural settings !!
  • The entire healthcare system is focused on medicine , doctors, clinics and hospitals etc. This has created a fear & suspicion amongst the healthcare users that healthcare means pills, surgery and hospitalization
  • New models of care are evolving for addressing the changing disease patterns and Indian healthcare system is ill prepared to handle the same
  • Time has come to take health ( not medical ! ) education from medical school to primary school. Basic healthcare education should be made compulsory at the school level.
  • 3G has now become a reality , so  mHealth will not just re-define the healthcare delivery but also healthcare education

In short , I would say that , the world over , no healthcare system has answers for our problems, as all the systems are already failed or heading towards a collapse . This provides a unique challenge and an

opportunity to build a robust healthcare system for India that is low cost,  agile ,  protocol driven, and evidence based and not eminence based system; one that avoids errors , trails and wastage . Then only we can have an outcome driven health system that cares !

Here is what I submit for your kind consideration :

NCHRH ( National Council for Human Resources for Health ) has been set up with the goals to overcome the acute shortage and uneven distribution of human resources in public health delivery system & aims at overhauling the current regulatory framework. Toward this end, it is proposed to set up a National Council

for Human Resources for Health as an overarching regulatory body to achieve the objective of enhancing the supply of skilled personnel in the health sector

What I can understand  from the above stated purpose for NCHRH  is that NCHRH will ;

  • Regulate the current set up
  • Identify the current need gap
  • Project the future requirement for the next 10, 20 & 30 years
  • Asses the population mix and the disease patterns and address the issues in a proactive manner
  • Create a resource pool & knowledge pool ( not just impart knowledge but create it as well )
  • Human resources for disaster management in healthcare is missing from the draft that I have gone through . It needs to be incorporated

Health in India has to be looked regionally and planned at the district level: It would be wrong to just limit it to five members headed by a chairman. I would suggest that you must create an “Indian Health & Wellness Service (IHWS )” for the entire nation on the lines of IAS . Today , if I have to complain against deficiency of healthcare services or standards or care at a hospital, there is no grievance redressal mechanism !! Because the system is ambiguous and there is no demarcation for people to look at health and wellness services. For erring police , I can go to SP City , DIG –Range or IGP or the DGP; for an erring postman , I can go to the Post master general etc., and the same for most of the services ; but if there is a deficiency in a hospital service provider where does a common man go ? Another hospital, I suppose !!

So when you are planning for NCHRH , You must consider having an all India service to tackle the multi headed monster called healthcare.

Have separate members in NCHRH, each having a clear role and responsibility for capacity building for the following :

  1. Urban Health
  2. Rural Health
  3. Tribal Health
  4. Health in hilly areas
  5. Health in Armed forces
  6. Health for retired government employees
  7. Health for private sector
  8. Work Place wellness
  9. Healthcare amongst Minorities
  10. Expatriates working in India
  11. Geriatric care in urban & rural health should be handled separately by different members
  12. Split ‘Mother and Child care’ under separate heads, each under a separate member . It is glaring to note that According to International Institute of Population Sciences , Mumbai , 56 % of the Indian women in the age group of 15-49 suffer from anemia
  13. Diabetes
  14. Hypertension
  15. Arthritis
  16. Cancer
  17. Epilepsy
  18. Mental Health
  19. Telehealth should be a strong focus area for Urban & rural health. It should also be a part of the Medical curriculum and a 3 month internship should be made mandatory for telehealth
  20. Medical Education
  21. Home health & care technicians
  22. Healthcare counselors and Physiotherapists
  23. Health administrators for clinics , hospitals other wellness providers
  24. Gyms & Wellness centers
  25. Diet and Nutrition
  26. Acute care
  27. Immunization
  28. Awareness & Education about wellness
  29. Awareness & Education about diseases
  30. NGO’s capacity building
  31. Disaster management in healthcare including outbreaks & epidemics
  32. Epidemiology & research on regional requirements . One example I will quote here. In north eastern part of India , in tea gardens , people take black ( known as red tea in NE ) with salt and so there is a very high incidence of Hypertension and stroke . Same applies to other belts in India which have very specific requirements that cannot be tackled with centralized planning and execution
  33. Technical up-gradation & training of the workforce on latest developments in equipments and technology
  34. CME for each level of workforce
  35. Nurses should be renamed as Physician’s Assistant (PA’s ) or Health & Wellness Officer (HWO’s ) . There should be a plan to create enough specialized resources under this head for rural health, geriatric care , telehealth , chronic diseases etc.  We need not make our healthcare system doctor & hospital centric . The number of PA’s / HWO’s should at least be double of that of the doctors in the next 10 years
  36. For medical education ( all streams ),  behavioral psychology should be added in the curriculum . This is one of the most important change that we need in the medical curriculum . Doctors have just been reduced to diagnosis & prescription machines . Whilst we might be imparting the best of medical knowledge, but  patient care and handling is missing totally from the curriculum . Writing prescriptions does not deliver care . Patient friendly care is a must . Because of the lack of understanding of the behavioral  psychology amongst doctors , the patients fear and suspect the doctors . Even the doctors do not go beyond prescriptions !! This needs an immediate change to ensure compliance and outcome from the treatment , most importantly, regain ‘Trust’ in the system by the users
  37. Put a separate head for innovation in healthcare education
  38. Separate head for guidelines, standards , treatment protocols , assessment & accreditation for each aspect of medical & health education and research

Further , each member should be responsible for research , planning &  execution for his department. It is clear that if we do not plan for human resources , it will not just lead to deficiency in healthcare services but also increase the cost of healthcare . Limited number of healthcare professionals would be available for jobs and that will definitely lead to unrealistic inflation of salaries amongst health professionals

Since this note is about the healthcare in the country , I would also like to add that, we must look at setting up a TAB ( Technology Adoption Board ). India must not import technologies simply because GE / Siemens have

produced it and it is the latest. Technology is one of the major cost drivers for healthcare . TAB must  ensure that the technologies that have demonstrated  positive impact on the treatment compared to its cost and accuracy of diagnosis should only be allowed in practice . In 2007  , a 64 slice CT Scan  was the most advanced , now it is 914 slide CT scan . The question is what is the difference in cost and accuracy of diagnosis compared to the earlier versions ?

Also, MOHFW should set up ICE – Insitute of Clinical Excellence to formulate and work on clinical pathways & protocol based treatment for all major illnesses , so that the doctors do not resort to expensive and arbitrary line of treatment at the cost & care of patient . A protocol based treatment would let all the stake holders in the continuum of care to work in close coordination

Also, the time has come to move to a greener healthcare system. I hope that we will learn from the MEA ( Ministry of External Affairs ). When you apply for a passport , the passport office gives you two or three receipts , one for the passport application fees, second for jumbo passport ( if you opt for ) and a third one for tatkal category ( if you fall under that category) . I fail to understand that, would it not be better to have one receipt with multiple options for ticking !!  It wastes paper , ink and generates three times the heat and noise printing three receipts . MOHFW needs to ensure that we move to a Mobile Health Record system (MHR ) that does not depend on paper . Mobile phones could carry all the records, and more so , when most of the people are likely to carry mobiles. Providers could sync all the medical records with SIM cards. But the success of this depends on the will of the policy makers, honesty and efficiency of implementers ( bureaucrats ) and literacy amongst users

Lastly, it is high time to check migration of our best brains & highly skilled manpower. We can build six AIIMS like buildings, but building institutions will be an onerous task in the current scheme of things, and this could well be the first test for NCHRH.

With some good leaders at the helm of affairs in healthcare , I am quite confident of the changes in healthcare for the benefit of the common man

I do hope that the recommendations are of some help. Incase, you need some clarifications or assistance , I remain at your disposal .

With best wishes

Rajendra Pratap Gupta

Email : President@dmai.org.in

C.C.-

Shri Ghulam Nabi Azad, Union Minister for Health  Family Welfare, Govt. of India

Dr.Syeda Hameed, Member , Planning Commission , Government of India

Shri Dinesh Trivedi, Minister of State for Health , Government of India

Sam Pitroda, Advisor , Prime Minister of India & Chairman, National Knowledge Commission .

Ms.K.Sujatha Rao, Health Secretary, MOHFW, Govt. of India

Dr.K.Srinath Reddy, President , PHFI, Government of India

Dr.Murli Manohar Joshi, MP.

Mrs.Sonia Gandhi , Chairperson ,NAC , UPA.

Rahul Gandhi

Dr.Sharat Chauhan, csharat@ias.nic.in / rshankar50@hotmail.com

Dr.Gautam Sen

Dr.Devi Shetty

Encl: note on healthcare reforms sent on 23rd November 2009.

Rich get richer and poor get poorer in India – GDP statistics


On 15th June , i wrote on my blog about the topic ‘ High GDP but low GDP per capita’ is like growth without progress and prosperity . Well, i did not know that 11 days after the blog a report would come out that would validate my analysis . Here is the report

According to the 2009 Asia Pacific wealth report , by Capegemini and Merrill Lynch wealth management , India’s high net worth Individuals ( HWNI’s ) are 120,000 ( 0.01 % ) but their combined net worth is close to one third of the India’s GDP

At the peak of recession ,in 2008, India had 84000 HNWI’s with a combined net worth of $310 billion . To put that figure in perspective , it was just under a third of India’s market capitalization , that is, the total value of all companies listed on the Bombay Stock Exchange – as of end March 2008. The average worth of each HNWI was Rs.16.6 crore .

According to the firm’s 2010 World Wealth Report , India now has 126,700 HNWI’s , an increase of over 50 % over the 2008 number . In 2009 alone , an estimated 13.6 million more people in India became poor or remained in poverty than would have been the case had the 2008 growth rates continued , according to the United Nations Department of Economic and Social Affairs ( UNDESA ). Also, an estimated 33.6 million more people in India became poor or remained in poverty over 2008 and 2009 than would have been poor has the pre-crisis (2004-7 ) growth rates been maintained .

I keep saying that recession or growth that we keep reading in the Times of India or The Economic Times , is only affecting people who read these newspapers. Rest all live under abject poverty .

Read the presentation that i made at the 6th India Innovation Summit on 18th June 2010 at Bangalore . You will see that our demographic dividend is fast becoming demographic disaster !! ( Download the presentation from http://www.rajendra.groupsite.com )

Rajendra Pratap Gupta

Email : office@rajendragupta.in

Dr.Bamboo – Tall & impressive but hollow – Dr.Manmohan Singh


I think , Dr. Manmohan Singh is like a Bamboo . Tall & Impressive in stature , but hollow .

See what he is doing  ? All across, the country is failing but his image continues to be a hit !

China has decided to do a nuclear deal with our Pakistan ! India has failed to check it

America is not as friendly with India , as it is with Pakistan

Inflation is going up and the government is clueless

Naxalites control 1/6th of India

This government is a failed government and BJP is not reining in the government ! I fail to understand why BJP is not addressing the important issues !!

Dr. Manmohan Singh is the Bamboo Prime Minister !! Time to raise voice and get the right issues addressed

Rajendra Pratap Gupta

Email : office@rajendragupta.in

Leading Effective Action Against Diabetes- LEAD


Join the fight against Diabetes. The campaign will focus on

1. Awareness

2. Education

3. Action

Lead will work at three levels A) Consumers  B) Communities C ) Doctors

Please visit http://www.dmai.org.in for more updates

The campaign will be driven under the leadership of Ms. Sangeeta Barde Email : sangeeta.barde@dmai.org.in or lead@dmai.org.in

India & China : New Super power and the next crisis state


India and China are headed for a new challenge . India has all the ingredients to qualify as the next super power . Unlike the US , Which has arrogated for itself the ‘Big brother’ status , and almost failed as a ‘Responsible super power’. China might have a big ‘Trade Surplus’ but has a huge  ‘Credibility deficit’. With no other credible alternative , it is for sure,  that India can work towards being the next ‘Responsible Super power’ by 2025

China is on the way to be become the victim of the ‘economic crisis’ that has already hit the USA & Europe, and for sure , now its China’s turn !!

Wait and watch

Rajendra Pratap Gupta

Email : office@rajendragupta.in

Pakistan , Pakistan Spy’s & Indian Fatwa’s


It is an established fact that,  Pakistan does not use funds that it seeks from US for the purpose that they are given. The funds are used for funding terror in India ,U.K. & the U.S.

It Is the right time that India asks for foreign observers ( Including and Indian representation ) to oversee and audit the use of any foreign fund in Pakistan

Also , we have seen two cases of Pakistan setting its strong hold in the Indian armed forces . We have just caught two of them ( Mrs. Gupta & Mr. Prasad ). I believe that there might be 100’s of such Pakistani moles within the Indian establishment and not just in forces and bureaucracy but also beyond . Time to act fast . Kargil , i believe , happened due to such a nexus !!

Also, over the last few weeks , i have see a lot of Fatwa’s issued by non-judicial entities . Why is our ‘Supreme’ court not taking a Suo moto action ?  It should be made a rule that no religious entity can issue any FATWA or order that goes against the fundamental rights enshrined in our constitution and the laws of the land . If anyone dares to do that , he or she must be tried for challenging the law of the land !!

Rajendra Pratap Gupta

Email : office@rajendragupta.in