💥Join UPSC 2027,2028 Mentorship (August Batch) + XFactor Notes & Microthemes PDF
Talk to Mentor

Civilsdaily

Login

Subject: Governance

Important aspects of Society

  • Brain drain of India’s health worker

    The article highlights the issue of shortage of healthcare workers in India even as it exports its healthcare workers to other countries.

    India as an exporter of healthcare workers

    • For several decades, India has been a major exporter of healthcare workers to developed nations particularly to the Gulf Cooperation Council countries, Europe and other English-speaking countries.
    • As per OECD data, around 69,000 Indian trained doctors worked in the UK, US, Canada and Australia in 2017.
    • In these four countries, 56,000 Indian-trained nurses were working in the same year.
    • There is also large-scale migration of health workers to the GCC countries but there is a lack of credible data on the stock of such workers in these nations.
    • There is no real-time data on high-skilled migration from India as in the case of low-skilled and semi-skilled migration.

    Shortage of nurses and doctors

    • The migration of healthcare workers is part of the reason for the shortage in nurses and doctors.
    • If we look at the figures for countries where we export our healthcare workers, we see just how big the difference is between the sending and the receiving countries.
    • As per government reports, India has 1.7 nurses per 1,000 population and a doctor to patient ratio of 1:1,404.
    • This is well below the WHO norm of 3 nurses per 1,000 population and a doctor to patient ratio of 1:1,100.
    • But, this does not convey the entire problem.
    • The distribution of doctors and nurses is heavily skewed against some regions.
    • Moreover, there is high concentration in some urban pockets.

    Factors driving migration

    • There are strong pull factors associated with the migration of healthcare workers, in terms of higher pay and better opportunities in the destination countries.
    • However, there are strong push factors that often drive these workers to migrate abroad.
    • The low wages in private sector outfits along with reduced opportunities in the public sector plays a big role in them seeking employment opportunities outside the country.
    • The lack of government investment in healthcare and delayed appointments to public health institutions act as a catalyst for such migration.

    Measures to check brain drain and issues with it

    • Over the years, the government has taken measures to check the brain drain of healthcare workers with little or no success.
    • In 2014, it stopped issuing No Objection to Return to India (NORI) certificates to doctors migrating to the US.
    • The NORI certificate is a US government requirement for doctors who migrate to America on a J1 visa and seek to extend their stay beyond three years.
    • The non-issuance of the NORI would ensure that the doctors will have to return to India at the end of the three-year period.
    • The government has included nurses in the Emigration Check Required (ECR) category.
    • This move was taken to bring about transparency in nursing recruitment and reduce the exploitation of nurses in the destination countries.
    • The government’s policies to check brain drain are restrictive in nature and do not give us a real long-term solution to the problem.

    Way forward

    • We require systematic changes that could range from increased investment in health infrastructure, ensuring decent pay to workers and building an overall environment to motivate them to stay in the country.
    • The government should focus on framing policies that promote circular migration and return migration — policies that incentivise healthcare workers to return home after the completion of their training or studies.
    •  It could also work towards framing bilateral agreements that could help shape a policy of “brain-share” between the sending and receiving countries.
    • The 2020 Human Development Report shows that India has five hospital beds per 10,000 people — one of the lowest in the world.
    • Increased investment in healthcare, especially in the public sector, is thus the need of the hour.
    • This would, in turn, increase employment opportunities for health workers.

    Consider the question “What are the factors driving the migration of healthcare workers from India? Suggest the measure to stem their migration.”

    Conclusion

    India needs systematic changes that could range from increased investment in health infrastructure, ensuring decent pay to health workers and building an overall environment that could prove to be beneficial for them and motivate them to stay in the country.

  • ICMR drops Plasma Therapy for COVID-19

    The use of convalescent plasma has been dropped from the recommended treatment guidelines for COVID-19, according to an advisory from the Indian Council of Medical Research (ICMR).

    Q.What is convalescent plasma therapy and what are the issues involved in its adoption?

    Convalescent Plasma Therapy

    • The therapy seeks to make use of the antibodies developed in the recovered patient against the coronavirus.
    • The whole blood or plasma from such people is taken, and the plasma is then injected into critically ill patients so that the antibodies are transferred and boost their fight against the virus.
    • A COVID-19 patient usually develops primary immunity against the virus in 10-14 days.
    • Therefore, if the plasma is injected at an early stage, it can possibly help fight the virus and prevent severe illness.

    How often has it been used in the past?

    • This therapy is no new wonder. It has been used several times.
    • The US used plasma of recovered patients to treat patients of Spanish flu (1918-1920).
    • In 2014, the WHO released guidelines to treat Ebola patients with convalescent whole blood and plasma.
    • In 2015, plasma was used for treating MERS patients.

    How is it done?

    • The process to infuse plasma in a patient can be completed quickly.
    • It only requires standard blood collection practices and extraction of plasma.
    • If whole blood is donated (350-450 ml), a blood fractionation process is used to separate the plasma.
    • Otherwise, a special machine called aphaeresis machine can be used to extract the plasma directly from the donor.
    • While blood is indeed extracted from the donor, the aphaeresis machine separates and extracts the plasma using a plasma kit, and the remaining blood components are returned into the donor’s body.

  • Article 311 of the Indian Constitution

    A suspended Maharashtra police officer was dismissed from service by Mumbai Police Commissioner under Article 311 (2) (b) of the Indian Constitution without a departmental enquiry.

    What is Article 311?

    • Article 311 says that no government employee either of an all India service or a state government shall be dismissed or removed by an authority subordinate to the owner that appointed him/her.
    • Section 2 of the article says that no civil servant shall be dismissed or removed or reduced in rank except after an inquiry in which s/he has been informed of the charges and given a reasonable opportunity of being heard in respect of those charges.

    Various safeguards under Art. 311

    • Article 311 is meant to act as a safeguard for civil servants that give them a chance to respond to the charges in an enquiry so that he/she is not arbitrarily dismissed from service.
    • The article also provides exceptions to these safeguards under subclause 2 provision b.
    • It states “when an authority empowered to dismiss or remove a person or to reduce him in rank is satisfied that for some reason, to be recorded by that authority in writing, it is not reasonably practicable to hold such enquiry”.

    What is the process of a departmental enquiry?

    • In a departmental enquiry, after an enquiry officer is appointed, the civil servant is given a formal chargesheet of the charges.
    • The civil servant can represent himself/herself or choose to have a lawyer.
    • Witnesses can be called during the departmental enquiry following which the enquiry officer can prepare a report and submit it to the government for further action.

    Are there other exceptions where a person can be dismissed without departmental enquiry?

    • As per Article 311 subclause 2 provision a, if a government employee is convicted in a criminal case, he can be dismissed without DE.
    • Apart from this, under 311 (2) (c), a government employee can be dismissed when the President or the Governor, as the case may be, is satisfied in the interest of the security of the state.

    Can the dismissal under section 311 (2) be challenged by the government employee?

    • Yes, the government employee dismissed under these provisions can approach either tribunal like the state administrative tribunal or the Central Administrative Tribunal (CAT) or the Courts.

  • Socio-Economic Impact of Pandemic on Women

    The article highlights the disproportionate impact of the pandemic on women and suggests measures to soften the impact.

    Widening gender employment gap

    • Even prior to 2020, the gender employment gap was large.
    • Only 18% of working-age women were employed as compared to 75% of men.
    • Reasons include a lack of good jobs, restrictive social norms, and the burden of household work.
    • The nationwide lockdown hit women much harder than men.
    • Data from the Centre for Monitoring Indian Economy Pvt. Ltd. show that 61% of male workers were unaffected during the lockdown while only 19% of women experienced this kind of security.
    • Men who did lose work were able to regain it, even if it was at the cost of increased precarity or lower earnings, because they had the option of moving into fallback employment arrangements.
    • Even as new entrants to the workforce, women workers had poorer options compared to men.
    • Women were more likely to enter as daily wage workers while men found avenues for self-employment.
    •  So, not only did women enter into more precarious work, it was also likely to be at very low earnings compared to men.

    Growing domestic work

    • With schools closed and almost everyone limited to the confines of their homes, household responsibilities increased for women.
    • The India Working Survey 2020 found that among employed men, the number of hours spent on paid work remained more or less unchanged after the pandemic.
    • But for women, the number of hours spent in domestic work increased manifold.
    • This increase in hours came without any accompanying relief in the hours spent on paid work.

    Way forward

    • The following measures are needed now:
    • The National Employment Policy, currently in the works, should systematically address the constraints around the participation of the women’s workforce.
    • Expansion of the Mahatma Gandhi National Rural Employment Guarantee Act (MGNREGA) and the introduction of an urban employment guarantee targeted to women as soon as the most severe forms of mobility restrictions are lifted.
    • There is a need for coordinated efforts by States to facilitate the employment of women while also addressing immediate needs through the setting up of community kitchens, the opening of schools and anganwadi centres, and engagement with self-help groups for the production of personal protective equipment kits.
    • Further, a COVID-19 hardship allowance of at least ₹5,000 per month for six months should be announced for 2.5 million accredited social health activists and Anganwadi workers, most of whom are women.
    • The pandemic has shown the necessity of adequate public investment in social infrastructure.
    • The time is right to imagine a bold universal basic services programme that not only fills existing vacancies in the social sector but also expands public investments in health, education, child and elderly care, and so on, to be prepared for future shocks.

    Consider the question “Examine the impact of the pandemic on women. Suggest the measures to mitigate the impact.”

    Conclusion

    As the country meets the challenge of the second wave of the pandemic, it is crucial to learn lessons from the first wave to chart the policy path ahead.

  • It is time to set up a National Tribunals Commission

    Context

    • The Centre has abolished several appellate tribunals and authorities and transferred their jurisdiction to other existing judicial bodies through the Tribunals Reforms (Rationalisation and Conditions of Service) Ordinance 2021.

    Issues with the abolitions of tribunals

    • The Ordinance has met with sharp criticism for not bypassing the usual legislative process.
    • Several tribunals such as the Film Certification Appellate Tribunal were abolished without any stakeholder consultation. 
    • Despite the Supreme Court’s direction in Rojer Mathew v. South Indian Bank (2019), no judicial impact assessment was conducted prior to abolishing the tribunals through this Ordinance.
    • While the Ordinance has incorporated the suggestions made in Madras Bar Association v. Union of India (2020) on the composition of a search-cum-selection committee.
    • But it has disregarded the court’s direction in Madras Bar Association v. Union of India (2020) for fixing a five-year term.

    No NCT constituted

    • Further, the Centre is yet to constitute a National Tribunals Commission (NTC), an independent umbrella body to supervise the functioning of tribunals, appointment of and disciplinary proceedings against members, and to take care of administrative and infrastructural needs of the tribunals.
    • The idea of an NTC was first mooted in L. Chandra Kumar v. Union of India (1997).
    • Developing an independent oversight body for accountable governance requires a legal framework that protects its independence and impartiality.
    • Therefore, the NTC must be established vide a constitutional amendment or be backed by a statute that guarantees it functional, operational and financial independence.
    • As the Finance Ministry has been vested with the responsibility for tribunals until the NTC is constituted, it should come up with a transition plan. 

    Advantages of NTC

    • The NTC would ideally take on some duties relating to administration and oversight.
    • It could set performance standards for the efficiency of tribunals and their own administrative processes.
    • It could function as an independent recruitment body to develop and operationalise the procedure for disciplinary proceedings and appointment of tribunal members.
    • Giving the NTC the authority to set members’ salaries, allowances, and other service conditions, subject to regulations, would help maintain tribunals’ independence.

    Consider the question “What are the issues with Tribunals Reforms (Rationalisation and Conditions of Service) Ordinance 2021? How the constitution of the National Tribunals Commission would help to improve the role played by tribunals?” 

    Conclusion

    The way to reform the tribunal system is to look at solutions from a systemic perspective supported by evidence. Establishing the NTC will definitely entail a radical restructuring of the present tribunals system.

  • Lend a helping hand to children the right way

    The article highlights the need to be aware of the legal provisions while helping a orphan child.

    Helping orphaned children

    • Social media is flooded with requests to adopt children who have lost their parents in the pandemic.
    • However, before handing over an orphan child to any agency, family or person, it is important to be aware of the laws.
    • If an orphan child is kept by someone without lawful authority, he or she may land themselves in trouble.
    • According to the Hindu Minority and Guardianship Act, 1956, the father, and in his absence the mother, is the natural guardian.
    • Not even a close relative can look after the child without authorisation.

    What are the options to help

    • First option is any individual who finds an orphan child or even any child who needs care and protection under the circumstances, should immediately call the toll free Childline number 1098.
    • It is an emergency phone outreach service managed by the Women and Child Development department’s nodal agency, the Childline India Foundation.
    • The second option is to intimate the district protection officer concerned whose contact details can be found on the National Tracking System for Missing and Vulnerable Children portal.
    • The third alternative is to approach the nearest police station or its child welfare police officer who is specially trained to exclusively deal with children.
    •  jOne can always dial the Emergency Response Support System (ERSS) which is a pan-India single number (112) based emergency response system for citizens in emergencies and seek the necessary help.
    • The non-reporting of such children is also a punishable offence under the Juvenile Justice (Care and Protection of Children) Act, 2015 (JJA).

    Procedure after a child reaches outreach agency

    • Once an orphan child is recovered by the outreach agency, it is the duty of the said agency to produce the child within 24 hours before the Child Welfare Committee (CWC) of the district.
    • The CWC, after an inquiry, decides whether to send the child to a children’s home or a fit facility or fit person.
    • If the child is below six years, he or she shall be placed in a specialised adoption agency.
    • The State thus takes care of all such children who are in need of care and protection, till they turn 18 years.
    • In Sampurna Behrua vs Union of India (2018), the Supreme Court of India directed States and Union Territories to ensure that all child care institutions are registered.

    Procedure for adoption

    • Once a child is declared legally free for adoption by the CWC, adoption can be done either by Indian prospective adoptive parents or non-resident Indians or foreigners, in that order.
    • Another important feature of the JJA is that it is secular in nature and simple in procedure.
    • While the Hindu Adoptions and Maintenance Act, 1956 is religion specific but also relatively cumbersome in procedure.
    • Second, the procedure of adoption is totally transparent and its progress can be monitored from the portal of the statutory body, the Central Adoption Resource Authority.

    Directives to the police

    • The Supreme Court in Bachpan Bachao Andolan vs Union of India directed all Directors General of Police, in May 2013, to register a first information report as a case of trafficking or abduction in every case of a missing child.
    • At least one police officer not below the rank of assistant sub-inspector in each police station is mandatorily required to undergo training to deal with children in conflict with the law and in need of care and protection.
    • They are not required to wear a uniform and need to be child-friendly.
    • Similarly, each district is supposed to have its special juvenile police unit, headed by an officer not below the rank of a Deputy Superintendent of Police.
    • The Supreme Court in Re: Exploitation of children in Orphanages in the State of Tamil Nadu (2017) inter alia, specifically asked the National Police Academy, Hyderabad and police training academies in every State to prepare training courses on the JJA and provide regular training to police officers in terms of sensitisation.
    • The National Commission for Protection of Child Rights (NCPCR) recently wrote to the Chief Secretaries of all States and Union Territories on the issue of children orphaned due to COVID-19.

    Conclusion

    Following the Covid surge and subsequent increase in request for adoption of children, the laws and procedure for the protection of children must be noted.

  • NITI Aayog’s proposal of allowing private entities to take over district hospitals

    The article highlights the issue of shortage of doctors in India and issues with the involvement of private sector in it.

    Government approach

    • Market-oriented approach towards medical education: NITI Aayog’s proposal of allowing private entities to take over district hospitals for converting them into teaching hospitals with at least 150 MBBS seats.

  • Issues with MHA notification for OCI

    About notification

    • The Home Ministry’s March 4 order that required professional Overseas Citizens of India (OCIs), such as journalists, engineers and researchers, to notify the Ministry about their activities in India.
    • The notification said that OCIs shall be required to obtain a “special permission or a special permit” from the competent authority or the Foreigners Regional Registration Office (FRRO) or the Indian mission “to undertake research, missionary or Tabligh or mountaineering or journalistic activities or internship in any foreign diplomatic missions
    • The Ministry issued a gazette notification that OCI cardholders could claim “only NRI (Non-Resident Indian) quota seats” in educational institutions.

    Issues with the notification

    • This will place undue burden on scientific, pharmaceutical, medical, biotechnology and other research fields.
    • Even if an OCI student has secured a high rank in an exam like NEET, several institutions of repute do not have NRI seats.
    • The exorbitantly high fees under the NRI quota cannot be afforded by many OCIs as they live and work in India.
    • India-domiciled OCI students are deprived of domicile status both in India [country of residence] as well as the country of their citizenship.
    • The notification equates India-domiciled OCIs with a foreigner.

    About OCIs

    • OCIs are of Indian origin but hold foreign passports.
    • India does not allow dual citizenship but provides certain benefits under Section 7B(I) of the Citizenship Act, 1955 to the OCIs.
    • So far, 37.72 lakh OCI Cards are said to have been issued.

  • India resists Community Transmission tag despite soaring cases

    How other countries are classifying themselves

    • Inspite of adding the highest number of cases in the world every day, India continues to label itself as a country with no community transmission (CT) according to the latest weekly report by the World Health Organisation (WHO) on May 11.
    • India opts for the lower, less serious classification called ‘cluster of cases’.
    • Countries such as the United States, Brazil, United Kingdom, France have all labelled themselves as being in ‘community transmission.
    • Among the 10 countries with the most number of confirmed cases, only Italy and Russia do not label themselves as being in community transmission.
    • Both countries have been on a declining trajectory for at least a month and together contribute less than 20,000 cases a day — about 5% of India’s daily numbers.
    • India, since the beginning of the pandemic has never marked itself as being in community transition.

    Understanding the classification

    • Broadly, CT is when new cases in the last 14 days can’t be traced to those who have an international travel history, when cases can’t be linked to specific cluster.
    • Instead, the classification, ‘cluster of cases’ says “Cases detected in the past 14 days are predominantly limited to well-defined clusters that are not directly linked to imported cases”.
    • The WHO guidelines further suggest four subcategories within the broader definition of CT.
    • CT-1 implying “Low incidence of locally acquired, widely dispersed cases…and low risk of infection for the general population.
    • The highest, a CT-4 suggests very high incidence of locally acquired, widely dispersed cases in the past 14 days.
    • Very high risk of infection for the general population.

    Why right classification matters

    • If cases were still a cluster, it would mean that the government ought to be prioritising testing, contact tracing and isolating to prevent further infection spread.
    • CT, on the other hand meant prioritising treatment and observing advisories to stay protected.
    • CT — far from being stigmatic or an indicator of failure — has a bearing on how authorities addressed a pandemic.

  • Black marketing during the pandemic

    The article highlights the issue of black-marketing of drugs during the pandemic and the factors responsible for it.

    Problem of fake and sub-standard drugs

    • There have been reports of fake remdesivir amid the Covid pandemic.
    • It is difficult to quantify the morbidity and mortality effects of fake or sub-standard drugs, but they are substantial.
    • Legally, the Drugs and Cosmetics Act (DCA) has different categories of misbranded, adulterated and spurious drugs.
    • In 2003 Mashelkar Committee noted that although the Drugs and Cosmetics Act has been in force for the past 56 years, but the level of enforcement in many States has been far from satisfactory.
    • The committee also noted that the problems in the regulatory system in the country were primarily due to inadequate or weak drug control infrastructure at the State and Central level.

    Steps taken to deal with the issue

    • Assistance has also been provided under the World Bank assisted Capacity Building Project to upgrade testing facilities and to establish new drug testing laboratories.
    • The Drugs & Cosmetics Act, 1940 has recently been amended in 2008 for providing more stringent penalties to those involved in the trade of spurious drugs.
    • There are specially designated courts and regulatory infrastructure has been strengthened.
    •  There is also a whistle-blower scheme.

    Distinction between hoarding and black-marketing

    • A hoarder is anyone who stocks up items.
    • The crime isn’t hoarding per se but of selling a drug without a licence.
    • Data on prosecutions, and convictions when prosecuted, of crimes under Drugs and Cosmetics Act, are not encouraging.
    • Incidentally, courts have ruled police officers can’t register FIRs, arrest and prosecute (for cognisable crimes) under this law.
    • That’s the job of drugs inspectors.
    • The notion of a black market is different, though the two can be related.
    • In this context, it means charging a premium when there is a shortage.
    • A black market occurs when the price at which a product is sold is higher than an administratively determined price.

    Conclusion

    Action not taken in the best of times now strikes back at us in the worst of times.