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History repeats in Congress - Mrs. Sonia Gandhi & Dr. Manmohan Singh , you must go now !

Mrs. Gandhi , Rahul & Dr. Singh,

Today, this great country is ashamed & aghast due to your cowardly & cold-blooded attacks at Ram Lila Maidan on 4th June 2011. India has reached a new low under your regime !

Every now and then, the supreme court has to intervene and direct the PM & his government to discharge routine duties towards the nation & its citizens. When the constitution of India was written , the constituent assembly laid the foundation of an independent judiciary , legislative & the executive , but due to gross misuse of constitutional powers bestowed upon the Prime Minister through his remote control boss ( Sonia Gandhi ) , you all have forced the Supreme court to run the government on important issues like corruption and high handedness , and this has never happened in the history of India .

Politics & governance under congress has reached the lowest level , and today, everyone realizes that the supreme court is running the nation on a day-to-day basis ( directly or under its fear of intervention ! ). After 4th June , Supreme court will have to make bureaucrats discharge their duties . Jai ho Supreme court and shame -shame for congress !

Congress created hue and cry when Rahul was arrested by Mayawati & now that you have mercilessly beaten up the sleeping protestors ! This clearly indicates a few things :

1. If one makes black money and does wrong , Congress will not kick you out ! ( means that Congress patronizes people who do wrong things and make money ). I believe, that you could not buy Ramdev through your so-called negotiations , and so you tried to assault him to kill him in cold blood ! I am sure that your government must be now planning to invoke your cronies in CBI , IT , ED & FDA etc to raid Ramdev’s establishments and take him to task. Same you have done to those who decided not to toe your line like Amitabh Bacchan and Narendra Modi

2. If people peacefully fast and demand the black money back , Congress will go and kick out people in mid night ?

This act on 4th June was not short of what is happening in the Arab World !! Mrs. Gandhi , since Congress party is running the government, and you have been the President of AICC & the Chairman of NAC , you have proven to be the most incompetent person in Congress as its leader. All your top functionaries are economists ( Chidambaram , Manmohan , Pranab, Montek ) , still you have failed to bring down the inflation , which was to be done in the first 100 days of coming to office !! , Common man has been left behind in all that your party is doing !

Congress has been reduced to the party of scams in the name of social schemes ! Corruption has become the order of the day & currency in this nation . Foreign media has tagged India to be more corrupt than developing ! A. Raja has become amongst the top most corrupt person in the recent international list released by a leading magazine . You are bringing down the country before the global forums . We cannot tolerate this as Indians , and I request you as a common man to resign and go immediately !!

I request the opposition parties to declare a “Corruption , mehagaye aur tanashaye ke virudh Bharat Bandh” ( preferably on a Sunday , to cause least inconvenience to people ) as a show of resentment against your dictatorial and corrupt rule . Congress has always played the politics in the name of Poor , Gandhi family and Religion and cheated the innocent poor for decades , it is time to end this rule . All national leaders marked in this email must come forward so that we do not repeat what happened on 4th June .

I must put these facts before you

The Indian Emergency of 25 June 1975 – 21 March 1977 was a blot in the name of democracy by Indira Gandhi

4th June 1989 , Tiananmen Square happened, and Sonia Gandhi’s Congress did it again on 4th June 2011

3– 6 June 1984, Congress stormed the Golden Temple and killed Sikhs in Operation Blue star Congress leaders led to mass killing of Sikhs post the death of Indira Gandhi

4th June 2011, Congress brutally attacked peaceful protestors in cold blood with an aim to assault Baba Ramdev, repeating the history of Gandhi’s & Congress , and the party has the audacity to call itself as United Progressive Alliance (UPA ) ? Shameful acts . This is what happens when you are afraid of being exposed and your black money is under threat ; Go out and kill innocent in cold blood , and , finally, the Supreme court has to take suo moto action for this cowardly act.

If you have to show courage , go to Pakistan and do an act like America did to capture Dawood Ibrahim !

Though this email , I request our national leaders in the opposition to promise that they will honor our Supreme court judges with at a least Padma Vibhushan ( if not Bharat Ratna ), who woke up our highly educated but ignorant PM to act against Raja, and the judges who took suo-moto action for the cold-blooded attacks on peaceful protestors on 4th June .

Our Tiananmen Square has happened, and now our Egypt like protest must happen . Time for India for a ‘Doosri Azadi’ from this inefficient , corrupt , bankrupt & dictatorial government . Sonia and Rahul are failed politicians and bankrupt with ideas , and a liability on the congress . I am hoping congress will stop idol worship of these two leaders; who brought down the congress in the eyes of a common man, and India in the eyes of the world & hopefully opposition will rise up to restore the faith of the common man

A Common Man

Rajendra Pratap Gupta

www.rajendragupta.wordpress.com

Nehru Gene , Congress & Faulty Policies - Let's move on or else suffer more !!

March – April meant a lot of travel and meetings for myself , but the most interesting part were a few conversations that I will never forget !!

Whenever I am travelling to places within India and abroad , I make sure that I interact with people and ask them how much they know of our great country and what they feel about it . I am always proud to be born in this great country . May be , this drives me to find some answers to questions that need not be stated here !!

One conversation I had was with a senior columnist in Kashmir during my visit last month . While we were talking , the issue of partition came up ( this topic is close to my heart as my mother was born and brought up in Lahore , now in Pakistan ) .

This columnist had an interesting point : He mentioned that due to the insatiable lust for power in Nehru , India got divided . His belief was that, Jinnah was at his fag-end due to cancer , if only Nehru would have waited for one more year ( It is not good to have a wish that one dies of cancer but...) , we could have saved ourselves from partition . The columnist went on to add , how could India leave Khyber pass and partition India and give away the pass to Pakistan ;The only way to reach Europe ?? I do not know geography so much , but he had an interesting point !

Other discussion I had was with my cab driver on the way from Washington DCA airport to the hotel . I figured out that the driver seemed to be from our part of the world , So I asked him where he belonged to ? I was right , he was from Pakistan but settled in the US for over 28 years !! While we kept talking about our countries before Partition and the sad story of strained relations now . He shared some very interesting information of why India got partitioned ?

According to this cabbie . India had the maximum number of Muslims , and Nehru & Congress party knew very well that, if India remained united , the vote of Muslims would swing to Indian Muslim League and not come to congress , so Nehru used his proximity with Edwina Mountbatten and planted the thought of partition in Jinnah. Well, I never thought of this angle !! Further this cabbie informed that, if you see the history of Jinnah a few years before freedom , he was never in favor of a partition . It was a congress and Nehru’s game plan and they never wanted to share a few states with IML ( Indian Muslim League ), which would have garnered power in some states, as some states had Muslims in majority , and Hindu’s & Muslims lived in complete harmony .

I completely empathise with this cabbie . I can only state that my mother’s family stayed in Lahore and Karachi , and I have seen my grandfather writing letters in Urdu , it never was an issue . It was planted by congress and today both nations are paying a price for the naked & insatiable lust of Nehru & his congress for grabbing power in 1947 .

The amount of money both these nations have spent on armed forces and conflict would have made this region developed in just 25 -30 years after freedom . But what we got was freedom for Nehru family to rule this nation and not for India !! Now we can well understand why Gandhi ji was in Calcutta during Independence and not with Nehru !! Gandhi ji died at the right time. Had he been alive , he would have revolted against Nehru .

AICC should have been dissolved after independence : Gandhi ji was never in favor of AICC continuing after freedom , In fact , he made a suggestion that since the objective of the congress were achieved by getting freedom from the British , it must be dissolved . But we know that Nehru had a different plan and India continues to ruin under this party !!

One of the interesting viewpoints I can share is from LKY ( Lew Kuan Yew , Father of Modern Singapore ). He has openly criticized Nehru for aping the central planning of the Soviet Union . LKY went on add that Nehru was a good writer & poet but not a great leader for India . Nehru kept promoting the non-aligned movement for the developing world but strongly sided with the soviet Union ( that is , he said one thing and did just the opposite , this is what I call the ‘Nehru Gene’ , which by the way is a legacy of the Gandhi family and its congress ) , and in the end, Nehru caused more harm to India than any other leader ! Nehru had a great opportunity to change the course of the nation immediately after freedom as he had a free hand and people believed in him , but he missed the opportunity .

Indians know that Nehru was the one who took Kashmir to United Nations , he was the one who promoted industries and not SME’s & agriculture ! Nehru guided India towards a disaster with his short-sighted policies ‘Nehru gene’ still rules the Gandhi family and the congress, and it is time to let this party be out of power for at least two terms so that the country can be brought back on track

Rajendra Pratap Gupta

www.rajendragupta.wordpress.com

Mental Healthcare Act 2010 - Needs Revisions

Registered Speed Post / E-Mail

Dated: March 24th 2011

Shri. Ghulam Nabi Azad

Hon’ble Health Minister

Government of India

Nirman Bhavan,

New Delhi -110108



Reference: Revision of Mental Health Act 1987 & Mental Health Care Act 2010 ( draft )

Dear Shri Azad ji,

This needs your esteem, kind and personal attention.

I am writing this note on behalf of the Disease Management Association of India – ( DMAI)- The Population Health Improvement Alliance . DMAI works with all the stake holders in the entire continuum of care, for improving the population health of the nation . Over the last few years, we have worked with different stake holders to help define the right priorities in healthcare for the policy makers & the care providers .

Through this note , I am drawing your attention to the revision of the mental health act of 1987 and the proposed Mental Health Care act 2010 (Draft). The process of revision of the Mental Health Act 1987 was initiated about a year back, to make it compliant to the United Nations Convention on the ‘Rights of Persons with Disability’. Disability includes persons with long term mental illness. This convention advocates equal rights for all disabled persons.

Dr Saumitra Pathare ( a private psychiatrist) and Dr. Jaya Sagade (a lawyer) of Pune were in charge of conducting the regional consultations on behalf of the Ministry. Over the last one year, there have been 5 regional consultations with various stakeholders. The major stakeholders consulted have been users, care providers, professional bodies in mental health, mental health institutions and state government representatives. However, it is to be noted that, the Medical Council of India, other specialties of modern medicine, and professional organizations of general health field, have not been consulted. This is important, as the changes which are evident in the draft bill have far reaching consequences in terms of the way the modern medicine is taught and practiced currently.

DMAI- The Population Health Improvement Alliance, is surprised with the outcome of the consultations , and that there was hardly any discussion on the final outcome to patients due to the significant changes which are being brought in terms of the 'mental health’ field of practice of medicine by way of promulgating this act. Proposed changes are likely to cost human lives , as persons who have not been trained to be physician (Clinical Psychologist, Psychiatric Social Worker, Psychiatric Nurse), will be entrusted with the role of independent examination, diagnosis and admission of patients in mental health facilities. Currently, this role rests with a Psychiatrist who is a medical doctor (MBBS) trained in Psychological Medicine. In modern system of medicine ,only a physician (M.B.B.S )can diagnose a patient, as only he has received training in all the specialties such as Medicine, Surgery, Eye, ENT, Obstetrics & Gynecology, Pediatrics, Orthopedics, Radiology, Dentistry, Dermatology, Anesthesiology, Pharmacology, Preventive and Social Medicine, Pathology, Microbiology, Physiology, Biochemistry, Anatomy etc. , which essentially means, covering all the systems of the body. Unfortunately, Human body cannot be compartmentalized and however we may wish, but we cannot have an Eye specialist who has studied only ‘Eye’ and not done MBBS ( as a basic general qualification and set of skills covering the entire human body system) to examine each and every system of human body. Similarly, we cannot have a Psychologist who has no training of the subjects studied at MBBS level, to diagnose mental disorders by only doing psychological examination!!!!

Only an MBBS trained doctor with the proper understanding of the entire human body system and its functioning, can do a detailed psychological evaluation and come to a diagnosis of whether the patient has a psychological illness or it is some physical illness, which is presenting itself as a psychological illness. In cases of latter, appropriate referral is required and any delay may even be fatal. S/he can also order various tests and imaging and interpret them for aiding in his diagnosis. After a diagnosis is arrived at, s/he can plan and provide physical treatment (ECT), pharmacological treatment or psychological treatment. The role of psychiatric nurse, clinical psychologist or a psychiatric social worker is to assist him by nursing the patient, helping him in psychological interventions, helping him in psycho-social interventions respectively. But the patient is under the overall care of a psychiatrist who is the leader of the mental health team. All the three categories of personnel work under the supervision of a psychiatrist .

A clinical psychologist, PSW ( Psychiatric Social Worker ) or a psychiatric nurse is not trained to be a physician. They have not studied the human body as an MBBS doctor and cannot do detailed physical or systemic examination, investigations and imaging like a psychiatrist. They are in no position to independently examine, diagnose and advise admission of patient. A PSW and Clinical psychologist have not general training in other subjects of modern medicine. Just by talking to patient, how can a Clinical Psychologist or PSW diagnose a mental disorder? They will be severely restricted by their inability to do general and systemic examination and order and interpret investigations and imaging. A Psychiatry examinee will fail in his examination if he did not touch the patient for examination ; however bright drug treatment he may formulate for the patient ; as without a general and systemic examination, a person cannot make a diagnosis of mental disorder. In many cases special investigations and imaging also has to be ordered and interpreted. As per the diagnostic criteria for mental illness, a mental disorder can only be diagnosed after ruling out that the signs and symptoms are not better accounted for by a medical illness or use/abuse of a substance. In this scenario, without proper validation of the reason for the particular condition , what is the validity of diagnosis of mental disorder by a Clinical Psychologist, PSW or a Nurse ? Even the quacks believe that they can diagnose and treat independently. Each such claim needs to be examined objectively in line of their competence and current practice related to their vocation.

In modern system of medicine, which is regulated by MCI, there is no specialization known as Clinical Psychology, PSW or Psychiatric Nursing. The mandate of ‘Rehabilitation Council’ is limited to rehabilitation of persons with disability and practice of modern medicine under Rehabilitation Council is neither required nor allowed. If at all, new independent specialties such as Clinical Psychology, PSW and Mental Health Nursing without any supervisory role of a Psychiatrist is being planned for modern medicine system, then the whole modern medical system (MCI, Indian Medical Association, Other Medical Specialties) must be consulted .

If we go as per the draft, it means that Clinical Psychology, PSW and Mental Health Nursing personnel are as much a specialist as a psychiatrist and can independently examine , diagnose, admit and treat patients with mental disorders.

It is not understandable why a psychiatrist has to do MBBS (study the whole human body) and then specialize in Psychiatry while for the other persons they need to study only psychology or social work and yet be assumed to be qualified to examine the whole body, diagnose, admit and treat patients (albeit without medicines) . The demand to prescribe medicines by non psychiatrist is also going around (and may be later on this will be also be made possible.) There is no institution in the country where a Clinical Psychologist, PSW, Mental Health Nurse examines patients independently, diagnoses a mental disorders, admits patients and treats them. This amounts to practice of Psychiatry under the modern system of medicine and would invite penal provisions of MCI. The sole aim of drafters is to get the bill through and take credit for drafting the bill rather than have a healthy development of the sector. Nowhere in the country there is a Clinical Psychology ward, PSW ward or Psychiatric Nursing ward. The decision to admit is taken by the leader of the mental health team who is a Psychiatrist and it is the Psychiatrist who is overall responsible for treatment of a patient with mental disorder.

One of the reasons given by the people behind the draft of the Mental Healthcare Act 2010, for giving the role of independent examination, diagnosis and admission in bill, is the shortage of psychiatrist in the country. But if we go by the definition of psychiatrist in the bill which is the same as that in the previous Act, ‘an MBBS qualified person with experience and training in Psychiatry can be designated a psychiatrist’ for the purpose of the Act.

At present , there are about 8 lac medical practitioners in the country and these can potentially be designated as psychiatrist. So where is the shortage for the purpose of the Act ? The only purpose which could be served by giving an independent examination, diagnosis and admission to Clinical Psychologist, PSW, Mental Health Nurse in the bill is to later on claim that if they are capable of doing these jobs, then this means that they can practice their trades independently under the modern system of Medicine. This would mean they will be physicians of mental disorders just like a psychiatrist.

The inclusion of Clinical Psychologist, PSW, Mental Health Nurse for purpose of independent assessment, diagnosis, admission to a mental health facility should be deleted and replaced by ‘psychiatrist’ (an MBBS qualified doctor with some training/experience in psychiatry). After this, there will not be a need for defining mental health professional in the Act. If at all it has to be defined, then Clinical Psychologist and PSW shall be designated as Assistant Mental Health Professional as in the present legislation (Section 22 of State Mental Health Rule 1990) and their role clearly specified as being- to assist a psychiatrist.

Further, the supervision and review of the decision of a psychiatrist by a Clinical Psychologist, PSW, Mental Health Nurse in the mental health review commission is not feasible as review is to be done by practitioner of the same specialty i.e. Psychiatrist. Thus, the provision of Psychiatrist in the review commission should be made mandatory.

In a multidisciplinary team such as a mental health team, each team member has a specific role. If everyone will do the same role, which is to independently examine, diagnose and admit, then there could be no team functioning. Rather the role of each mental health person should be clarified in the Guidelines /Rules clearly, so that there is good team functioning and the public is well informed and is not misguided by manipulative persons. Can we imagine a similar provision for a Nurse specializing in Medical, Surgical, OBG, Cardio-thoracic nursing to independently examine, diagnose and admit patients in Medical, Surgical or OBG, Cardio-Thoracic ward respectively? Then why should we consider similar provision for Clinical Psychologist posted with Neurology department?

Psychiatry is a medical discipline as any other discipline. If Clinical Psychologist, PSW and Psychiatric Nurse want to independently examine , diagnose, admit and treat patients without even having the training and skills for the same and government wants to allow the same, then they should be allowed to start their own wards to do so and be responsible for their decisions. If we allow such changes to be brought, this would mean that a Psychiatrist too does not need to do MBBS. Then all the specialties of modern medicine should have direct specialization rather than first spend 5.5 years to be a General doctor. Human body cannot be divided in a compartments. All organs and systems are interrelated. A stroke can present itself as a depression in a mental health facility. What skill a psychologist or a PSW has to diagnose it without doing a full neurological examination or relevant investigations. They will treat for depression while the patient will die. In my view , compartmentalised knowledge is dangerous for the medical profession and defeats the basis of evidence based medicine

We are trying to make Clinical Psychologist, PSW and Mental Health Nurse into Physicians in mental health by giving the role of a Physician to them under the new draft bill on the pretext of shortage of Psychiatrist. However, there are less than a 1000 Clinical Psychologist and PSW both combined in the country. Further, there is no dearth of Psychiatrist under Mental Health Act, as Govt. can very well designate MBBS doctors with some experience in Psychiatry as Psychiatrist (as per the definition and provision in current legislation and the draft Bill). So even the assumptions for the shortage of psychiatrists is not a right justification for this act

The role given to Clinical Psychologist, PSW and Psychiatric Nurse in the draft bill is ; independent examination of patients, diagnosis , admission and then review of decisions taken by a Psychiatrist. Instead of this, in the draft bill, the role of a Clinical Psychologist and PSW- as a rehabilitation professional , and Psychiatric nurse - as a specialized nurse, should have been clarified and focused.

The position of a Psychiatrist as a mental health team leader should be reiterated and the decision of a psychiatrist should only be reviewed by a board having a psychiatrist. These rules could further be clarified In the draft bill psychiatric social worker and clinical psychologist has been mentioned as mental health professional just like a psychiatrist. However, In section 22 of the State Mental Health Rules’1990 (the existing legislation) the PSW and Clinical Psychologist are referred to as Assistant mental health professional. The change in the draft bill under consideration has been done with a view to make their role fit for independent examination, diagnosis, admission to a mental health facility by the drafters, without any regard to the impact of this on the patient care and safety. If they are full-fledged professionals (as they claim) who can diagnose, admit and treat patients, why do they need to be defined as such in the Act. At no place in the draft bill their role has been mentioned separately. At all places they are bunched as mental health professional with no individual roles. At no place it is mentioned that they will function under the supervision of a psychiatrist. If they independently examine, diagnose and admit patients they are then deemed to have an independent role. This will increase the role conflict which is already very high in the mental health team. So much so that at some places there is no team work. In Kerala High Court, there is a case going on, to allow clinical psychologist to independently practice in community to treat patients of mental disorders.

This is a serious issue and needs to be taken up strongly so that untrained people are not given the role of a physician i.e. to practice independently to treat patients.

DMAI insists that the Medical Council of India, Indian Medical Association & patient groups & DMAI needs to be taken in confidence and consulted, as independent examination, diagnosis and admission and also treatment by psychological or psycho-social means is practice of psychiatry under modern medicine and could not be allowed to be done by persons who do not even have a MBBS degree, in view of patient safety and care.

All health personnel shall work within the limits of their competence. In section 43 and 45 of the draft bill related to admission in a mental health facility: a mental health professional (i.e. Clinical Psychologist, PSW, Psychiatric nurse) has a role to examine a person suspected to be mentally ill independently, assess mental illness and its severity and advise admission. This is a role which goes beyond their competence. There are already instances of Clinical Psychologist practicing treatment of mental disorders independently as isolated examples. There is growing demand from clinical psychologist to allow them to practice independently the treatment of mental disorders. This change in the draft bill will allow them to be recognized as persons who can independently examine, diagnose, and admit patients, which will substantiate their claim to practice independently in community rather than under the supervision of a psychiatrist. It’s altogether different matter that they are not trained to examine and diagnose mental disorders as it requires ruling out other physical disorders as well and it requires a person to be a physician to do that. In section 22 of the draft bill : Constitution of district panels of mental health review commission , two members could be mental health professionals (i.e. Clinical Psychologist, PSW, Psychiatric nurse) which may not include a psychiatrist if he is not available, but then how the commission can judge the decision of a psychiatrist if no psychiatrist is in the commission? One needs to have knowledge of psychiatry to assess the correctness of the decision of a psychiatrist in a particular case. Provision of a psychiatrist in the review commission should be mandatory rather than being replaced by non-psychiatrist personnel Mental disorders are medical disorders and should not be treated by non-medicos .

I am quite sure that you will intervene and ensure that the corrective measures are taken to address the lacunae in the bill Also,

DMAI- The Population Health Improvement Alliance has initiated a ‘NCD Policy of India’ initiative, and would be glad to have the views of the ‘Ministry of Health’ involvement on the initiative

I am quite convinced that committed leadership will take cognizance of this note and take measures to implement the suggestions after a debate with all the stake holders in the continuum of care.

Should you need any assistance at my end, do let me know.

With best regards

Rajendra Pratap Gupta

CC. Dr.Manmohan Singh, Sonia Gandhi ,Rahul Gandhi , Dr.Syeda Hameed, Dr.Murli Mahohar Joshi , Montek Singh Ahluwalia ,Shri Dinesh Trivedi , Sitaram Yechury, Members of Parliament , Sam Pitroda , Secy-Health & Family Welfare , GOI, Dr.K.Srinath Reddy, Debasish Panda , Secretary (ME) Governors , MCI DGHS,MOHFW, Dr.Sudhir Gupta , CMO, NCD-MOHFW ,Dr. Suman Sinha, Psychiatrist, IMA , Chief Minister’s of States

Include Homeopathy in National Health Schemes

DMAI wants the govt to give due weightage to homoeopathy in NRHM

Suja Nair Shirodkar, Mumbai Wednesday, March 30, 2011, 08:00 Hrs [IST]

The Disease Management Association of India (DMAI) has recommended the Public Accounts Committee (PAC) of the central government to increase the role of homoeopathy in the National Rural Health Mission (NRHM), especially for acute illness.

At present homoeopathy is not being leveraged properly under NRHM in spite of it being the cheapest way of treatment in the country. Rajendra Pratap Gupta, president and director DMAI pointed out that the homoeopathic medicines are cheaper and much more accessible to patients thus it is only natural that its potential should be utilised properly under NRHM.

Though the treatment used in homoeopathy is superficially similar to the medicines prescribed by a conventional doctor it differs in their source, preparation and dosage. He observed that in spite of having enough qualified homoeopathic physicians in the country the government is not giving them enough chance to play any role in the national health program. “Today there are hospitals and colleges that cater to homoeopathy and encourage its use then why isn't the government utilising these resources to increase the demand for homoeopathic medicines among the rural population.

The government should take step to ensure that the people in the rural India can also benefit from this system,” he pointed out. He said that the demand for homoeopathy has increased over the years as more and more people are adopting homoeopathic treatment due to its effectiveness compared to other available methods. Thus it should be put to use more effectively. He added, “Homoeopathic medicines are very cheap, in almost two rupees a patient can get a weeks worth of medicines which will be a great support to the rural population, it would provide them with cheapest alternative that assures best treatment.”

Homoeopathy is a system for the treatment of illness that is based both on the recognition of patterns within the symptoms of the illness and a wider consideration of how the individual is as a person. Although conventional medical assessment also takes these issues in to account, the homoeopathic approach integrates personality type, previous experiences, emotional state, the influence of the environment and other social factors to a greater degree than is usual with standard medical practice.

http://www.pharmabiz.com/NewsDetails.aspx?aid=62119&sid=1

Rajendra Pratap Gupta

DMAI wants the government to extend the NRHM till 2017 with radical operational changes

The Disease Management Association of India (DMAI), a non-profit organisation propagating disease management concept and tools in the country, has urged the Public Accounts Committee (PAC) of the central government to reconsider its recommendations for scrapping of National Rural Health Mission (NRHM) as the NRHM has made an impact on the lives of the rural population in the country.

The DMAI suggestion in this regard was put forth by the DMAI president and director Rajendra Pratap Gupta in a letter addressed to PAC chairman Dr Murli Manohar Joshi recently.

The NRHM was launched in the country on April 12, 2005 for a period of seven years i.e. from 2005 to 2012 for providing integrated comprehensive primary health care services, specially to the poor and vulnerable sections of the society. It means that NRHM will get expired by 2012. However, seeing its impact on the rural population, the government is thinking of a possible extension for another five years. In this regard the government had asked PAC to review the NRHM. However, in its reports the PAC has recommended on scrapping the NRHM scheme.

However Gupta suggested, “NRHM is a very useful programme and has been successful in having its presence felt even in the remote parts of the country. However, there are many radical administrative and operational changes needed to be made in the present format of NRHM.”

He suggested that with proper administrative and operational tactic, this programme certainly will have the power to create desired impact in the rural health scene. In his recommendations to the planning commission on the changes needed in NRHM for the 12th five year plan, Gupta suggested that technology must be leveraged in NRHM for accountability, transparency and telehealth and that 12th five year plan must consider opportunities to digitise NRHM in all spheres of its implementation.

He said, “There are many important changes that needs to be undertaken in the NRHM, but of all changes the first and foremost change should be to improve the quality of medicines that is being supplied at the NRHM centres. Secondly, minor surgeries are not allowed in Primary Health Centres (PHCs) as of now. This should be changed and the government must allow minor surgeries in the PHCs as it would help reduce a lot for hassles for the villagers and bring revenue for the government as well.”

Other issue that he had highlighted in the letter was on the inadequate fund flow on time which could lead to corruption among the people working at the lowest level in PHC and sub centres.

“I have met people who were not paid salary for months, and also discovered the fact that the funds that were supposed to be sent for 2010 were received by the centres in mid January 2011. Such delays must be stopped with immediate effect as this clearly will encourage and lead to corruption as people drawing a monthly salary of Rs.5000-8000 won’t be able to sustain their family without salary for months. Either they will resort to bribing, selling the government supplies or starts absconding and working for employers in parallel. Thus I suggest that the fund meant for a sub centre or PHC must be transferred in advance for the quarter if not half yearly,” Gupta points out.

He put special stress on telehealth adoption goals for NRHM and other healthcare projects, as setting up and manning the physical infrastructure with qualified professionals at remote places is nonviable. To stress the importance of telehealth adoption in the country the Telemedicine Society of India (TSI) is organising a three-day conference Telemedicon’ 11 in Mumbai from November 11 to 13. TSI is completely dedicated to the promotion of telehealth in India and is being organised at a time when there is a big push from the government and private players in the field of telehealth in India.

Rajendra Pratap Gupta

http://www.pharmabiz.com/NewsDetails.aspx?aid=61977&sid=1

www.telemedicon11.com

Nuclear deal , FDI , Inflation & Black money - You did not change India , but changed India's image Dr. Singh !

Dear Dr.Singh,

I read the top story in the current issue of the International Magazine ‘The Economist’ , and felt sad . Whenever , people like us visit outside of India , we are questioned or pointed towards corruption in India , and believe you me , it is painful to accept such criticism for our great country ! You put us to shame !

Nuclear deal & Jaitapur Plant : Recently , Wikileaks have exposed that Nuclear deal was not even acceptable to congress MP’s but money was paid to get votes !! It calls for a review and legal action against people making mockery of the most sacred institution of our country – Parliament ! Dr. Singh , please step down , we cannot bear more international assault due to your misdeeds ! Also, that India must immediately have a rethink on the location of all the nuclear installations from a public safety point of view . Jaitaput plant in Maharashtra is in Seismic risk zone and had 92 quakes in the past 20 years . The earth quake in 1992 was measuring 6.2 on Richter scale !! It calls for a fresh consideration of the approval granted in light of the developments in Japan post the Tsunami

FDI : Last week , I read that the government is considering granting FDI in retail for metros . Please desist from implementing your flawed policies again . Do not create hype and investment around metros , it leads to lopsided development and migration . If at all you want to grant FDI , please allow it in class 3 & 4 towns first , so that the local people get employment and we can see some reverse migration of populations and the burden on metros can reduce . Frame policies where foreign retailers cannot own more than 26 % in Indian companies across board . We do not want to lose our freedom Dr. Singh ! Also , as I have always mentioned change the definition of FDI from Foreign direct investment to Finance from domestic institutions ! Encourage retailer friendly policies for locals. Britishers financially exploited India , and took our wealth . Today MNC’s ( Multinational corporations ) are acquiring flourishing Indian companies and will take the profits away ! Are not getting back to pre-1947 days ? We will be exploited financially again and forever ! We are losing freedom with every investment & acquisition ! What is the use of such independence when the financial exploitation is similar to that under the British rule ? Please come up with rules that, in any sector , investments more than 26 -40 % cannot happen . Significant majority has to be with Indians ( Resident Indians). This is in the interest of national security & maintaining independence

Inflation : I have been watching your statements for the cause of inflation . Earlier , you attributed it to recession in 2008, poor rainfall in 2009 , and now you are attributing it to money from NAREGA !! Please do not blame the poor for every thing !! When you blamed poor rainfall as a cause of inflation , people were skeptical about it . When rainfall was good in 2010 , inflation still did not go down , now you had to find another reason , and quite cleverly , yourself & Pranab have been saying that because people are getting NAREGA money so they are buying more , thereby , leading to inflation . Please do not make lame excuses Mr. Prime Minister ! You & Montek have said that we must start to live with inflation as growth and inflation are intertwined . Sorry Dr. Singh , you need to study Economics again . History has shown that high growth and low inflation is possible and has happened in Germany & China and other parts of the world. So please do not give lame excuses . The real issue with inflation is that , because of your flawed policies for rural India , the migration has become perennial , and there is a tremendous loss in productivity ( multi-dimensional loss ) and that has caused inflation . Raising interest rates would not help ever , and time will tell us this hard fact . It is difficult to find a farmer less than 30 years in age .

NAREGA In its present form is causing irreparable damage to rural India , and I do hope that the educated economists in your team and the planning commission will attend to it as top most priority

I am scared that, if God forbid , India had a famine , how are we prepared ? We know such things can happen & without any notice like the recession ,and are not prepared for any such eventuality . Please let your cricket minister work on the worst case scenario’s as well.

Black Money : Last point is about the black money . We have seen all the estimates so far , and every number is an eye popping trillion dollar amount . Please challenge my number if you can !! India spends close to 30 % of its GDP in running the government and bureaucracy every year . it is a hard fact that, every employee who takes bribe gets almost double his salary in bribes ! Now another reality is, that senior bureaucrats and politicians get disproportionately high money in bribes when it comes to comparing bribes with their salaries . So clearly , the average B-GDP ( Black GDP ) is certainly 1.5 times the 30 % of GDP that the government spends on administrative costs of running the government . So If I average out the last five years GDP at half trillion dollars a year . India would have lost One trillion dollars in black money in just last five years , and trust me , these are the most pessimistic numbers ,and so are on the lower side . Your government & Mr.Khursheed talks about corporate governance ? When political governance of the nation is a sham and people have to take out thousands of cores off the balance sheet as bribes to your cabinet ministers , how can transparency and corporate governance work in this nation ? Take the case of telecom licenses ; every telecom company paid money other than the license fee . Where did the money come from , and where did it get accounted ? Not certainly in the legitimate account books , and so the corporate governance was severely compromised . Dr. Singh , The change should start at the top . if the political governance is good , corporate governance is good , if the political governance is shady , the corporate governance can never be imagined .

Dr.Singh , the nation recalls your letter to appear before the parliamentary accounts committee . I think that is not enough . You must be interrogated by CBI and charge sheeted for leading the most corrupt government in history of India ,and perhaps the world !

Read the article below from the Economist !

A Common Man

Rajendra Pratap Gupta

www.rajendragupta.wordpress.com

Article from the latest issue of The Economist

Corruption in India

A rotten state

Graft is becoming a bigger problem—and the government should tackle it

Mar 10th 2011 | from the print edition

INDIANS’ anger over rising corruption has reached feverish levels. What people are calling a “season of scams” includes the alleged theft of billions by officials behind last year’s Commonwealth games in Delhi; $40 billion in revenues lost from the crooked sale of 2G telecoms licenses; and over $40 billion stolen in Uttar Pradesh alone from schemes subsidising food and fuel for the poor. Foreign businessmen, who have slashed investment over the past year, rank graft as their biggest headache behind appalling infrastructure. Now India’s anti-corruption chief has been forced out over, well, corruption (see article).

Graft is hardly new in India: the Bofors scandal brought down the government in 1989. But there seems to be more of it about than ever, if only because India is getting richer fast, and the faster the economy grows, the more chances arise for mind-boggling theft. The government says that in the next five-year plan period, which starts next year, $1 trillion will be spent on roads, railways, ports and so on, with billions more on re-equipping the armed forces and welfare. Add in an insatiable appetite for scarce land, water and minerals and a monsoon of bribes is forecast.

Some are inclined to shrug their shoulders. After all, corruption does not seem to be stopping India from growing. Yet imagine how much better the country would be doing without it. Corruption raises costs not just to Indians, but also to the foreigners whose capital India needs. Thanks in part to those scandals, India’s stockmarket was the worst-performing outside the Muslim world over the past year.

To its credit, the government has begun to take action against powerful individuals. Maharashtra state’s chief minister was forced out over a property scandal. Police have quizzed Suresh Kalmadi, the politician who ran the Commonwealth games. Most strikingly, Andimuthu Raja, the cabinet minister who oversaw the 2G telecom licences, was arrested.

A 2005 act giving the right to information is welcome, as are auctions for public goods, such as last year’s lucrative sale of the 3G telecom spectrum. Technology is helping. In some states, bids for state contracts are being run online, allowing anti-corruption bodies to monitor them. Gujarat does this for all contracts over 500,000 rupees ($11,000). It also puts land records and death certificates online, cutting down on one form of petty graft. Websites, led by ipaidabribe.com, reveal the cost of graft by publicising the sums demanded for everything from registering a baby to fixing a broken water supply.

The central government should now implement a plan for a universal, computerised ID scheme. It would allow welfare payments to be paid into individuals’ bank accounts, hindering theft by state workers.

The licence Raj lives on Most of all, India must redouble its efforts to liberalise. The state could outsource official tasks, cut red tape and sell wasteful and corrupt state-owned firms (why does the government make watches?). For all that the “licence Raj” was supposedly scrapped two decades ago, it can still take nearly 200 days to get a construction permit and seven years to close a business. Regulations are not, by and large, deterrents to corruption, but a source of it.