- “The local self government system in India has not proved to be an effective instrument of governance”. Critically examine the statement and give your views to improve the situation. (Answer in 150 words) (10)
- “The National Digital Health Mission is a step in the right direction for both patients and the healthcare system, but concerns around data privacy need to be addressed.” Examine. (Answer in 250 words) (15)
1. “The local self government system in India has not proved to be an effective instrument of governance”. Critically examine the statement and give your views to improve the situation. (10 Marks)
- Local self government system i.e. Panchayati Raj Institutions (PRIs) in India were given constitutional status under 73rd and 74th Amendments.
Effectiveness of PRIs
- Democratic Decentralisation - devolution of power at local level
- Inclusive and participatory - through reservation to vulnerable groups (SCs/STs/Women)
- Effective public service delivery - Social audit, bottom-up approach
- Need based approach - development by keeping the needs of stakeholders in mind
- Deepening of democracy - active political participation through local level elections, Gram sabha etc.
Not effective -
- Funds: Limited sources of funds, less funding from state governments
- Functions: The progress of devolution of powers and responsibilities to local governments at various levels is poor and uneven. Many important subjects are kept as not mandatory in the 73rd-74th amendment.
- Functionaries: There is a capacity deficit among the personnel and elected functionaries due to lack of capacity building.
- Sarpanch Pati culture
Way forward -
- Better funding - through consolidated fund of states + local revenue collection powers
- Devolution of more subjects to local level
- Training and capacity building of local functionaries (political + bureaucracy)
- State Finance Commissions should evolve objective and transparent norms for devolution and distribution of funds.
By ironing out the issues, the local self government system in India can transform the governance to be more people centric and accountable.
2. “The National Digital Health Mission is a step in the right direction for both patients and the healthcare system, but concerns around data privacy need to be addressed.” Examine. (10 Marks)
- Under the National Digital Health Mission (NDHM) a unique digital health ID will be provided to the people, which will contain all the health records of the person.
NDHM- A step in Right direction:
- The mission will enable access and exchange of longitudinal health records of citizens with their consent.
- The NDHM is a complete digital health ecosystem. The digital platform will be launched with four key features — health ID, personal health records, Digi Doctor and health facility registry.
- At a later stage, it will also include e-pharmacy and telemedicine services, regulatory guidelines for which are being framed.
- This will ensure ease of doing business for doctors and hospitals and healthcare service providers
- The Digi Doctor option will allow doctors from across the country to enrol and their details, including their contact numbers if they want to provide them, will be available.
- The national health ID will be a repository of all health-related information of every Indian.
- Various healthcare providers — such as hospitals, laboratories, insurance companies, online pharmacies, telemedicine firms — will be expected to participate in the health ID system.
- This mission will create interoperability within the digital health ecosystem, similar to the role played by the Unified Payments Interface in revolutionizing payments, the PMO said.
- Citizens will only be a click-away from accessing healthcare facilities
- Data misuse – It is a challenge to secure the health data of the citizens along with other personal information to avoid a breach of the right to privacy.
- Leakages from health repositories – Technological advancement and high security to avoid any leakage of the data.
- Foreign surveillance
- It must be ensured that the health records of the patients remain entirely confidential and secure.
- Data localisation - as suggested by BN Srikrishna committee
- Specific provisions for health data protection under the Draft Data Protection bill
- The failure of a similar National Health Service (NHS) in the United Kingdom must be learnt from and the technical and implementation-related deficiencies must be proactively addressed prior to launching the mission on a pan India scale.
- While a boon in general, the implementation of National Digital Health Mission should be done by keeping data privacy at the forefront of the concerns that need to be tackled.