Headless Health: Our Pride!

 Why they prefer ‘Temporary’ Directors?

ANY organization, government or otherwise, is known by the person heading it. The person at the helm of affairs intentionally and unintentionally determines the way the organization will function & grow. 

Health is a service-oriented system which will run, at least partly, even without a boss. The doctor will treat, the surgeon will operate, and the nurse will provide care because of empathy, conscience, sense of responsibility, fear of God, or even public anger. Most of the time services, whether preventive or curative, run spontaneously, even if some members in the hierarchy are missing. For example, in the absence of a doctor, the medical assistant will provide services to an extent that only rarely one feels his absence. In fact, the basic consideration in health care in the Kashmir Valley is that ‘the sewage should not spill’. In medical jargon, the unwritten but implied parameter is that the pus should not show from outside. Therefore, in the vast majority of cases, the public is happy with the arrangement, and the administration happy that that the media ca not find something to exploit it. 

The health services in J & K have a big boss called the Director. Protocol-wise he is one of the most important Directors because he is the boss of a highly sensitive & politically volatile department. He will be present almost all meetings relating to public services and gets a very prominent position after the class A1 bureaucrats. He is generally a highly experienced person who can vouch for his department in the local & central government & even in international fora. Regretfully, we have not stuck to some basic essentials for the incumbent for a long time now. 

Like many other departments, health services have seen all types of people coming & going as Directors. The majority, I have no qualms in accepting this, have had an unnoticed stint. They just came to retired as a Director. For convenience, the department has two vital components: technical & the administrative. We know that most of the Directors the J&K has seen acted like mere clerks – of course highly paid ones – who looked after sanctioning of leave, transfers, promotions, and adjustment of their Minister’s people. Only a rarity has contributed to the department.

My myopic definition of ‘contribution’ is doing something positive which would not happen without that particular person. Using this definition we can immediately say whether they have contributed and, accordingly, justified their salaries which run into tens of lakhs, besides other legal & illegal perks. 

Crucial departments and organizations cannot be run on temporary arrangements. The health department has often suffered on this account. After Dr Muzaffar retired after a long stint of 12 years, Dr Wani, already holding two other important posts (Project Director, JK State AIDS Prevention & Control Society & the Medical Superintendent elsewhere)  was ‘temporarily’ made the Director Health Services, Kashmir (DHSK). People were made to believe that it was a stop gap arrangement, yet he continued and was confirmed just before his retirement to give him full benefits of being DHSK. When the senior people in the department objected, they were told that he was a postgraduate, which he was not. It was never explained as to why was a person, already too busy with his two crucial departments,  asked to head  a volatile department like health! After all there was no dearth of senior doctors with postgraduation in the health department.  

His last day in the office was baffling for all. While he was waiting in his office for a call granting him extension, the cruel clock in his room struck 4.00 pm and he started receiving customary congratulations for relinquishing the office respectably. No one cared for his farewell party. He was asked by the government to handover the charge to the then Deputy Director (HQ), Dr Gurcharan Singh, a postgraduate in Dermatology. The handover-takeover papers were inked, and the new incumbent started receiving wishes for being the new incharge DHSK. The news reached in a flash to all districts, good wishing started pouring in, and the suspicion over the impending extension of Dr Wani was over. The I/C DHSK occupied the seat of the Director. So far so good! Dr Saleem, then Dy Director Schemes, too congratulated the new Director & left the fooice.

At 6.30 pm, however, the flash from the Administrative Department said that Dr Saleem would be the new in-charge! With the message, the scene changed completely and Dr Saleem too returned to the office. 

It is pertinent that Dr Saleem is much junior to Dr Gurcharan Singh and definitely not a postgraduate. He has his so called diploma from the Jaipur campus of the Indian Institute of Health Management & Research – neither the institute nor their diplomas – are recognized by the Central government, J&K State government, MCI or any other statutory body anywhere. In fact, the Delhi Campus of the said Institute had offered me a faculty post which I declined after visiting the campus in Dwarka & meeting their ‘faculty’. 

It is curious that the government has perpetually been changing the eligibility criteria for Director’s post. Once PG (MD, MS) was essential; then for Dr Wani & Dr Saleem, the PG was done away with. The government should actually publicize the criteria laid down for different posts including that of the Director. 

It is sad that the government, and not a selection board, should be competent to appoint Director Health. We may ask a simple question: when the Director of the SKIMS is advertised why not that of the Principal Medical College & the Director Health Services whether in Jammu or in Srinagar. Why should it be a hush-hush affair? In this era of competitions, let there be an open competition where eligible people freely compete. How can a minister take the decision as to who should be a Project Director or Director? It is simply ridiculous.

The Minister gets the Director appointed on temporary basis for 3 months, then forgets to confirm him.  Being temporary keeps the Director at the mercy of his Minister & senior bureaucrats, other ministers, trade union leaders, and even other government servants in the administrative department. Dr Wani almost passed his entire tenure as a temporary Director; Dr Saleem has also passed 2 years like that. It is evident that the ‘temporary’ arrangement suits the concerned Minister (s) and other political bosses.

The eligibility criteria for the Director’ post should be known, and the post should be advertised and filled by open competition. The incumbent should have actually worked in the rural areas for at least 5-10 years. A board, and not the government, should complete the selection process. The best among the lot, not the favourite one, should occupy these chairs. 

Now, what this ‘temporariness’ means for the department?. Unlike a ‘confirmed’ Director, the temporary one has to obey his Minister’s every dictat, and has to be at his beck and call. He passes more time in paying ‘salaams’ to one or the other politician. He is humiliated himself, and then humiliates his subordinates. He cannot take important decisions. He can be easily cowed down by his own subordinates who are close to political masters. And the services suffer, since the Director’s entire time is wasted in appeasing those who help him to retain the job.

The Hon’ble High Court has, again, come to the rescue of the common man. We want a department which focuses on providing preventive, promotive & curative care to the masses. We don’t want it to be headed by people who are intentional or inadvertent partners in the small and big political games played in the State or at the Centre. Everyone outside or within the department should be satisfied about the transparency of the selection process for a Director or a Principal. The eligibility criteria should be known, and the posts should be advertised and filled by open competition. The Director (Deputy Directors etc) should have actually worked in the field for at least 5 years which should be one of the eligibility criteria. The best among the lot, not the favourite one, should occupy these chairs. 

We know that in the J&K nothing solid comes out of any exercise unless the Hon’ble Courts intervene, which in our opinion they should be requested to do actively, to protect the interests of the ignorant masses by way of dedicated and improved services. 

Dr Bashir Gaash – a former member of the Health Sector Reforms Committee – served the Health Department for 32 years.  He can be reached at:  [email protected].

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