Economy
Cabinet nod for subsidy to set up 5,000 MW solar projects
New Delhi : A union cabinet panel on Wednesday approved the setting up of over 5,000 MW of grid-connected solar photovoltaic (PV) power projects at an estimated outlay of Rs.30,000 crore.
 
Briefing reporters here following the meeting of the Cabinet Committee on Economic Affairs (CCEA), Power and New and Renewable Energy Minister Piyush Goyal said the decision to promote solar power through "viability gap funding" (VGF) was in line with Prime Minister Narendra Modi's promise to make India the world's largest generator of solar power.
 
"Installation of 5,000 MW solar PV plants will generate about 8,300 million units per year, which caters power to almost 2.5 million households," said a release from the ministry of new and renewable energy.
 
According to the statement, the estimated requirement of funds to provide VGF for 5,000 MW capacity solar projects is estimated to be Rs.5,050 crore.
 
This includes handling charges to state-run Solar Energy Corp. at the rate of 1 percent of the total grant disposed and Rs.500 crore for the payment of security mechanism for the VGF schemes.
 
"These projects will have a market-found base rate, and thereafter reverse bidding will determine who wins the VGF. Actual funding will be determined by reverse bidding," Goyal said.
 
The government has set a target of achieving 1,00,000 MW grid-connected solar power by 2022.
 
Disclaimer: Information, facts or opinions expressed in this news article are presented as sourced from IANS and do not reflect views of Moneylife and hence Moneylife is not responsible or liable for the same. As a source and news provider, IANS is responsible for accuracy, completeness, suitability and validity of any information in this article.

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What Ails Healthcare Services in Mumbai? - Part 2
Here is a three-pronged plan to bring in much-needed efficiency in the public-healthcare system
 
There is a gross disparity in availability of health services and the health indices are very poor in slum and peripheral areas. The life expectancy at birth is around 64 years for India, 67 or 68 for Maharashtra but for a Mumbaikar it is a dismal 57 years. Tuberculosis (TB) is increasing and there is near 100% increase in deaths due to this. The incidence of malaria is also on the increase and in both diseases, resistant strains are causing a serious threat. Extremely resistant TB accounts for nearly 10% of the new cases. There are probably two and a half lakh patients of TB in the city.
 
The Infant Mortality Rate (IMR) in Mumbai is around 40 per 10,000, but it is deceptive. It was found that IMR was as high as 55 to 60 in some slum areas and inaccessible peripheral localities. Immunization is 90 to 95% successful. But 45.5% of children and 37.4% of women are anaemic—the percentage rises to 76% and 42%, respectively for the slum areas. More than 50% children under the age of three are underweight, 49% are stunted and 21% are wasted. Though HIV /AIDS was under control, the withdrawal of assistance by Bill & Melinda Gates Foundation is resulting in shortage or non-availability of drugs and there is a lurking fear that AIDS may re-appear.  
 
The teaching hospitals are over-over crowded—out patient department (OPD) attendance being around 32 lakhs in a year. King Edward Memorial (KEM) Hospital claims to see 4,000 to 5,000 OPD cases every day; the figure for Lokmanya Tilak Municipal Medical College (Sion Hospital) being 2500 or so. Sion Hospital conducts 16,000 to 17,000 deliveries every year—a child is born every half an hour. How can one do justice to these patients?  
 
The same is true of peripheral hospitals. But, though crowded, mostly they are under-utilised. There is dearth of full-time specialists and honorary specialists avoid taking responsibility due to “lack of modern facilities”.  
 
Similarly, primary centres are more concerned about govt. programs like immunization, Maternal and Child Health (MCH) and directly observed treatment (DOT) for TB, but early good primary care is hardly administered there. The result is people are forced to attend private clinics and nursing homes despite financial difficulties. The growing middle class is squeezed to pay high price in private hospitals only because of the mad rush and confusion at public hospitals. The total outcome is very poor health service for the large majority of the people except those who can afford i.e. the organized section of the society.
 
And I have not even touched upon the burden of non-communicable, life style diseases. Cardiac diseases take the highest toll of even the young age population. About 10% of the adults are likely to be having diabetes. And the poorer sections of the society are equally vulnerable to these illnesses. The biggest killer is trauma. Assaults and accidents bring nearly 4000-5000 patients every month to Sion Hospital alone with mortality of 20% or more. Majority of emergencies of all sorts are managed in public hospitals in Mumbai. Private hospitals have hardly any emergency service worth the name except for cardiac emergencies. Thus, there is a great burden of modern diseases on the public hospitals, which they cannot handle efficiently.
 
Why are these inequities, insufficiencies? The main reason is that there is no system. Anybody can attend any clinic or hospital. Even tertiary care is given to the patient who goes there—not to the patients who need them. Any medical officer can refuse to treat a patient quoting one reason or the other—usually lack of facility and sometimes lack of assistants. If we look at the duties for health service personnel, it will be realized that administering primary and secondary care is but one of the multiple functions and is being given the least importance. Even if a case was seen at a primary centre and then referred to a hospital for further care, there is no preference given to such a patient. He/she is just one among the crowd and may not be seen at all by the relevant speciality. 
 
On the other hand, most people seek direct consultations at the teaching hospitals, thereby increasing the work-load there unnecessarily. It is believed that at least 30% of the cases could have been treated at primary centres; while referred patients from private doctors also directly approach the specialists and are usually seen with priority. 
 
Thus public dispensaries are reduced to zero significance, the medical officers become least interested, primary centres are least utilised. There is no scope for expanding primary care. Yet, primary care must expand. 
 
I had suggested a three pronged plan – 
 
a) There should be a primary care centre for every 20,000 population. It will run round the clock, served by about four doctors in each of the morning and evening shifts and helped by a physio-therapist, and a psychological counsellor. Only simple investigations (not costing more than Rs500) will be allowed and only simple medications (not costing more than Rs250 per daily dose) will be prescribed. The patients will have to be referred to the hospital if more is needed and in the hospital, these patients will be seen with priority at specified time of OPD. They will be treated free of charge (or nominal charge as of now). Any other patient attending directly will be seen at a different timing and will be charged fees (at least 25% of the market price). Such a duel system of charging will ensure that the poor are properly treated, and the marginally affording middle class will also be looked after but with reasonable charges that will bring revenue to the public sector for further expansion. About 20 to 25% beds will have to be reserved for the latter group in the hospital. 
 
b) MBBS doctors, who do not secure a post-graduate seat, should be specially trained for the role of primary physician. The medical world is moving fast towards high technology. That affects the teaching pattern as well and the medical student is taught recent advances in medical technology. Thus, he becomes totally incompetent to practice medicine with more observation and less investigations and cheap but effective medicines or surgical procedures. 
 
These graduates should be offered a two year course in general practice wherein they will work partly in primary centres and spend part of the time in hospitals rotating through various departments. At the primary centres, they are allowed to prescribe only simple investigations and cheap effective medications as stated earlier. In this two years’ time, they will develop immense confidence to treat the patients “under adverse circumstances”.  
 
c) “Advanced technology” needs to be de-glamorized. It is extremely sad to see the social activists strongly supporting the demand for more and more super-specialists and new modern equipment “to improve the health service”. Modern facilities cannot reduce costs. They improve services only selectively. De-glamorizing is a difficult task so I leave that discussion here.
 
You may also want to read…
 
(Dr Sadanand Nadkarni, is former Dean of Lokmanya Tilak Municipal Medical College (Sion Hospital), author of several books, a serious thinker of medical issues and hugely respected for a series of path-breaking ideas on improving the delivery of medical services to the aam aadmi. His book “Management of the Sick Healthcare System” is among the first to speak out about medical malpractice and other issues.)

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A policy for open spaces in Mumbai
Mumbai has less than 2 square meters (sq mts) of open space per person, compared to 9 sq mts, the minimum requirement laid down by WHO. We can increase our open space if we first have a clear policy on open spaces. Here is a draft of such a policy that can be discussed further
 
All cities must provide adequate open spaces for its inhabitants.  These are the lungs of the city which provide fresh air, playgrounds, recreation grounds and gardens. They are essential to ensure the mental and physical wellbeing of its inhabitants. Unfortunately, Mumbai has less than 2 square meters (sq mts) of open space per person, compared to 9 sq mts, the minimum requirement laid down by the World Health Organisation (WHO). In this extremely limited space, children must play and frolic; everyone must have space for games and sports; those living in small tenements must get some space for leisure; senior citizens, who cannot afford clubs, should find a space to walk, exercise and chat, discuss and reminisce about their lives.
 
According to the Development Control Regulations (DCR) 1991, the Parks and Gardens Department of the Municipal Corporation of Greater Mumbai (MCGM) has already taken possession of 1,068 plots covering 1,200 acres of open spaces. These plots must be developed as per their reservations and function accordingly. Some additional plots are also expected to be taken over by the MCGM’s Parks and Gardens Department. Fresh policy guidelines are required for the development of such reserved plots including all plots already in possession and use.
 
Mumbai is a megacity and the financial capital of India.  The MCGM formulates development plans (DPs) in which there are specific reservations for all open spaces such as gardens, recreation grounds, playgrounds and parks. These, in turn, should be developed, redeveloped or refurbished in accordance with their reservation for the access and benefit of general public. The MCGM runs the city by elected representatives to whom citizens have given legitimacy. The bureaucracy also owes their jobs and allegiance to the citizens. There is a need for a policy for Open Spaces, which should among other objectives:
  1. Increase these spaces.
  2. Beautify and maintain them to make the citizens’ quality of life better in an equitable manner without any distinction.
  3. Safeguard these extremely valuable properties from encroachment and private acquisition.
  4. Provide for the recreation, sports and leisure needs of all its citizens.
 
A policy must attempt to serve these objectives. Here is an attempt to suggest such a policy.
 
Assumptions and key guidelines:
The MCGM is charged under Section 61 with “the maintenance of a municipal office and of all public monuments and other property vesting in the corporation”. It also has the power to make laws as per Section 461 which states:  The corporation may from time to time make by-laws, not inconsistent with this Act, with respect to the following matters:
 
(5) securing the protection of public parks, gardens and open spaces vested in or under the control of the corporation from injury or misuse, regulating their management and the manner in which they may be used by the public and; providing for the proper behaviour of persons in them;
 
Thus, it is a duty which must be performed. It is recognised that it would be a good idea to have the participation of citizens in this. There were some earlier policies by which MCGM’s Open spaces have been abducted by some private parties and such mistakes must not be repeated. 
 
Suggested policy:
The MCGM should take all its Open Spaces, which were earlier given on caretaker or adoption policies under its physical control. No Municipal Open Spaces should be given to any private party. MCGM must recognise and accept its responsibility to create recreation grounds, play grounds, parks and gardens. It may do this by giving contracts for providing various needs to protect and maintain them. 
 
Any officer of MCGM who gives any legal rights to any third party in any Open Spaces should be charged under Section 13 (1) (c ) of the Prevention of Corruption Act.
 
The MCGM should display on its website complete details of agreements with contractors and also the bills and payment details, along with the inspection reports of MCGM officers. 
 
To ensure proper maintenance of the work MCGM should appoint Audit and Monitoring Agencies for three years at a time.
 
I) Eligibility criteria for Audit and Monitoring Agency: 
Applicant maybe one or more of the following:
  1. Association OR Federations of the local housing societies
  2. Resident associations
  3. Business associations
  4. Associations of shopkeepers
  5. NGO’s from respective electoral wards.
  6. Public sector undertakings (PSU’s)
  7. Government Institutions
  8. Institutions/Bodies which organise or sponsor sporting events (having presence at administrative ward levels)
  9. Educational institutes (having presence at administrative ward levels)
  10. Corporate houses 
 
II) Plot eligibility:
  1. Plots developed by the municipal corporation
  2. Plots developed using MP/MLA funds or District Planning and Development Committee (DPDC) funds (under guardian minister) or corporator fund
  3. Plots developed and preserved using funds from private institutions.
  4. Any other plot which is reserved as Open Space.
 
III) Public outreach and intimation for selecting Audit & Monitoring Agency:
Every ward officer with the advice of the zonal garden superintendent or his deputy should prepare a list of recreation grounds, playgrounds, gardens and parks. Such a list should be put up on the notice board of the ward office as well as the MCGM website.  The lists should also be published in leading English and Marathi newspapers.
 
IV) Submission requirements:
All eligible parties interested in acting as Audit & Monitoring Agency for the aforementioned plots should within 30 days of the public notice by the MCGM, submit an application along with the following documents:
  1. Statement of accounts/audited financial reports of last 3 years 
  2. Documents to establish credentials of NGO’s 
  3. Experience statement giving its experience 
  4. The proposed plan for development/redevelopment/refurbishment of the plot.  A separate maintenance plan for the same period is also to be provided.
 
If there is more than one institution volunteering to be an Audit & Monitoring Agent, an appropriate mechanism should be devised and not more than two such agents should be approved for a plot. The MCGM may then float tenders for the development, maintenance of the Open Space after finalising development and maintenance requirement with the Audit & Monitoring Agency. The MCGM should select the appropriate contractor and supervise the work. It should also provide a copy of the agreements with each contractor, the inspection report of a MCGM officer and the bills presented by the contractor to the Audit & Monitoring Agent within seven days. The responsibility of the Audit and Monitoring Agent must be to ensure the Open Spaces are properly secured and maintained. They should also audit and monitor work of the contractor. They should submit a report on the 1st and 15th of every month to the Assistant Commissioner, in which they must also report any deficiencies of the contractor’s work. The Assistant Commissioner can either take penal action against the contractor, or put his remarks if he feels that the Audit and Monitoring Committee’s report is not reasonable. If there is a disagreement in two consecutive reports, the matter should be raised to the Deputy Municipal Commissioner and if there is a disagreement in four reports, the Additional Commissioner should take a decision. If the Audit and Monitoring Committee fails to submit its report for two consecutive fortnights, it should be replaced by another. The Audit and Monitoring Committee’s report should also be displayed on the website of MCGM. 
 
The primary responsibility of maintaining and developing the Open Spaces should rest with the MCGM with the Audit & Monitoring Agency providing free assistance. 
 
(Shailesh Gandhi served as Central Information Commissioner under the RTI Act, 2005, during 18 September 2008 to 6 July 2012. He is a graduate in Civil Engineering from IIT-Bombay. Before becoming a full time RTI activist in 2003, he sold his packaging business. In 2008, he was conferred the Nani Palkhivala Memorial Award for civil liberties.)

 

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COMMENTS

Jyoti Dua

1 year ago

Excellent suggestion. Handing over the space to any private agency should be No No. The citizen should be associated in maintenance and upkeep. Volunteers from senior citizen should be encouraged. Revenue from Parks may be generated by advertising rights.

MG Warrier

1 year ago

Excellent suggestions. Need to be pursued by policy makers. If I am not diverting the issue, a related issue, which I tried to take up through print media, but failed to attract attention, is about cleaning the gutters in Mumbai.A short write-up on the subject I had circulated is copied below:
"The Pocket Oxford Dictionary before me defines a gutter as ‘a shallow trough beneath the edge of a roof, or a channel at the side of a street, for carrying off rain water’. In Mumbai gutter has assumed different meanings for different people. For most of us, a gutter is a trench provided by municipal corporation where dirty water get collected and people dump waste. Now, let me ‘come to the point’!
A 12 feet wide gutter flows adjacent to the housing complex in Bhandup (West) where we stay. It comes from somewhere beyond Pawai and silently flows beyond our area, perhaps terminating somewhere near Vashi creek. The stretch of the gutter from Powar Public School to some distance beyond Bhandup Railway station has huge accumulations of waste and water has no free flow. The sides of the gutter ‘house’ snakes, rats and other ‘wild life’ creatures. The gutter provides a fertile breeding ground for mosquitoes and a variety of fleas.
The one kilometre stretch visible from Bhandup Railway Station supports the following:
i) Sale of about 20,000 units of mosquito repellents per month to 10,000 households.
ii) Fumigation contracts in several housing societies in the area.
iii) Builders who get vacant land in the vicinity of dirty areas at a cheaper rate!
iv) Medical profession providing healthcare support to residents in this area.
v) Savings for some families which throw their waste into the gutter.
The list is illustrative and not exhaustive. Just wondering, whether any vested interests are preventing the authorities from periodical cleaning of gutters. When normal and routine thing do not happen normally and routinely, citizens use their imagination to formulate ‘allegations’. In Kerala, at one stage, people alleged commercial interests of ‘anti-rabies medicines lobby’ to be behind supporters of ‘save street dogs campaign’!
Speaking from the ramparts of Red Fort, Prime Minister Narendra Modi had exhorted people of India to cleanse their premises. ‘Swacch Bhaarat Abhiyaan’ is a follow up of this.
In Mumbai, gutters are cleaned once in a year, sometime in May/June to ensure free flow of water to prevent flooding of streets. What is preventing Municipal Corporation from ensuring that the gutters remain clean during other periods also? If someone has an answer, express it!"

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