Regulations
Implications of SEBI limits on directorships

‘A person can serve as an independent director on the boards of a maximum 7 listed companies and a maximum of 3 listed companies in case the person is serving as a whole time director in a listed company’ says SEBI. What does this mean?

SEBI has recently announced new Corporate Governance norms with reference to independent directors. Besides mandating a woman director on each board, SEBI has now stipulated that a person can serve as an independent director on the boards of a maximum 7 listed companies and a maximum of 3 listed companies in case the person is serving as a whole time director in a listed company.

  

According to Pranav Haldea, managing director, PRIME Database, which runs www.indianboards.com, a joint initiative of PRIME Database and NSE, “this would mean that 97 persons would have to resign from 283 independent directorship positions in NSE-listed companies by 1st October 2014…This is a welcome move as independent directors would now be able to spend more time on a company.”

 

The person with the maximum number of directorships in listed companies is Mr Pradip Kumar Khaitan with 14 directorships.

 

 Maximum Number of Directorships in companies listed on NSE & BSE

 

Director Name

No.of
Directorships

MR.PRADIP KUMAR KHAITAN

14

MR.ANIL HARISH

13

MR.DILIP JAYANTILAL THAKKAR

13

MR.RAJENDRA AMBALAL SHAH

13

MR.SANJAY KHATAU ASHER

13

MR.BANSIDHAR SUNDERLAL MEHTA

12

MR.NASSER MUKHTAR MUNJEE

11

MR.PRADIP PANALAL SHAH

11

MR.SRINIVASAN NATESAN

11

MR.AMBALAL CHHITABHAI PATEL

10

MR.BALAJI RAO JAGANNATH RAO DOVETON

10

MR.BRIJ BEHARI TANDON

10

MR.HAIGREVE PRADIP KUMAR KHAITAN

10

MR.JAYANT NARAYAN GODBOLE

10

MR.RADHA KRISHNA PANDEY

10

 

MR.SURESH NARSAPPA TALWAR

10

Source: indianboards.com

 

According to Mr Haldea “what is welcome is that SEBI has at least prescribed that if a person has already served as an Independent Director for 5 years or more in a listed company (as on 1 October 2014), he shall be eligible for appointment for only one more term of 5 years.”

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Why are healthcare costs shooting up? – Part I

The pharmaceutical industry is spending lavishly on medical scientists and doctors for hospitality in expensive hotels, gifts, honorariums, conference and symposia expenses, consulting fees, and research grants. This money eventually is paid by the consumers in the form of soaring cost of medical treatment

Recently The New York Times has exposed a startling fact. More than 47% of the Harvard Medical School faculty are on the regular pay roll of drug companies. Here is what NYT found out.
 

 “The ties between clinical research and industry include not only grant support, but also a host of other financial arrangements. Researchers serve as consultants to companies whose products they are studying, join the advisory boards, and the speakers’ bureaus, enter into patent and royalty arrangements, agree to be listed authors of articles ghost written by interested companies, promote drugs and devices at company sponsored symposia, and allow themselves to be plied with expensive gifts and trips to luxurious settings. Many also have equity interest in companies. Academic medical institutions are themselves growing increasingly beholden to industry. Harvard used to be an exception; but they are also softening their stand,” wrote Marcia Angell.
 

This should give a wake up call to all thinkers. I have been writing for years that most of what doctors learn from textbooks and their teachers is the “wisdom” distilled by the vested interests in pharmaceutical and medical devices industries!  Harvard revelation is only the tip of the iceberg. In India, many doctors make a comfortable living thanks to the largesse of the industry. The unholy bond between the academia and the drug industry is getting stronger.
 

The word ‘intelligence’ is derived from the roots inter (between) and ligere (to choose). An intelligent doctor, therefore, should be able to choose between the good and the evil for the sake of his/her patients as also to become a person of value and not just a person of success. It was Albert Einstein who wrote that one should “try to be a man of value, rather than a man of success.” An editorial in the New England Journal of Medicine deplores the evil in medical science.  My lamentations about medicine having gone to the market place, riding piggyback on technology, making it almost impossible to believe any of the short case-control studies published even in the “respectable” journals for years, had only fallen on deaf ears. I have become a laughing stock in the higher echelons of the Indian medical academia! I am told that a group of cardiologists in Mumbai, when asked to assess me for the Fellowship of the Academy of Medical Sciences some years ago, had opined that “he is only a quack and has no idea what cardiology is all about!”  I did become Fellow-thanks to a few thinkers still in the organisation. 
 

And now, comes this news from America which shows how thoroughly compromised the academics are. I am sure our holy cows would now wake up from their sedative induced slumber. They would want things to come from America for them to believe anything in any field. Our western slavish mentality knows no bounds. We could realise that Amarthya Sen is a gem (Bharat Ratna!) only after the Nobel Committee identified him!

I could quote some of my bitter experiences, which I had shared with readers from time to time, here to complete the picture. A symposium on treatment of high blood pressure was being held in a five-star hotel in Goa. I was pitted to speak against a star speaker from America. This gentleman is a regular company “employee”, having a very high academic status in addition. The drug in question was a receptor blocker of a particular new variety. While the American went on to describe the drug as the panacea for all hypertensives and that it should be the first drug of choice, I had to, per force, take the opposite stand as I was convinced that this drug was not the drug of first choice.
 

The great master ridiculed me and the audience, of course, was with him! In March 2000, while I was on a lecture tour of some Universities in the US, early morning my hotel room was blaring out the news item that this very drug, in the first ever human study, had caused many more heart failures, while it is touted as the drug to prevent heart failure! The study has since been stopped and the newscaster was asking nearly a million Americans who are already on the drug to contact their doctors to get the drug changed immediately. I tried in vain to contact the “great” man but to no avail. This happens again and again. The drug in question was one of the alpha blockers. Any blocker, alpha, beta, ACE or H1—or, for that matter, any other drug that blocks any normal body function, is not conducive to normal body physiology. Recent revelations about metaprolol in the POISE study are a good example. There are other ills which follow all the above blockers but space does not permit me to go into them in greater details.  
 

No one has so far described science in a way that satisfies everyone. “Science, for example, can not give absolute proofs of the laws of nature because, although we can test an idea repeatedly, we can never be sure that an exception does not exist,” says Michael Cross in the New Scientist 2000 February 19th.  Every time something goes wrong and is detected, anyone could take refuge under this clause. This statement of Cross should not be misread to say that science is not good. It only goes to emphasise the fact that scientific methods are but one of the many ways to human wisdom. 
 

One other subtle way of taking the practicing doctor for a ride by the companies is the use of confusing statistical jargon which, unfortunately, most medical students do not get to study in the medical school. This specially applies to the risk factor correcting efforts using drugs, a real money spinner. There are seventeen studies (RCTs) in the area of blood pressure lowering drugs, where the collective relative risk reduction (RRR) was only -20% and this is the one sold in the journal articles and company literature. If one were to analyse the absolute risk reduction (ARR) it comes down to -0.8% only! This will translate into a very insignificant survival benefit (SB) of just 0.8%. To put it differently, if a healthy man with moderately raised blood pressure were to take the drugs religiously for five years to reduce his box blood pressure, despite lots of other inconveniences due to the drug in question, his chance of survival becomes 96.8%, whereas it would still be 96% without any drug at all for five years but with simple change of mode of living!  

Almost identical figures arise from all the cholesterol lowering drugs. That is not all. The number needed to treat (NNT) unnecessarily is another serious matter. To save one young man with mild to moderate hypertension from a possible stroke in the next five years, the doctor will have to treat 850 normal people with the same level of BP for a period of five years. The adverse drug reactions of those drugs in five years would be enormous, to say the least, both in morbidity and mortality, leave alone the cost! Practising doctors get to see only the RRR figures that look very impressive. The table below shows it all! 

 

“Who lies for you will lie against you.” -Bosnian Proverb  
   

(This is the first part of a two part series)
 

( Professor Dr BM Hegde, a Padma Bhushan awardee in 2010, is an MD, PhD, FRCP (London, Edinburgh, Glasgow & Dublin), FACC and FAMS. He is also Editor-in-Chief of the Journal of the Science of Healing Outcomes, chairman of the State Health Society's Expert Committee, Govt of Bihar, Patna. He is former Vice Chancellor of Manipal University at Mangalore and former professor for Cardiology of the Middlesex Hospital Medical School, University of London.)

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COMMENTS

Merchant M S

3 years ago

SIR,
Today our people need safe drinking water, proper disposal of sewage and garbage, planning proper drainage, planned housing, stop air pollution, grow more tress, unadulterated food products, simple hygiene like washing your hands before eating,
basic immunization, importance of exercise and simply walking a mile a day. Any takers? Crores of rupee is spent on chemotherapy without any increased survival

Gopalakrishnan T V

3 years ago

Greed and maximisation of profit have become the order of the day and this has been encouraged by the top management institutes. MBAs are the brain behind and trapping everyone in some transaction or other has been their hallmark. Insurance, consumer durables, travel costs and any transaction of commercial nature, these MBAs brain work and customers are trapped and exploited without being questioned and without any ethics and principles. Every transaction comes out with a rider and it becomes a recurring expenditure. MBAs have changed the very culture of commerce and trade and Greed is the deciding factor in pricing the commodity or service. Inflation in India is also due to such aggressive pricing. This article is a proof as to how consumers are exploited mercilessly.

Narendra Doshi

3 years ago

Respected Dr. Hegde,
What are your observations on early morning fasting everyday for around six hours and then start with amla/palak/methi etc vegetable juice followed by tomato juice etc when next hungry followed by raw fruits when next time hungry to be followed by again only raw fruits and vegetables preferably or a cooked food with lots of vegetables as a daily diet.Pl refer http://www.newdiet4health also. This lifestyle has eliminated and avoided any medicine intake and doctor visits, for any type of illness. It is a low cost healthy solution for masses.More cooked eating, milk & dairy products intake and oily food leads to more diseases.

Yerram Raju Behara

3 years ago

A great revelation! Governments do not budget adequately for safe drinking water and good drainage and sewerage systems but go after creating health budgets. If the former two are taken care of the budgets of all families - rural and urban - will go more for good food and better health. But the doctors, consultants, educationists and executives in governments, insurance companies survive on poor systems and lack of basic amenities for good living. Coming to Harvardians, they constitute ( do not exclude IIM_A) are after all hired intellectuals. When I told somebody that there is intellectual prostitution, he asked me "why do we want to insult prostitutes?". I feel he is right.

Supreme Court refers 'euthanasia' issue to larger Constitution bench

The petitioner had contended that a terminally ill person whose life was ebbing out should be allowed to die and not to with artificial medical support

The Supreme Court on Tuesday referred the issue of legalising euthanasia in India to a five-judge Constitution bench, saying there has been 'inconsistent' opinion in its previous verdicts on withdrawing medical support to terminally ill patients.

 

A three-judge Bench headed by Chief Justice P Sathasivam said that it is extremely important to have a clear enunciation of law on this issue and referred the matter to a larger Constitution Bench.

 

The court said that the Constitution Bench will go into all aspects of the issue and take a final decision on framing guidelines.

 

The Bench also comprising justices Ranjan Gogoi and SK Singh passed the order on a public interest litigation (PIL) to allow a terminally ill person not to continue with artificial medical support.

 

The Centre had vociferously opposed the plea terming it as “suicide” which could not be allowed in the country.

 

With today’s direction, the apex court’s earlier order, which had rejected the plea for active euthanasia, will also be relooked into by the larger bench.

 

The PIL filed by Common Cause, an NGO, had contended that when a medical expert opines that the person afflicted with terminal disease has reached a point of no return, then he should be given the right to refuse being put on life support system as otherwise it would only prolong his agony.

 

The petition was filed in 2008 when the apex court had issued notices to the Union Ministry of Health and Law and sought their response on the issue.

 

The petitioner’s plea was earlier opposed by Additional Solicitor General Siddharth Luthra who had submitted that euthanasia cannot be permitted in Indian society and it would be against the law and medical ethics.

 

He had said prayer made in the PIL was not tenable in law and it cannot be allowed through judicial exercise.

 

Advocate Prashant Bhushan, appearing for the NGO, had contended that those “at the end of their natural life span and likely to go into a state of terminal illness or permanent vegetative state, are deprived of their right to refuse cruel and unwanted medical treatment, like feeding through hydration tubes, being kept on ventilator and other life supporting machines in order to artificially prolong their natural life span.”

 

The petitioner had contended that a person whose life was ebbing out should be allowed to die as the continuance of the life with the support system was an unnatural extension of the natural life span.

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COMMENTS

MOHAN

3 years ago

Pope John Paul II stated that 'euthanasia' is a grave violation of the law of God, since it is the deliberate and morally unacceptable killing of a human person.

But is it not a grave violation of the law of God the right to refuse cruel and unwanted medical treatment, like feeding through hydration tubes, being kept on ventilator and other life supporting machines in order to ARTIFICIALLY PROLONG their NATURAL life span?

Vaibhav Dhoka

3 years ago

If one visits any hospital one can find minimum 10-15 patients in ICU just to prolong life and have HUGE earnings to CONSULTANTS.Hospitals have become butcheries for many ICU patients.

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