Date:21-09-17

 Behind the 100% swayamsevak

Deen Dayal Upadhyaya’s ideology and political action transcended party lines. He is more relevant today than in his own time

His impact on contemporary political actors can be gauged by his acceptance as an original thinker who transcended party affiliation: Veteran Congressman and a former chief minister of Uttar Pradesh, Sampoornanand, wrote the preface of Upadhyaya’s Political Dairy, which contains social, cultural and political insights. He described Upadhyaya as “one of the most notable political leaders of our time, a man devoted to the good of his country, a person of unimpeachable character, a leader whose weighty words swayed thousands of educated men” and considered Political Dairy essential reading for future political workers.

Is it not a tragedy that the spirit of political socialisation and mutual admiration, which was visible in the 1950s and ’60s, has increasingly eroded? The Nehruvian-left intellectual stream, deluded by its hegemonic status, denied space to diverse thoughts and icons. Our historiography attributed divinity to certain figures and disproportionately glorified their role. Any new inclusion in this pantheon is considered a diminution of Gandhi and Nehru. Research has led to the emergence of many grass-roots women warriors and martyrs from the freedom movement. One of them is Uda Devi. Would the celebration of a Dalit woman patriot be considered a deliberate reduction of Rani Laxmi Bai’s status and role?

Greatness in public life is not measured merely by political success but also by contributions to the advancement of human values, which make democracy virtuous. Indian politics witnessed two contradictory events in the early 1950s. The Congress Working Committee delegated the final say on the selection of more than 4,000 candidates for elections to the Lok Sabha and state assemblies to Jawaharlal Nehru in 1952. That a party with scores of visionaries and leaders felt crippled to contest Nehru’s hegemony shows that its culture of political grooming was weak.

While the Congress inaugurated a personality cult, Upadhyaya demolished this trait before it could take root in the BJS and eventually expelled the party president, Mauli Chandra Sharma, and another veteran leader, Vasant Rao Oak. This tradition can be seen in the symbiotic autonomy of the BJP’s parliamentary party and party organisation. In a democracy, an experiment within a party becomes part of the larger political culture. The Congress and BJP represent two distinct political cultures. While the Congress vice president, Rahul Gandhi, justifies dynastic politics, Modi’s obvious displeasure at the micro-dynasties which infected his party was witnessed during the last election.Upadhyaya’s idealism is more relevant in contemporary India than in his time. In 1963, by-elections were held in four Lok Sabha seats and became a war of prestige between the Congress and the Opposition. Opposition stalwarts, socialists Ram Manohar Lohia (Farrukaabad) and J.B. Kripalani (Amroha), Swatantra Party’s Minoo Masani (Surat) and Upadhyaya (Jaunpur) were in the fray.

Upadhyaya’s victory was considered a forgone conclusion for two reasons: The vacancy occurred due to the death of the sitting BJS MP and caste equations in the constituency were assumed to be in his favour. For Upadhyaya politics was a mission, not a profession. He spoke against caste polarisation and identity-based voting, which led the conservatives to ensure his defeat. However, for him, it was a “victory of the BJS”. He advised parties, “not to sacrifice principles for quick gains” and people to do their duty while exercising their franchise “in a judicious and intelligent manner” to correct the distorted perspective of political parties.

Upadhyaya wanted to decolonise Indian political thought which was largely, as he said, “a Western political picture in the Indian background”. He strongly argued against the left-right division as being detrimental to the growth of a constructive, transformative pro-people ideology. He argued, “this categorisation does not give a correct idea of the politics of India because many programmes of these parties defy any classification on this orthodox basis”.After decades, this view has emerging from many corners of the world. The “creative destruction” he employed for the “third way” led to a greater cohesion between opposing ideas and politics in the 1960s. The BJS, Swatantra Party, socialist parties and the CPI didn’t just form coalitions, the ideological discourse too took a more interactive shape. However, this socialisation was dealt a death blow by the excessive foreign influence on both academia and politics.

Upadhyaya believed that a reactionary politics does not leave the ground for reconstruction and fails to succeed in generating an alternative. He exemplified these beliefs in his political actions. When anti RSS-BJS propaganda by the Indian left was at the centre of the discourse, many wanted to turn the BJS an ideological hub for right-wing politics. Their efforts, however, were in vain. Upadhyaya knew the communists lacked the spirit to Indianise themselves and predicted their decline. He made egalitarianism the first principle of the party, which led to the expulsion of five out of eight BJS MLAs in the Rajasthan assembly opposed to the abolition of zamindari.The Swatantra Party garnered a significant voteshare in the 1962. Following the result, there was a strong move to merge the BJS, the Swatantra Party and Swami Karpatri’s Ram Rajya Parishad (RRP). Upadhyaya raised fundamental questions regarding such a merger: He described the Swatantra Party as a “Dalal Street party” and said that though it was opposed to socialism “it, however, does not know if there can be any better alternative to socialism except the discredited capitalism”. Similarly, the many affinities with their social philosophy did not stop him from writing about the RRP as “a party run not from the cottage of Swami Karpatri ji but from the palace of zamindars and capitalists”, in Panchajanya.

Politics must be controlled by the masses, not the wealthy. Neoliberalism has challenged democracies to ensure they do not become beholden to corporate interests. Upadhyaya cautioned that “if steps are not taken to mend them, powerful lobbies will emerge in the country’s legislatures and political decisions will hardly be taken in an objective manner taking into consideration only the welfare of the people and furtherance of national interests.”Upadhyaya’s “third way” is reflected in his philosophy of integral humanism in which he provided a holistic idea of human welfare. Materialism, spiritualism and cautious desire each have a role in achieving happiness: An economic index cannot be the sole measure of satisfaction or happiness. He pleaded for diversities in economic and social philosophies against a single meta-narrative ruling the world or a nation.Most people have remained ignorant of Upadhyaya’s ideas for decades and now, PM Modi’s emphasis on his thoughts is contested polemically which is pushing India’s public discourse back to a battle between hegemony and counter-hegemony of political ideas. Sampoornanand, while writing the preface for Political Diary, said that the book might be “surprising to some people”.Therefore, it is no surprise that uninformed intellectuals groomed in a culture of political binaries see Upadhyaya merely as a party icon. Sampoornanand’s words are a beacon for contemporary India: He said in the preface to Political Dairy that we must practice “a simple expression of the great virtue of tolerance… if democracy is to take root in our country”.

The decision by the Ministry of Corporate Affairs to crack down on so-called ‘shell companies’, disqualify select directors in these entities and debar them from taking board positions for a specified period of time cannot be faulted. This would begin the clean-up of the Augean stables of firms set up in many cases with less than bona fide intent and having virtually no business operations. However, the Union government’s move to publicise the identities of some of these individuals with a view to ‘naming and shaming’ them is fraught with risk; the devil, as always, is in the detail. While the underlying motive for this action, as cited by the ministry, of “breaking the network of shell companies” in the government’s fight against black money is laudable, there is a real danger of inadvertently tainting genuine firms and individuals. This was in evidence when the Securities Appellate Tribunal recently gave relief to some entities over trading curbs hastily imposed on them by SEBI. Also, given the sheer scale of the task at hand, with the ministry identifying more than 1.06 lakh directors for disqualification, it is imperative that there be great care and diligence to ensure that the authorities do not penalise anyone who for non-mala fide reasons failed to comply with the relevant provisions of the Companies Act. After all, when the intention is to create “an atmosphere of confidence and faith in the system” as part of improving the climate for ease of doing business, the onus must be on taking to task only those who intend to subvert the law.

At a broader level, the Centre and the regulatory arms need to address the underlying systemic shortcomings that have allowed so many companies, both listed and unlisted, to become vehicles of malfeasance. For one, as so many entrepreneurs establishing medium, small or micro enterprises have found to their chagrin, it is far easier to register a firm than it is to dissolve or wind it up. Similarly, in the case of public limited companies, a major portion of the extralegal activities including price rigging of shares, insider trading and other questionable practices have been found to occur in the large mass of smaller companies. The problems of acute illiquidity, weak governance and regulatory oversight have combined with the difficulty in delisting to make these firms prime targets for financial fraudsters and money launderers. The solutions, therefore, need to be targeted at addressing the deep-rooted maladies rather than just the symptoms, making it easier for entrepreneurs to deregister and/or delist a company. The government has already shown it is prepared to act in terms of enacting the necessary legislation to address banking sector stress by adopting the Insolvency and Bankruptcy Code. A simplified process, possibly online, to dissolve or delist would usher in significant benefits, including improved governance, and ensure that all stakeholders from small retail investors to corporate promoters have an enabling atmosphere to operate freely by remaining compliant with the law or risk facing stringent penal action.

Date:21-09-17

 States of the Opposition

Political parties must frame their campaign as a referendum not on leadership but on democratic values

G. Sampath

 late, it’s become almost a matter of conventional wisdom that the 2019 Lok Sabha elections are the Bharatiya Janata Party’s for the taking. The only unknown, apparently, is the margin of victory. If the party’s ambitious ‘Mission 350-plus’ plan proves successful, we could soon have a Parliament that is practically ‘Opposition-mukt’.

In such a scenario, does it still make sense to hope for a meaningful Opposition in the run-up to 2019 and after? If yes, what might be the contours of a political strategy that would enable it to pose a credible challenge to the BJP juggernaut?

Reams have been written about the failures of the Opposition parties. Far from holding the government to account, they have either been dormant or busy fighting for survival. The BJP, on the other hand, has been steadily expanding its footprint. It was in power in five States before the 2014 polls. Today the National Democratic Alliance is in power in 18 out of the 29 States. Thirteen of those have a BJP Chief Minister.

Some have argued that the Indian polity has reverted to a state it has witnessed before — that of single-party dominance, with the BJP taking the place of the Congress. While this is true in a formal sense, there is a big difference in substantive terms, one that could seal the fate of Indian democracy as we have known it.

 The Congress system

For more than two decades after Independence, political competition in Indian democracy took place within the confines of what political scientist Rajni Kothari termed ‘the Congress system’. It denoted a polity marked by single-party dominance. Until the onset of the ’70s, the Congress incorporated oppositional drives into itself by way of multiple factions at the regional and national level that mirrored the extraordinary pluralism and diversity of a complex nationhood.In a traditional society where a political culture centred on democracy was yet to strike roots, it was the accommodative pluralism of the ‘Congress system’ that allowed the normative modernity of the Constitution to slowly achieve a fragile social hegemony. More than the ‘steel frame’ of the bureaucracy, it was the elastic frame of the ‘Congress system’ that held the country together by respecting its pluralistic genotype.

Subsequently, as the Congress went into decline, regional configurations came to power in State after State, and India entered the coalition era. As it lost ground in State politics, the Congress was forced to play ball with smaller parties at the national level. Seen another way, the intra-party coalitions within the ‘Congress system’ became externalised into an inter-party dynamic in the coalition era that began with the ninth Lok Sabha in 1989, and continued till the 2014 elections.

Political competition being what it is, the vacuum at the national level caused by the shrinkage of the Congress has now been filled by the BJP. It did so by scripting an alternative national narrative around three elements: a Hindutva-infused nationalism; turning elections into a referendum on national leadership, specifically Narendra Modi’s leadership; and framing the electoral competition in all-India terms rather than engage with State-level issues.If the Opposition has floundered so far, it is because it has tried, without much conviction, to challenge the BJP on its narrative home ground. Not surprisingly, its attempts have failed to strike a chord.

Debating nationalism ends up giving more oxygen to chauvinism. The Opposition does lack a politician who can match Mr. Modi’s appeal. And regional leaders are better off sticking to State-level issues where they are on stronger political ground than trying to reinvent themselves overnight for a national role. In other words, the Opposition needs to stop being reactive and formulate its own counter-narrative.

 Lessons from the past

Much has been made of the Congress being reduced to 44 seats in the Lok Sabha. It is taken as a sign of structural weakness in the Opposition camp. Yet, after Independence, in the first five Lok Sabhas, the highest number of seats held by an Opposition party was 44 seats. Did that mean India was ‘Opposition-mukt’ for a quarter of a century?History shows us that the Congress’s own fall from dominance was sparked by challenges at the State-level, not by a national rival. But that was possible because of the space for political pluralism offered by the ‘Congress system’.

The fundamental difference between the ‘Congress system’ and the ‘BJP system’ of one-party dominance is the latter’s determination to eliminate this pluralistic space. Politically, this is the toughest challenge facing the Opposition, as well as the biggest weakness of the BJP, one that could be tapped to construct an alternative narrative.Put simply, the Opposition’s counter-narrative would need to dwell on two aspects. One, it must convey that the 2019 polls are about choosing between two options: a coalition regime structurally constrained to protect the values of pluralism and federalism, and a stable majority under an authoritarian leadership unlikely to entertain democratic niceties.Second, the Opposition needs to frame the election as a referendum not on leadership but on democratic values. A massive win for the BJP in 2019 would certainly pose a threat to the historical consensus, established at the time of Independence, which institutionalised pluralism, a degree of federal autonomy, and a democratic framework for nation-building. The Opposition has the simple but onerous task of using its political imagination to bring this threat to the centre of the electoral agenda.

 Onus on regional parties

Its political strategy, therefore, must aim for a hung Parliament and a coalition government. An ideal outcome would be one where no party gets more than 170-180 seats. A ‘Mission 180 minus’, as it were. With such numbers, even a BJP-led coalition government would be a victory for the Opposition, as the objective of safeguarding India’s pluralism would have been achieved.

Regional parties are best placed to take the lead here, for they are the ones which would be hardest hit by a creeping centralisation of power. If they could come together, with or without the Congress, over a single point agenda of protecting India’s pluralism, it would obviate the need for a formal pre-poll or seat-sharing arrangement. There is no other way that, say, a Trinamool Congress and a Communist Party of India (Marxist) would come together to battle a common rival that could prove more lethal to both than they have been to each other. Given that the BJP has always struggled more against non-Congress, regional opponents, it is also a more canny electoral strategy.And in case they still lose badly, they can take heart from the fact that India’s political traditions give the Opposition an institutional role disproportionate to their actual numbers in Parliament, through mandatory membership of key committees, appointments panels, and so on. So, regardless of how they fare in 2019, Opposition parties would continue to have a major role to play.

All said and done, Indian democracy has never fared well under powerful parliamentary majorities led by a charismatic Prime Minister unchecked by coalition dynamics. We have two examples, in Indira Gandhi and Rajiv Gandhi. While one briefly downed the shutters on democracy, the other gave a fillip to Hindu fundamentalism and tried to muzzle the press.The Opposition’s success would ultimately hinge on how effective it is in convincing the people that if they value their nation’s democratic traditions as much as they do development, they must either elect a coalition government in 2019, or force the ‘BJP system’ to become more like the ‘Congress system’, not by importing Congressmen, but by imbibing the values of pluralism and respect for dissent that the Congress stands for in its Nehruvian vision of itself, if not always in reality.

Date:21-09-17

 उम्र के इस मोड़ को चाहिए जीने के नए मुकाम

ऋतु सारस्वत, समाजशास्त्री (ये लेखक के अपने विचार हैं)

देश के लगभग आधे लोग अपने बच्चों के भरोसे ही काम से रिटायर होते हैं। भारतीय रिजर्व बैंक की हाउस होल्ड फाइनेंस समिति ने कहा है कि इससे देश की युवा पीढ़ी पर काम का अनावश्यक दबाव पड़ता है, साथ ही दो पीढ़ियों के रिश्तों में भी तनाव बढ़ता है। रिपोर्ट में कहा गया है कि 77 प्रतिशत लोग या तो इस बात की कल्पना ही नहीं करते कि वे रिटायर होंगे, न रिटायरमेंट की कोई योजना बनाते हैं। लगातार ऐसे अध्ययन सामने आ रहे हैं, जो बुजुर्गों की खराब स्थिति की ओर इशारा कर रहे हैं। हेल्पेज इंडिया की ओर से किए गए सर्वे भी बता रहा है कि घर से लेकर बाहर तक बुजुर्र्गों को असम्माननीय व्यवहार का सामना करना पड़ता है। पिछले कुछ दशकों में कई बार इस संबंध में चिंताएं भी जाहिर की गई हैं। ‘माता-पिता और वरिष्ठ नागरिक रखरखाव और कल्याण अधिनियम 2007’ का प्रावधान, बुजुर्गों को कानूनी ढाल देता तो है, लेकिन भारतीय अभिभावक न्यायालय का दरवाजा खटखटाने से हिचकते हैं, क्योंकि इसे वे अपने परिवार की प्रतिष्ठा पर आंच के रूप में देखते हैं।

भारत ही नहीं, दुनिया भर में बुजुर्गों की स्थिति ठीक नहीं है, इसलिए जरूरी है कि बड़े स्तर पर इसके निराकरण के मार्ग ढूंढे़ जाएं। हमें यह स्वीकार करना ही होगा कि समाज परिवर्तनशील होता है। चाहे-अनचाहे भारतीय सामाजिक और सांस्कृतिक पृष्ठभूमि में जो परिवर्तन हुए हैं, उन्होंने बुजुर्गों को असहायता और अकेलापन दिया हैै। इसका एक मुख्य कारण आर्थिक निर्भरता है, जो उनके आत्मविश्वास को तोड़ती है और भावनात्मक रूप से उन्हें कमजोर बना देती है। ‘बच्चों को बुढ़ापे की लाठी’ मानने की मानसिकता का त्याग अब जरूरी हो गया है, लेकिन  समाज में कोई वैकल्पिक सोच उपलब्ध नहीं है। यकीनन बच्चों की उन्नति और शिक्षा का दायित्व अभिभावकों का है, लेकिन उसके लिए अपनी सारी जमा-पूंजी लगा देना, उचित नहीं। यह जरूरी है कि अपनी आय का एक निश्चित अनुपात वृद्धावस्था के लिए बचाना चाहिए। आर्थिक सबलीकरण, सुखद वृद्धावस्था की पहली शर्त है, लेकिन जहां गरीब ही नहीं, निम्न मध्यवर्ग तक के लोग बमुश्किल गुजारा करने लायक कमा पाते हों, वहां यह काम बहुत आसान भी नहीं है।

आंद्रे नारुआ ने कहा है कि ‘व्यस्त आदमी को बूढ़ा होने की फुर्सत ही नहीं’ मिलती। सच भी यही है, पर यह तब तक संभव नहीं है, जब तक कि व्यस्तता का पैमाना वृद्धों के लिए बच्चों व घर की चारदीवारी के भीतर तक हो। घर के बाहर अपने हमउम्र साथियों के बीच रहना, अपने उन सपनों को पूरा करना है, जो जीवन की आपाधापी में कहीं पीछे छूट गए, यही साथ उनके जीवन में रंग भर देता है। सामाजिक सरोकार से जोड़ने का प्रयास एकाकीपन को दूर करने का बेहतर रास्ता है। एकाकी परिवार, भारतीय समाज का अब सच बन चुके हैं। एक या दो बच्चों के बीच अपनी खुशियां तलाशने की कोशिश पारिवारिक उलझनों को पैदा करती है। समाज को अगर युवाओं की ऊर्जा की आवश्यकता है, तो बुजुर्गों के अनुभवों की भी उतनी ही जरूरत है। अपने हमउम्र साथियों के  साथ समय बिताना और उन लोगों से जुड़ना, जिनके अपने बाहर रहते हैं या है ही नहीं, जीवन को एक नई परिभाषा देगा। ‘ओल्ड एज होम’ को अभिशाप मानने की बजाय एक नई परिपाटी शुरू की जा सकती है। ‘फ्रेंड्स होम’ आर्थिक विवशताओं और दुव्र्यवहारों के लिए नहीं, बल्कि अपने हमउम्र साथियोंके साथ रहने की चाह के कारण अस्तित्व में लाए जाएं। ये आश्रय वृद्धावस्था को सहजता से भर सकते हैं।इसकी एक बानगी छत्तीसगढ़ के रायपुर में देखी जा सकती है, जहां 700 युवा अकेले रह रहे बुजुर्ग दंपतियों की जरूरतों का ध्यान रखते हैं। उनकी चिकित्सा सुविधा से लेकर अन्य कामों में भी उनकी सहायता करते हैं। ये वे बुजुर्ग हैं, जिनके बच्चे नौकरी या बिजनेस के चलते विदेश या देश के अलग-अलग हिस्सों में शिफ्ट हो गए हैं और ऐसा कोई करीबी व्यक्ति भी नहीं है, जो उनकी देखभाल कर सके। वृद्धावस्था कोई बीमारी नहीं है, जीवन का एक पड़ाव है और यह पड़ाव तभी सुखद हो सकता है, जब हम इसके लिए खुद को तैयार करें। साथ ही इस सच को भी स्वीकारें कि संयुक्त परिवार का दौर अब नहीं लौट सकता।

Date:21-09-17

 हर हाल में हो दुरुस्त

के.सी. त्यागी

नीति आयोग द्वारा सार्वजनिक स्वास्य व्यवस्था में एक अभुतपूर्व बदलाव की सिफारिश के तहत स्वास्य सेवा को निजी हाथों में देने की बात कही गई है। पिछले माह घोषित इस योजना के अंतर्गत ‘‘पीपीपी’ यानी पब्लिक-प्राइवेट-पार्टनरशिप के तहत जिला स्तरीय सार्वजनिक अस्पतालों व स्वास्य केंद्रों को निजी संस्थानों के साथ सम्बद्ध किया जाना प्रस्तावित है। गैर-संचारी रोगों के इलाज के लिए निजी अस्पतालों की भूमिका बढ़ाने के उद्देश्य से इस मॉडल अनुबंध का प्रस्ताव नीति आयोग और केंद्रीय स्वास्य व परिवार कल्याण मंत्रालय द्वारा किया गया है। प्रस्तावित मॉडल के तहत जिला अस्पताल की इमारतों में निजी अस्पतालों को 30 वर्षो के लिए पट्टे पर जगह व अन्य व्यवस्था मुहैया कराने और देश के आठ बड़े महानगरों को छोड़कर अन्य शहरों में 50 से 100 बेड वाले अस्पताल बनाने के लिए जमीन प्रदान करने की अनुमति दी गई है।

निजी निवेशकों को आकर्षित करने के क्रम में आयोग द्वारा अस्पताल परिसर के 60,000 वर्ग फीट जमीन प्राइवेट संस्थान को देने का प्रस्ताव भी है। शर्त है कि जिन जिला अस्पतालों में प्रतिदिन एक हजार से ज्यादा मरीज इलाज के लिए आते हैं; केवल उन्हीं अस्पतालों में निजी व्यवस्था स्थापित की जाएगी। इस प्रस्ताव को लेकर नीति आयोग की दलील है कि नई नीति के लागू हो जाने से हृदय संबंधी, कैंसर और श्वास रोगों पर काफी हद तक काबू पाया जा सकेगा। सच है कि देश में गंभीर बीमारियों की वजह से होने वाली मौत में लगभग 35 फीसद भागीदारी इन्हीं तीन बीमारियों की है। आयोग की सिफारिश को रोग उन्मूलन की दृष्टि से देखे जाने पर स्पष्ट है कि सरकार लचर पड़ी चिकित्सा व्यवस्था को बल देना चाहती है। इससे इतर दूसरा और मजबूत पक्ष यह भी है कि क्या व्यवस्था के निजीकरण मात्र से आम जनमानस को अपेक्षित लाभ मिल पाएगा? सवाल यह भी है कि जब पूर्णत: सरकारी तंत्रों की निगरानी में कैंसर, हृदय रोग और श्वास रोग आदि पर काबू नहीं पाया जा सका तो क्या गारंटी है कि निजी संस्थानों से सम्बद्धता के बाद मरीजों को सुविधाजनक एवं सस्ता उपचार मिलना शुरू हो जाएगा? यह पहली बार नहीं जब नीति आयोग की ओर से निजीकरण के संकेत मिले हैं। सर्वप्रथम 2015 में आयोग द्वारा स्वास्य क्षेत्र में निजी निवेशकों और बीमा कंपनियों को मुख्य भूमिका में लाए जाने की कवायद शुरू हो गई थी। इसी दौरान सार्वजनिक चिकित्सा के खर्चो में कटौती करने और इस क्षेत्र में हो रहे निवेश पर काबू पाने और सार्वजनिक स्वास्य सुविधा के तहत मरीजों को निशुल्क मिल रही दवाइयों व अन्य सेवाओं को नियंत्रित करने की भी अनुशंसा की गई थी। हालांकि मंत्रालय द्वारा इस दिशा में अब तक बदलाव की घोषणा नहीं हुई है लेकिन निजीकरण की ओर बढ़ती प्रक्रिया से खासकर गरीब जनसंख्या में अविास का संचार जरूर हुआ है। चिंता है कि निजीकरण का असर उनकी प्राथमिक चिकित्सा को प्रभावित न कर दे। निजीकरण की स्थिति में सबसे बड़ी चुनौती यह होगी कि सरकार पीपीपी मॉडल का संचालन किसके जिम्मे छोड़ेगी? निवेशकों की हिस्सेदारी की स्थिति में निश्चित रूप से उनका भी दबदबा होगा। नीति निर्माण से लेकर, मरीजों से बर्ताव और प्राइवेट डॉक्टरों की मनमानी आमजनों की चिंता के मुख्य बिंदु हैं।

वर्तमान व्यवस्था में सरकारी डॉक्टरों द्वारा लापरवाही बरतने, अनुपलब्धता और इलाज को मना किए जाने तक की बात सामने आती रहती है। नई प्रस्तावित व्यवस्था में राहतपूर्ण यह है कि गंभीर हालत के मरीजों को सार्वजनिक अस्पताल परिसरों से परिचालित निजी अस्पतालों में त्वरित देख-भाल के लिए भेजा जा सकता है। इसके लिए चिकित्सा अधीक्षक की अनुमति का प्रावधान है। इसी माह उत्तर प्रदेश के गोरखपुर जिले के बीआरडी मेडिकल कॉलेज की घटना न सिर्फ सार्वजनिक चिकित्सा व्यवस्था पर एक बड़ा तमाचा है बल्कि यह देश भर के सरकारी-प्राइवेट अस्पतालों के लिए आईना भी है। समय-समय पर इस तरह की घटनाएं सरकारी तंत्रों की पोल खोलती रहती हैं। हैरानी है कि भारत पहले से ही स्वास्य क्षेत्र पर सबसे कम खर्च करने वाला राष्ट्र है। कुल जीडीपी का मात्र एक फीसदी हिस्सा देश के सार्वजनिक स्वास्य पर खर्च किया जाता है जो नियंतण्र सूची में निम्नतम है। विकसित राष्ट्रों में यह आंकड़ा लगभग 10 गुना ज्यादा है। 12 वीं पंचवर्षीय योजना यानी 2012 से 2017 के दौरान सरकारी खर्चे में कटौती की गई है। वर्ष 2014-15 के स्वास्य बजट में 5100 करोड़ की कटौती हुई। इस बार सांकेतिक बढ़ोतरी जरूर हुई लेकिन वर्तमान चुनौतियों से लड़ने में नाकाफी है। नये बजट में वर्ष 2017 तक कालाजार और फलेरिया, वर्ष 2018 तक कुष्ठ रोग एवं 2020 तक खसरा एवं 2025 तक टीबी से देश को मुक्ति दिलाने की घोषणा निश्चित रूप से उत्साहवर्धक है लेकिन विश्व स्वास्य संगठन के एक मूल्यांकन के अनुसार भारत को टीबी मुक्त होने में 2050 तक का समय लग सकता है। दो विासपात्र स्रेतों के भिन्न मतों से संशय होना भी लाजिमी है। पिछले कुछ वर्षो में तमाम सुख-सुविधाओं से लैस हजारों की संख्या में बड़े आधुनिक अस्पताल खोले गए हैं लेकिन महंगे इलाज के कारण इन अस्पतालों से भारतीय जनसंख्या के बड़े हिस्से को किसी प्रकार का लाभ नहीं मिल पाया है। ऐसे में संपन्न और आम नागरिकों के इलाज के बीच एक बड़ी खाई बन गई है। स्वास्य बीमा भारतीय संरचना के अनुकूल नहीं है। एनएसएसओ की रिपोर्ट के अनुसार 80 प्रतिशत से अधिक आबादी के पास न तो कोई सरकारी स्वास्य स्कीम है और न ही कोई निजी बीमा। इस दुर्दशा में निजीकरण के बजाय वर्तमान व्यवस्था का सुदृढ़ीकरण ज्यादा कारगर हो सकता है। सार्वजनिक स्वास्य के लिए अधिक बजट का प्रावधान, अनियमितता के प्रति कड़ी निगरानी, आधारभूत संरचना का विकास, जेनरिक दवाइयों को बढ़ावा आदि बीमार पड़ी चिकित्सा व्यवस्था को पुन: दुरुस्त कर सकता है।(लेखक जद (यू) के राष्ट्रीय प्रवक्ता हैं)