Indian state failed to provide a comprehensive solution to the Covid crisis.
Concept of Flailing state
A Failing state is the one where the government at the central and state levels appears responsive and effective but it has very little feedback system with the grassroots level. The grassroots level continues to linger on with backwardness.
Features of Flailing State
The state was capable of undertaking “thin”, logistical, tasks. Tasks, where goals are clear outputs visible and include command-and-control actions, could be achieved.
India managed to conduct large-scale elections, vaccination programmes (the irony is inescapable), even handled natural disaster relief with relative competence highlights that it can undertake thin, logistical tasks. An example of the Flailing State Public health system is an example of it.
In India, at the top level, multiple schemes related to health services are run which focus on improving the infrastructure, improving the number of personnel. But at the grassroots level, such facilities are missing.
Barely, there is no availability of doctors and good infrastructure at the district level.
Failure of the State
Lack of services to citizens:
Citizens are struggling to find oxygen, basic medicines and hospital beds. No Government: The national government is no longer visible
Lack of Policy Formulation:
The Centre has failed to develop policies on oxygen supply, availability and access to basic medicines, treatment protocols, data systems, vaccinations. The political leadership, from the Prime Minister downwards, is completely absent, and bureaucracy is drafting confused policy.
Lack of coordination with state government:
Oxygen supply chains and aid distribution cannot be streamlined weeks even after hospitals and state governments sounded alarm bells. Central and state governments have locked themselves in a bitter political war.
Required Policies by Government
A comprehensive hospital policy is required to clearly demarcate between covid and non-covid hospitals.
It also requires establishing when the hospital would admit any patient in case of covid.
A transparent human resource policy is needed at the district which will clearly outline on availability of no of personnel, their training status especially with regard to the capability to run a ventilator.
The government needs to develop policies based on evidence-based data on oxygen requirement, allocation and supply processes.
The government needs to establish war rooms at every level of administration to help citizens find beds, oxygen, medicines and teleconsultation.
Resource primary health centres and wellness centres with medicines, oxygen and capacity to triage patients to reduce stress on hospitals.
We need enhanced surveillance capacity, transparent and accurate data on every aspect of the disease. There is a need for enhanced inter-state coordination.
Set up an inter-state council within the National Disaster Management Authority, comprising the PM, chief ministers, senior ministers and bureaucrats from both states and the Centre.