The efficient functioning of healthcare systems relies heavily on the competency of those appointed to manage various levels of healthcare facilities. Appointing capable health managers is paramount at the levels where policies and programs are being implemented. When it comes to appointments, a flawed methodology known as “Seniority and Clinical Experience” is adopted to select those officers. That often leaves us with two things – an incompetent manager without a vision and a void of a clinician. “A leader without the vision, to strive to improve things, is no good. Then you will just stay put, you won’t progress.” – Lee Kuan Yew
We have come a long way from where we were at the end of the last century. But the question is where are we heading? Norman Vincent Peale had it beautifully when he said “Shoot for the moon. Even if you miss, you will land among the stars.” We often become complacent about our achievements by comparing J&K with the Southern states of India like Kerala and Tamil Nadu. Yes, we have had our share of challenges and success but that should not stop us from aspiring what we can achieve. And it all comes down to the person sitting in the cockpit of that flight to success.
The medical and health department is run by a senior person fulfilling some basic eligibility criteria and is usually about to retire from government services. He/she has reached the pinnacle of his/her career and wants to play safe to have an uneventful retirement. He/she won’t bring any laurels to the department. It is like appointing a person on his way home as the General of the Army preparing for a war or like appointing a captain of a ship. The whole process of selecting the chief of the health department is preposterous and ill-conceived. The same is true for tertiary and secondary care hospitals, and even other departments.
The appointment of under qualified or bad health managers can have far-reaching consequences that affect the quality, accessibility, and effectiveness of healthcare services. The implications of such appointments can manifest in various detrimental ways: Service delivery disruptions, misallocation of resources, loss of public trust, stifled progress, and waste of public funds. Instead the position is considered as a retirement gift given to the person for working his whole life in the department and can boast it to their family and friends. Even their team won’t listen as they know the person is retiring and any new initiatives taken will go down with every passing day close to retirement. What a waste of the position and resources!
Different countries have adopted different strategies for appointing the person in charge of maintaining and promoting the health of millions of its citizens. They not only look at the education and experience but also at the skills and abilities of an individual. In the US, a Director of Health for Public Services is required to have a master’s degree in Public Health with experience in a leadership position in development, management, implementation, and transformative healthcare initiatives. In the UK, a Director of Healthcare/ Tertiary Care Hospital must possess, in addition to essential qualifications, a skill set comprising leadership, analytical, communication, interpersonal, and strategic thinking. In addition, (s)he should have a high understanding of epidemiology and statistics, public health practice, health promotion, health economics, and health care evaluation. In Singapore, a Director of a tertiary care hospital should possess strong leadership qualities, project management skills, analytical skills, communication and presentation skills, and strategic thinking in addition to the basic qualifications and experience. In Thailand, a Director of Health is required to be a public health graduate with leadership qualities, communication and interpersonal skills, project management, and analytical skills.
Effective leaders, be it the Director of Health Services, or the Director of a tertiary care hospital, should possess a comprehensive understanding of public health challenges, be adept at navigating complex healthcare landscapes, and possess innovative ideas to address emerging health issues. Without this vision, we will lag in implementing crucial health policies, adopting modern healthcare practices, or responding swiftly to health crises. A to-be director should be passionate and knowledgeable about healthcare services and health programs, yet to reach his/her pinnacle, and should have the ability to convey his/her vision and to bring the strength of his/her team to work on shared goals.
It is time we stop envying those who have made moderate advancement, rather we appoint leaders to have the vision to dream of a barrier-free healthcare system and should set goals based on our own challenges to make that vision possible. It is time to appoint a leader rather than a clinician as the Director. It is time to be envied upon by the rest of the country. It is time South should look to North.
(The author is a public health expert working with a reputed international public health organization and writes under the pen-name “Dr. Idai” and can be contacted on request)
