This new enterprise could become a trailblazer to show how emerging nations like Nepal can also innovate in the field of public management and social innovation. The appointed CEO should just answer to the Ministry of Health and Population but with the Prime Minister in a position to monitor the progress in timely fashion
With a full cabinet still to be formed at the time of writing, this piece is proposing an idea that could be picked up by the new government under the leadership of Prime Minister Sher Bahadur Deuba.
It is about a legacy project from the previous Oli administration. If properly executed, this could become a legacy also for the new government, something that could truly become a game changer so that the country would be able to achieve the Sustainable Development Goal No. 3 focused on good health.
It is what I branded in a previous column of mine as the "396 Public Health National Mission" that is based on the decision of the Oli government to set up 396 new hospitals and advanced health care centres throughout the nation.
Interestingly and promising enough, the latest budget that was tabled included initial resources to start this mammoth undertaking.
We know that as always and not only in Nepal, there is always a vast gap between words and intentions, even the noblest ones and real deeds.
The decision to create such a large number of new health infrastructures and the initial allocation of resources for them were based on wisdom and farsightedness.
Even though it might be fair game to cynically think the opposite, that the launch of such a plan was just an outcome of sloganeering and campaigning.
Whatever might be your opinion, the plan is in place, and now the new Deuba administration should do whatever it takes to bring it forward and complete it.
Given the dimension and ambition of the initiative, provided the new government will embrace it, a lot of attention should be put at the level of detailed planning and implementation.
Are the local governments, provincial and municipal, fully on board for this ambitious project? They should be, otherwise it is unthinkable imagining successfully completing it.
As relationships between different tiers of government have been rocky in the past, I do sincerely hope that the new administration will put in enough efforts to adequately prepare the groundwork, from the financing plans to environmental assessments, to ensure from the outset that there will be enough qualified health care professionals running the new structures.
For all this to happen smoothly and efficiently, the country does not need just an excellent Ministry of Health and Population but also tons of managerial skills and qualities that might not be available right now among the officers at the ministry, also because all the most senior among them are busy handling the coronavirus pandemic.
Then why not create a special purpose public entity entirely designed to implement the programme, from the planning to construction to hiring of new staff and, perhaps, even in the future managing the new structures? This can be a public entity entirely owned by the Ministry of Health and Population, and it should be run by someone with proven management experience, a clean and respected outsider, possibly from the business community that, understanding how the state sector operates, can act swiftly and without the hesitation that bureaucrats often show.
It is true that for all this to be possible, we need to design new legislation, a process that itself can be marred by politicking with delays and incessant lobbying.
Undeniably there is a prevailing opinion that distrusts any state enterprise because more often than not, as reality shows, these can be easily turned into vehicles for nepotism and exchange of favours among politicians.
Yet this is a false myth because public companies do not necessarily have to become paragons for mismanagement and corruption.
There have certainly been plenty of such cases (and by the way not only in Nepal)to prove that solid and honest management can lead. We all know how the Nepal Electricity Authority (NEA) was fixed a few years ago.
Therefore, I do imagine a top CEO that is well regarded and with already considerable achievements to lead this "special purpose vehicle".
There will be a time frame, and the CEO will have maximum authority and responsibility to achieve the goal.
Enlightened and progressive management practices will apply in this new set up, all driven by maximisation of the public good through the delivery of public health for all.
I also imagine top professionals from the civil society, private sector and even very promising junior public officers in special assignment forming a very diverse working force led by women and persons living with disabilities (among these two groups, there is plenty of expertise in public health) and also promising graduates from the social sciences, management and engineering from historically disadvantaged groups.
This new enterprise could become a trailblazer to show how emerging nations like Nepal can also innovate in the field of public management and social innovation.
The appointed CEO should just answer to the Ministry of Health and Population but with the Prime Minister in a position to monitor the progress in timely fashion.
The power should not rest in any high coordination committee made by politicians or officers.
Instead there will be a board of directors chaired by the Prime Minister and with the Minister of Health and Population acting as the vice chair with responsibility to enable the CEO to do the job.
Other members of the board would represent the local governments, the civil society and business sector with former top bureaucrats also included, all providing insights, expertise and acting as guarantors of the public good.
Any ideas on the name of this new innovative public company? What about branding it as the National Public Health Challenge Corporation, in short simply Mission 396?
Galimberti is the co-founder of ENGAGE, an NGO partnering with youths living with disabilities. Opinions expressed are personal.
A version of this article appears in the print on August 9 2021, of The Himalayan Times.
