Dear all,
Let me explain what does it mean concretely when Abhay says that JSA regional organisers would need to play a huge role in coordinating, communicating and organising regional hearing. For the Western regional hearing, two SATHI staff members worked full time for two months to follow up with activists to send details of the cases as per the format of NHRC, to help in the analysis of these cases and to prepare the documents to be sent to NHRC; more than dozen SATHI staff were working full time for more than 2 weeks for the preparatory work for the logistics; Arun Gadre and myself were involved in analysis of whatever cases that had been received from private and public sector respectively and out of these, selection of the twenty cases and the write ups about these cases for sending these to NHRC. Abhay was involved almost full time for many months to liaison with NHRC and with JSA-NCC. It can be said major part of Abhay's inputs were not directly related to Western hearing as such and large part of such inputs will not be required in further regional hearings. But the rest of the inputs will generally be required in other regional hearings.
Secondly, NHRC does not have mandate to summon private doctors or to take any action against them; it can summon only public officials. So cases must be made against Medical Council officials to show dereliction of duty/unjust decisions etc. There is no point in saying in general terms that taking private sector is non-negotiable for JSA. We can negotiate to have a slot for private sector only if we can prepare cases against the regulators. All the work done for the Western Hearing related to private sector cases was a waste. That Syriac Joseph even refused to listen to private sector cases was quite irritating. But such 'hearing' would not have led to any specific strictures against specific MMC officials because we had not posed the problem in such a manner; in a manner in NHRC needed it for taking any actions against the MMC officials/passing specific strictures or giving them any specific directions. The presentation on the second day about failure of MMC by presenting some statistics and arguments was useful for getting some recommendations from NHRC. But the documentation of cases was of no use.
Anant Phadke
On 3 November 2016 at 17:15, Abhay Shukla <abhayshukla1@gmail.com> wrote:
Dear all,Thanks to Vandana for adding some key points, and good to see responses from Ameer, Renu, Ekbal and Sudha - these points need to be kept in mind while deciding about the further process.However before responding to NHRC, it will be good to get the responses from other states / regions also, esp. the JSA regional organisers, who would need to play a huge role in coordinating, communicating and organising for each further regional hearing. Since the Eastern region is now being slated as venue for the next hearing, it is important that JSA organisers from this region give their views at earliest.I would suggest that Sulakshana, Gauranga, Shakeel, Gurjeet, Fuad, Amulya, Esha, Sanjiv, Isfaqur, Satnam and any other concerned JSA organisers from various regions may respond with their views in next couple of days (by 5th Nov.), about proceeding with the further series of public hearings, based on report of the recent discussion with NHRC. We are to send a response to NHRC on 7th Nov., and we need to take into account the views of JSA regional organisers while committing to further regional public hearings.With regards,AbhayOn 27 October 2016 at 18:15, Sudha N <nsudha13@gmail.com> wrote:SudhaRegards,3. Regarding the southern region, we will have more internal discussions. While there are a number of initiatives, campaigns, studies etc. in the region, getting those involved to participate in such hearings or partner with JSA is a challenge.2. Since SATHI cannot provide the kind of support it did for the WRH, each region must be prepared for the effort required, which is significant. Maybe this should be negotiated with the NHRC - 3 coordinators could be supported per region in the month before the hearing to make sure all cases are documented as per NHRC requirements and to coordinate the system-level cases. Or separate funds would have to be raised for the same.Congratulations Abhay and Vandana for navigating through a very difficult meeting!1. As others have expressed, I think the inclusion of private medical sector cases should be non-negotiable. Some of the cases we received in the Southern Region can be analysed for this and I can help in the effort provided it is to be completed before Nov 7th.On Thu, Oct 27, 2016 at 4:46 PM, Dr.B.Ekbal <ekbalb@gmail.com> wrote:Thanks Abhay and Vandana for doing a highly professional but value based negotiation with NHRC. We can go forwards with organising the Eastern hearing. And engagement with the private sector should be a non negotiable condition for the hearing. We can continue to have PHRN be the financial administrative coordination with the NHRCEkbal--On 27 October 2016 at 16:10, 'renu khanna' via JSA NCC <jsa-ncc@googlegroups.com> wrote:Thank you, Abhay and Vandana for the detailed documentation of the Oct 26th meeting. I can imagine how contentious it must have been. So congratulations for holding your cool and stating your points firmly.I think that it is up to the Eastern Region and Southern Region to respond to your queries about the dates and the budget. I think that we cannot get away from the Private Sector issue.Pl.s ee below for specific responses to each question.a. Given this response by NHRC, do we as JSA definitely want to go ahead with the remaining series of public hearings? IT IS GOING TO BE EXTREMELY CHALLENGING. IF THE REGIONS ARE COHESIVE AND COMMITTED AND PREPARED, THEN WE SHOULD GO AHEAD. REGIONS/STATE JSAS HAVE TO EXPRESS THEIR INTEREST/COMMITMENT.b. In case we do want to go ahead, are there any other issues that also need to be emphasised to NHRC during the further negotiations? I THINK TAHT WE SHOULD BE PREPARED FOR ISSUES TO KEEP CROPPING UP AND NEEDING TO BE RESOLVED. IF WE CAN RESOLVE THE EXISTING ISSUES WITH NHRC, WE SHOULD BE HAPPY.c. What are the changes we want to suggest in the budget and TOR? How would the national coordination with NHRC related to programmatic preparations and conduction of the hearings be organised by JSA? THIS NEEDS A SKYPE DISCUSSION OR SOMETHING - VANDANA SAYS THAT PHRS IS RELUCTANT... SO WHAT ARE THE OPTIONS? I THINK THE SUGGESTION THAT AMIT AND SAROJINI BE IN TEH STEERING COMMITTEE IS GOOD. DO WE NEED TO EMPLOY A SHORT TERM PERSON WHO CAN BE STATIONED IN PHRS AND COORDINATE WITH THE REGIONS?d. We are proceeding with the understanding that PHRN would continue the financial-administrative coordination with NHRC and within JSA, this was done by PHRN ably for the Western region hearing, and endorsement of PHRN continuing this role may be positively reiterated by JSA.e. Do we regard inclusion of private medical sector cases in some form as a kind of non-negotiable for going ahead with further hearings? YES VERY IMPORTANT. BUT WE ALSO HAVE TO LEARN TO FRAME OUR CASES/ANALYSIS IN TERMS OF WHERE THE PUBLIC OFFICE - AND WHICH PUBLIC OFFICE - FAILED IN THEIR RESPONSIBILITY.f. Are we comfortable with going for the Eastern region hearing as the next, maybe in late Feb or March 2017? What would be the further likely sequence of regions? EASTERN REGION HAS TO SAY.g. Would we like to combine any regions in case their likely level of preparedness seems less that the requirements of NHRC? EAST AND NORTH EAST? NORTH AND CENTRAL?Renu KhannaSAHAJ1 Shri Hari Apartment. Near Express Hotel, Alkapuri, Vadodara 390007 - Gujarat, India
From: Abhay Shukla <abhayshukla1@gmail.com>
To: jsa-ncc <jsa-ncc@googlegroups.com>; Vandana <chaukhat@yahoo.com>
Sent: Thursday, October 27, 2016 12:18 AM
Subject: Discussion in NHRC steering committee on public hearings and need for JSA decisions nowDear all,Today (26th Oct.) we had a meeting of the NHRC-JSA steering committee for series of Public hearings on Right to Health care, after a gap of nearly a year. This meeting had been called by NHRC to discuss the further regional hearings, since NHRC has now decided to go ahead with the remaining hearings after the Western Region Hearing (WRH).Vandana and myself represented JSA, while Mohanty (Secy General), Kochher, Savita Bhakhry and other officials represented NHRC. There was also a representative of the Union Health Ministry, who did not make any significant contribution to the discussion.As expected, it was a stormy and difficult meeting, with the threat of breaking down at one stage, since we raised a range of critical issues emerging from the process until now esp. the WRH. We emphasised the need for NHRC to treat JSA as a partner, not a sub-contractor, and pointed out the range of administrative – financial issues as well as spectrum of programme related problems faced by JSA prior to, during and after the WRH. The lack of effective follow up related to several WRH cases where compensations have been ordered but not actually given yet, as well as various deferred cases where no decision has yet been made (such as the Mortuary workers case), was emphasised. Without going into all the details, I will try to put down the main functional points, I am not giving here the detailed discussion on follow up of WRH cases (which was mostly related to specific Maharashtra cases where compensation has been ordered, or cases have been deferred without decision until now) since these details are not relevant for everyone.Some key points that I could put down are as follows, based on which the JSA national coalition needs to take some decision, about whether we want to go ahead with this process and how:a. NHRC has clearly decided to move ahead with the further public hearings. They were expecting the Southern region hearing to be the next, and were proceeding to discuss the dates etc., when we intervened and strongly argued that without resolving various concerns of JSA, we could not discuss the further process. Vandana quite skilfully but clearly communicated the need for clarity on these issues as a precondition for further collaboration. This ‘disruption’ by us nearly led to the meeting being adjourned by Mohanty, but after some back-and-forth, the meeting proceeded.b. It was agreed that the entire Terms of Reference (TOR) for the collaboration, including the budget for the hearings, needs to be revisited. It was emphasised by us that the budget for regional hearings would go up, since the venue costs had been under-estimated and some other costs had not been taken into account which emerged during the WRH. Also that costs of smaller preparatory meetings in various states prior to the hearings need to be built into the budget. Now NHRC has asked for a revised TOR and budget to be submitted by JSA. We tentatively said that this could be given by JSA by 7th November.c. NHRC continued with their insistence that JSA should appoint a ‘National coordinator’, preferably based in Delhi, who would alone deal with NHRC for the hearings. We argued that JSA as a network does not function in this fashion, hence this is not an appropriate demand. We emphasised that for each regional hearing, JSA would have a regional coordinator, who would primarily deal with NHRC regarding the preparation and conduction of that regional hearing. At the same time, it may be possible for JSA to ask for additional funds and appoint a full time / part time person based in Delhi, who could specifically deal with coordination with NHRC for the public hearings. As mentioned in the February JSA-NCC meeting, SATHI would not be in position to give intensive day-today inputs for coordination with NHRC for each of the subsequent hearings. Hence we need to discuss about this issue within JSA.d. Regarding the manner of hearing individual cases related to public health system, we reiterated our concern that systemic aspects should be emphasised, and it should not just be an exercise in targeting certain individual public health system providers. However, NHRC officials stated that given their mode of functioning, dealing with individual cases is what comes in their mandate, and by ordering compensation in some cases, they feel that pressure is put on state health systems to improve. They also stated that Day-2 was devoted to more systemic issues, and this process and related recommendations would continue. Also they are continuing with the idea of having a National hearing at the end of all the regional hearings, where systemic issues emerging from various regions would be focussed. So we need to decide if we would like to proceed, given the manner in which public health system related cases were dealt with in the WRH.e. We mentioned that some cases have been collected in Southern and Eastern region in 2015 in preparation for the then planned hearings, but now they would be falling beyond the one-year time limit of NHRC. We said that these cases should be allowed for presentation in the hearings now. However, according to their rules, those cases that have actually been submitted to NHRC (from Southern region) can be taken since these entered their system within one year of the alleged denial. However other cases which have not been submitted to NHRC would not be taken if the instance of denial is more than a year old.f. Regarding number of cases to be taken up in a particular day by each bench, it was agreed by NHRC that too many cases had been slated in the WRH, in further hearings they would have only 20 cases per bench on one day, which would amount to 60 cases for the hearing based on 3 NHRC Members being present, each member heading a bench. In case overall larger number of cases is received, then based on inputs from JSA regarding the criteria, NHRC would shortlist cases to ensure that during the hearing, there are not over 20 cases per bench.g. Concerning cases related to the Private medical sector, there was again quite some discussion. NHRC accepted that although this component had been planned in all the prior discussions and TOR, such cases were not allowed to be presented in the WRH. We argued as earlier that there was often failure of public regulatory authorities leading to denials in the private medical sector, hence such cases must be taken up by NHRC. Mohanty sort of agreed that some arrangement might be possible to hear private sector related cases, but the final decision would have to be taken by the members of the Commission. They have asked JSA to submit a detailed outline of the kind of private sector cases that could be heard, with justification of public regulatory failure, so that this may be discussed in the Commission.h. NHRC again emphasised that all cases must be submitted with full details, signed statement by the complainant etc. We said that already a JSA format has been prepared, on which all WRH cases and some cases in other regions had been documented, this can be somewhat modified / enlarged to include the mandatory information required by NHRC, and this was agreed. The need for the complainant himself / herself to be present during the hearing was repeated by NHRC.i. Based on our recent communication with activists from Southern and Eastern regions (the two regions that have been next in line) regarding their willingness for preparation, we stated that if we are going ahead, the next region would be Eastern region. We also emphasised that at least three months of preparatory time would be required by any region to go for a hearing, after the TOR has been signed and funds have been released by NHRC. Based on this, the tentative possibility of the Eastern region hearing being held some time in maybe second half of Feb. or March 2017 was discussed.j. Further, the possible scenario was discussed, where perhaps in some particular region adequate preparations in terms of mobilising the required number of cases does not seem feasible to JSA. Here the possibility of combining two contiguous regions to have a single hearing, for example Northern region and Central region (UP + MP) having a single common hearing, was discussed. In this regard again, within JSA we need some discussion and an assessment whether adequate number of cases with the rigour and detail required by NHRC in time bound manner, would be possible to mobilise in all regions.Now based on this situation, within JSA we need to decide on some issues including the following:a. Given this response by NHRC, do we as JSA definitely want to go ahead with the remaining series of public hearings?b. In case we do want to go ahead, are there any other issues that also need to be emphasised to NHRC during the further negotiations?c. What are the changes we want to suggest in the budget and TOR?How would the national coordination with NHRC related to programmatic preparations and conduction of the hearings be organised by JSA?d. We are proceeding with the understanding that PHRN would continue the financial-administrative coordination with NHRC and within JSA, this was done by PHRN ably for the Western region hearing, and endorsement of PHRN continuing this role may be positively reiterated by JSA.e. Do we regard inclusion of private medical sector cases in some form as a kind of non-negotiable for going ahead with further hearings?f. Are we comfortable with going for the Eastern region hearing as the next, maybe in late Feb or March 2017? What would be the further likely sequence of regions?g. Would we like to combine any regions in case their likely level of preparedness seems less that the requirements of NHRC?There may be other issues too that need to be addressed which can be added by others. I would also request Vandana to add any important issues from the discussion, which I may have missed out. Let us circulate our responses by end of this week (30th Oct) if possible, so that we can then move towards some consensus after Diwali, and send a comprehensive response to NHRC by 7th November if possible.Looking forward to timely responses and suggestions,With regards,Abhay--
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With Regards,
Sincerely Yours,
Anant
Anant and Sandhya Phadke,
8, Ameya Ashish Society, Kokan Express Hotel Lane,
Kothrud, Pune 411038
Phone - 020 25460038
Anant - 9423531478
Sincerely Yours,
Anant
Anant and Sandhya Phadke,
8, Ameya Ashish Society, Kokan Express Hotel Lane,
Kothrud, Pune 411038
Phone - 020 25460038
Anant - 9423531478
