NURSING MANAGEMENT
UNIT I: INTRODUCTION
Administer derived from the Latin word ―ad ministraire- to care for or to look after people to manage affairs. Administration is the activities of groups co-operating to accomplish common goals. -Herbert A Simon Administration may be defined as the management of affairs with the use of well thought out principles and practices and rationalized techniques to achieve certain objectives. - Goel
DEFINITION: ADMINISTRATION:
Administration is the organization and direction of human and material resources to achieve desired ends‖ - Pfiffner and presthus
Administration has to do with getting things done; with the accomplishment of defined objectives. - Luther Gullick
MANAGEMENT:
• Management may be defined as the art of securing maximum results with a minimum of effort so as to secure maximum prosperity and happiness for both employer and employee and give the public the best possible service. - John Mee
• Management is distinct process consisting of planning, organising, actuating, activating and controlling, performed to determine and accomplish the objectives by the use of people and resources. - George
Management and Administration: These two words are slightly similar and can employ interchangeable.
Management‘ refers to private sector. Whereas administration refers to public sector.
Management or Administration is the process for exceeding the goal expected."
- Derek French and Heather Saward.
Difference between administration and management
Basis of difference
Administration
Management
Nature of work
It is concerned about the determination of objectives and major policies of an organization
It puts into action the policies and plans laid down by the administration.
Type of function
It is a determinative function
It is an executive function
Scope
It takes major decisions of an enterprise as a whole
It takes decisions within the framework set by the administration.
Level of authority
It is a top-level activity.
It is a middle level activity
Nature of status
It consists of owners who invest capital in and receive profits from an enterprise.
It is a group of managerial personnel who use their specialized knowledge to fulfill the objectives of an enterprise
Nature of usage
It is popular with government, military, educational, and religious organizations.
It is used in business enterprises.
Decision making
Its decisions are influenced by public opinion, government policies, social, and religious factors.
Its decisions are influenced by the values, opinions, and beliefs of the managers.
Main functions
Planning and organizing functions are involved in it.
Motivating and controlling functions are involved in it.
Abilities
It needs administrative rather than technical abilities.
It requires technical activities
Managerial Concerns: Efficiency - ―Doing things right‖ Getting the most output for the least inputs Effectiveness - ―Doing the right things‖ Attaining organizational goals .
Who are Managers?
Someone who coordinates and overseas the work of other people so that organizational goals are accomplished. First-line Managers Individuals who manage the work of non-managerial employees. Middle Managers Individuals who manage the work of first-line managers. Top Managers Individuals who are responsible for making organization-wide decisions and establishing plans and goals that affect the entire organization. Functions:
• Planning - Defining goals, establishing strategies to achieve goals, developing plans to integrate and coordinate activities.
• Organizing - Arranging and structuring work to accomplish organizational goals.
• Leading - Working with and through people to accomplish goals.
• Controlling - Monitoring, comparing, and correcting work.
Role:
• Interpersonal roles - Figurehead, leader, liaison
• Informational roles - Monitor, disseminator, Spokesperson
• Decisional roles - Entrepreneur, Disturbance handler, resource allocator, negotiator
Skills:
• Technical skills - Knowledge and proficiency in a specific field
• Human skills - The ability to work well with other people
• Conceptual skills - The ability to think and conceptualize about abstract and complex situations concerning the organization
Importance of management: The Value of Studying Management:
The universality of management
Good management is needed in all organizations.
The reality of work
Employees either manage or are managed.
Rewards and challenges of being a manager
Management offers challenging, exciting and creative opportunities for meaningful and fulfilling work.
Successful managers receive significant monetary rewards for their efforts.
PHILOSOPHIES OF ADMINISTRATION
Philosophy is based on the following key points: Administration believes in:
• Cost effectiveness
• Execution and control of work plans
• Delegation of responsibility
• Human relations and good morale
• Effective communication
• Flexibility in certain situation
PRINCIPLES OF ADMINISTRATION
Meaning of management principles: Management principles are statements of fundamental truth which act as guidelines for taking managerial action. Management principles are derived and developed in the following two steps. (a) Deep Observations (b) Repeated experiments Henri Fayol (1841 - 1925): Graduated from the National School of Mines in Saint Etrenne in 1860
Fayol’s 14 principles of management
1. Division of Work. Specialization allows the individual to build up experience, and to continuously improve his skills. Thereby he can be more productive. Small task, Competent, Specialization, Efficiency, Effectiveness
2. Principle of Authority and Responsibility Authority means power to take decisions. Responsibility means obligation to complete the job assigned
3. Principle of discipline: General rules and regulations for systematic working in an organization.
4. Principle of unity of command: Employee should receive orders from one boss only
5. Unity of direction: All the efforts of the members and employees of the organization must be directed to one direction that is the achievement of common goal.
6. Subordination of individual interest to general interest: Subordination of individual interest to general interest the interest of the organization must supersede the interest of the individuals.
7. Principle of remuneration of persons: Employees must be paid fairly or adequately to give them maximum satisfaction
8. Principle of centralization and decentralization: Centralization refers to concentration of power in few hands. Decentralization means evenly distribution of power at every level.
9. Principle of scalar chain: Means line of authority or chain of superiors from highest to lowest rank
10. Principle of Order: Principle of Order It refers to orderly arrangement of men and material a fixed place for everything and everyone in the organization
11. Principle of Equity: Principle of Equity Fair and just treatment to employees.
12. Stability of tenure of personnel: Stability of tenure of personnel No frequent termination or transfer.
13. Principle of Initiative: Principle of Initiative Employees must be given opportunity to take some initiative in making and executing a plan
14. Principle of Esprit De Corps: Principle of Esprit De Corps Means union is strength.
ELEMENTS OF ADMINISTRATION: POSDCORB”
• Planning
• Organizing
• Staffing
• Directing
• Co-ordinating
• Reporting
• Budgeting
SCOPE OF ADMINISTRATION
Political: Functions of the administration includes the executive –legislative relationship.
Defensive: It covers the hospital protective functions.
Economic: Concerns with the vast area of the health care activities.
Educational: Its involves educational administration in its broadest senses.
Legislative: It includes most not mealy delegated legislation, but the preparatory work done by the administrative officials.
Financial: It includes the whole of financial, budget, inventory control managements.
Social: It includes the activities of the department s concerned with food, social factors.
Local: It concerned with the activities of the local bodies.
INDIAN CONSTITUTION
Introduction
The majority of the Indian subcontinent was under British colonial rule from 1858 to 1947. This period saw the gradual rise of the Indian nationalist movement to gain independence from the foreign rule. The movement culminated in the formation of the on 15 August 1947, along with the Dominion of Pakistan. The constitution of India was adopted on 26 January 1950, which proclaimed India to be a sovereign democratic republic.
Evolution of the Constitution Acts of British Parliament before 1935
After the Indian Rebellion of 1857, the British Parliament took over the reign of India from the British East India Company, and British India came under the direct rule of the Crown. The British Parliament passed the Government of India Act of 1858 to this effect, which set up the structure of British government in India.
Government of India Act 1935
The provisions of the Government of India Act of 1935, though never implemented fully, had a great impact on the constitution of India. The federal structure of government, provincial autonomy, bicameral legislature consisting of a federal assembly and a Council of States, separation of legislative powers between center and provinces are some of the provisions of the Act which are present in the Indian constitution.
The Cabinet Mission Plan
In 1946, at the initiative of British Prime Minister Clement Attlee, a cabinet mission to India was formulated to discuss and finalize plans for the transfer of power from the British Raj to Indian leadership and providing India with independence under Dominion status in the Commonwealth of Nations. The Mission discussed the framework of the constitution and laid
down in some detail the procedure to be followed by the constitution drafting body. Elections for the 296 seats assigned to the British Indian provinces were completed by August 1946. The Constituent Assembly first met and began work on 9 December 1946.
Indian Independence Act 1947
The Indian Independence Act, which came into force on 18 July 1947, divided the British Indian territory into two new states of India and Pakistan, which were to be dominions under the Commonwealth of Nations until their constitutions were in effect.
Constituent Assembly
The Constitution was drafted by the Constituent Assembly, which was elected by the elected members of the provincial assemblies. Jawaharlal Nehru, C. Rajagopalachari, Rajendra Prasad, SardarVallabhbhai Patel, MaulanaAbulKalam Azad, Shyama Prasad Mukherjee and NaliniRanjanGhosh were some important figures in the Assembly. In the 14 August 1947 meeting of the Assembly, a proposal for forming various committees was presented. Such committees included a Committee on Fundamental Rights, the Union Powers Committee and Union Constitution Committee. On 29 August 1947, the Drafting Committee was appointed, with DrAmbedkar as the Chairman along with six other members. A Draft Constitution was prepared by the committee and submitted to the Assembly on 4 November 1947.
Parts Parts are the individual chapters in the Constitution, focused in single broad field of laws, containing articles that address the issues in question.
Preamble
Part I - Union and its Territory
Part II - Citizenship.
Part III- Fundamental Rights
Part IV - Directive Principles and Fundamental Duties.
Part V- The Union.
Part VI- The States.
Part VII - States in the B part of the First schedule (Repealed).
Part VIII - The Union Territories
Part IX - Panchayat system and Municipalities.
Part X - The scheduled and Tribal Areas
Part XI - Relations between the Union and the States.
Part XII - Finance, Property, Contracts and Suits
Part XIII - Trade and Commerce within the territory of India
Part XIV - Services Under the Union, the States and Tribunals
Part XV - Elections
Part XVI - Special Provisions Relating to certain Classes.
Part XVII - Languages
Part XVIII - Emergency Provisions
Part XIX - Miscellaneous
Part XX - Amendment of the Constitution
Part XXI - Temporary, Transitional and Special Provisions
Part XXII - Short title, date of commencement, Authoritative text in Hindi and Repeals
Federal Structure
The constitution provides for distribution of powers between the Union and the States. It enumerates the powers of the Parliament and State Legislatures in three lists, namely Union list, State list and Concurrent list. Subjects like national defense, foreign policy, issuance of currency are reserved to the Union list. Public order, local governments, certain taxes are examples of subjects of the State List, on which the Parliament has no power to enact laws in those regards, barring exceptional conditions. Education, transportation, criminal laws are a few subjects of the Concurrent list, where both the State Legislature as well as the Parliament has powers to enact laws.
Changing the constitution
In 2000 the National Commission to Review the Working of the Constitution (NCRWC) was setup to look into updating the constitution of India.
Judicial review of laws
Judicial review is actually adopted in the Indian constitution from the constitution of the United States of America. In the Indian constitution, Judicial Review is dealt under Article 13. Judicial Review actually refers that the Constitution is the supreme power of the nation and all laws are under its supremacy. Article 13 deals that 1. All pre-constitutional laws, after the coming into force of constitution, if in conflict with it in all or some of its provisions then the provisions of constitution will prevail. If it is compatible with the constitution as amended. This is called the Theory of Eclipse.
2. In a similar manner, laws made after adoption of the Constitution by the Constituent Assembly must be compatible with the constitution, otherwise the laws and amendments will be deemed to be void-ab-initio. In such situations, the Supreme Court or High Court interprets the laws as if they are in conformity with the constitution.
HEALTH CARE DELIVERY SYSTEM IN INDIA
Introduction
Health is the birth right of every individual. Today health is considered more than a basic human right; it has become a matter of public concern, national priority and political action. Our health system has traditionally been a disease-oriented system but the current trend is to emphasize health and its promotion.
Selected health care definitions:
Health: According to WHO, health is defined as ―a dynamic state of complete physical, mental and social well-being not merely an absence of disease or infirmity.‖
Health care services: It is defined as ―multitude of services rendered to individuals, families or communities by the agents of the health services or professions for the purpose of promoting, maintaining, monitoring or restoring health.‖
Definitions of health care delivery:
1. Health care delivery system refers to the totality of resources that a population or society distributes in the organization and delivery of health population services. It also includes all personal and public services performed by individuals or institutions for the purpose of maintaining or restoring health. -Stanhope(2001)
2. It implies the organization, delivery staffing regulation and quality control.
J.C.Pak(2001)
Philosophy of Health Care Delivery System:
Everyone from birth to death is part of the market potential for health care services.
The consumer of health care services is a client and not customer.
Consumers are less informed about health services than anything else they purchase.
Health care system is unique because it is not a competitive market.
Restricted entry in to the health care system.
Goals/Objectives of Health Care Delivery System:
1) To improve the health status of population and the clinical outcomes of care.
2) To improve the experience of care of patients families and communities.
3) To reduce the total economic burden of care and illness.
4) To improve social justice equity in the health status of the population.
Principles of Health Care Delivery System:
1. Supports a coordinated, cohesive health-care delivery system.
2. Opposes the concept that fee-for-practice.
3. Supports the concept of prepaid group practice.
4. Supports the establishment of community based, community controlled health-care system.
5. Urges an emphasis be placed on development of primary care
6. Emphasizes on quality assurance of the care
7. Supports health care as basic human right for all people.
8. Opposes the accrual of profits by health-care-related industries.
Functions of Health Care Delivery System:
1) To provide health services.
2) To raise and pool the resources accessible to pay for health care.
3) To generate human and physical sources that makes the delivery service possible.
4) To set and enforce rules of the game and provide strategic direction for all the different players involved.
Characters of Health Care Delivery System:
1) Orientation toward health.
2) Population perspective.
3) Intensive use of information.
4) Focus on consumer.
5) Knowledge of treatment outcome.
6) Constrained resources.
HEALTH CARE DELIVERY SYSTEM IN INDIA
In India it is represented by five major sectors or agencies which differ from each other by health technology applied and by the source of fund available. These are:
I. PUBLIC HEALTH SECTOR
A. Primary Health Care
Primary health centres. Sub- centres.
B. Hospital/Health Centres
Community health centres. Rural health centres. District hospitals/health centre. Specialist hospitals. Teaching hospitals.
C. Health Insurance Schemes
Employees State Insurance. Central Govt. Health Scheme.
D. Other Agencies
Defence services. Railways.
II. PRIVATE SECTOR
A. Private hospitals, polyclinics, nursing homes and dispensaries.
B. General practitioners and clinics.
III. INDIGENOUS SYSTEMS OF MEDICINE
Ayurveda
Sidda
Unani
Homeopathy
Naturopathy
Yoga
Unregistered practioners.
IV. VOLUNTARY HEALTH AGENCIES
V. NATIONAL HEALTH PROGRAMMES
ORGANIZATION AND ADMINISTRATION OF HEALTH SERVICES IN INDIA AT DIFFERENT LEVELS.
India is a union of 28 states and 7 Union territories. Under the constitution states are largely independent in matters relating to the delivery of health care to the people. Each State, therefore, as developed its own system of health care delivery, independent of the Central Government.
Health administration at the central level The official organs of the health system at the national level consist of 3 units:
1. Union Ministry of Health and Family Welfare.
2. The Directorate General of Health Services.
3. The Central Council of Health and Family Welfare.
I. Union Ministry of Health and Family Welfare Organisation The Union Ministry of Health and Family Welfare is headed by a Cabinet Minister, a Minister of State, and a Deputy Health Minister. These are political appointment and have dual role to serve political as well as administrative responsibilities for health. Currently the union health ministry has the following departments:
1. Department of Health
2. Department of Family Welfare
3. Department of Indian System of Medicine and Homoeopathy
a. Department of Health
It is headed by a secretary to the Government of India as its executive head, assisted by joint secretaries, deputy secretaries, and a large administrative staff.
Functions Union list
1. International health relations and administration of port-quarantine
2. Administration of central health institutes such as All India Institute of Hygiene and Public Health, Kolkata; National Institute for Control of Communicable Diseases, Delhi, etc.
3. Promotion of research through research centres and other bodies.
4. Regulation and development of medical, nursing and other allied health professions.
5. Establishment and maintenance of drug standards.
6. Census, and collection and publication of other statistical data.
7. Immigration and emigration.
8. Regulation of labour in the working of mines and oil fields and
Concurrent list
The functions listed under the concurrent list are the responsibility of both the union and state governments. The centre and states have simultaneous powers of legislation. They are as follows:
1. Prevention of extension of communicable diseases from one unit to another.
2. Prevention of adulteration of food stuffs.
3. Control of drugs and poisons.
4. Vital statistics.
5. Labour welfare.
6. Ports other than major.
7. Economic and social health planning
8. Population control and family planning.
Department of Family Welfare
It was created in 1966 within the Ministry of Health and Family Welfare. The secretary to the Government of India in the Ministry of Health and Family Welfare is in overall charge of the Department of Family Welfare. He is assisted by an additional secretary and commissioner, and one joint secretary. The following divisions are functioning in the department of family welfare.
1. Programme appraisal and special scheme
2. Technical operations: looks after all components of the technical programme viz. Sterilization/IUD/Nirodh, post partum, maternal and child health, UPI, etc.
3. Maternal and child health
4. Evaluation and intelligence: helps in planning, monitoring and evaluating the programme performance and coordinates demographic research.
5. Nirodh marketing supply/ distribution
Functions a. To organize family welfare programme through family welfare centres. b. To create an atmosphere of social acceptance of the programme and to support all voluntary organizations interested in the programme. c. To educate every individual to develop a conviction that a small family size is valuable and to popularize appropriate and acceptable method of family planning d. To disseminate the knowledge on the practice of family planning as widely as possible and to provide service agencies nearest to the community.
Administer derived from the Latin word ―ad ministraire- to care for or to look after people to manage affairs. Administration is the activities of groups co-operating to accomplish common goals. -Herbert A Simon Administration may be defined as the management of affairs with the use of well thought out principles and practices and rationalized techniques to achieve certain objectives. - Goel
DEFINITION: ADMINISTRATION:
Administration is the organization and direction of human and material resources to achieve desired ends‖ - Pfiffner and presthus
Administration has to do with getting things done; with the accomplishment of defined objectives. - Luther Gullick
MANAGEMENT:
• Management may be defined as the art of securing maximum results with a minimum of effort so as to secure maximum prosperity and happiness for both employer and employee and give the public the best possible service. - John Mee
• Management is distinct process consisting of planning, organising, actuating, activating and controlling, performed to determine and accomplish the objectives by the use of people and resources. - George
Management and Administration: These two words are slightly similar and can employ interchangeable.
Management‘ refers to private sector. Whereas administration refers to public sector.
Management or Administration is the process for exceeding the goal expected."
- Derek French and Heather Saward.
Difference between administration and management
Basis of difference
Administration
Management
Nature of work
It is concerned about the determination of objectives and major policies of an organization
It puts into action the policies and plans laid down by the administration.
Type of function
It is a determinative function
It is an executive function
Scope
It takes major decisions of an enterprise as a whole
It takes decisions within the framework set by the administration.
Level of authority
It is a top-level activity.
It is a middle level activity
Nature of status
It consists of owners who invest capital in and receive profits from an enterprise.
It is a group of managerial personnel who use their specialized knowledge to fulfill the objectives of an enterprise
Nature of usage
It is popular with government, military, educational, and religious organizations.
It is used in business enterprises.
Decision making
Its decisions are influenced by public opinion, government policies, social, and religious factors.
Its decisions are influenced by the values, opinions, and beliefs of the managers.
Main functions
Planning and organizing functions are involved in it.
Motivating and controlling functions are involved in it.
Abilities
It needs administrative rather than technical abilities.
It requires technical activities
Managerial Concerns: Efficiency - ―Doing things right‖ Getting the most output for the least inputs Effectiveness - ―Doing the right things‖ Attaining organizational goals .
Who are Managers?
Someone who coordinates and overseas the work of other people so that organizational goals are accomplished. First-line Managers Individuals who manage the work of non-managerial employees. Middle Managers Individuals who manage the work of first-line managers. Top Managers Individuals who are responsible for making organization-wide decisions and establishing plans and goals that affect the entire organization. Functions:
• Planning - Defining goals, establishing strategies to achieve goals, developing plans to integrate and coordinate activities.
• Organizing - Arranging and structuring work to accomplish organizational goals.
• Leading - Working with and through people to accomplish goals.
• Controlling - Monitoring, comparing, and correcting work.
Role:
• Interpersonal roles - Figurehead, leader, liaison
• Informational roles - Monitor, disseminator, Spokesperson
• Decisional roles - Entrepreneur, Disturbance handler, resource allocator, negotiator
Skills:
• Technical skills - Knowledge and proficiency in a specific field
• Human skills - The ability to work well with other people
• Conceptual skills - The ability to think and conceptualize about abstract and complex situations concerning the organization
Importance of management: The Value of Studying Management:
The universality of management
Good management is needed in all organizations.
The reality of work
Employees either manage or are managed.
Rewards and challenges of being a manager
Management offers challenging, exciting and creative opportunities for meaningful and fulfilling work.
Successful managers receive significant monetary rewards for their efforts.
PHILOSOPHIES OF ADMINISTRATION
Philosophy is based on the following key points: Administration believes in:
• Cost effectiveness
• Execution and control of work plans
• Delegation of responsibility
• Human relations and good morale
• Effective communication
• Flexibility in certain situation
PRINCIPLES OF ADMINISTRATION
Meaning of management principles: Management principles are statements of fundamental truth which act as guidelines for taking managerial action. Management principles are derived and developed in the following two steps. (a) Deep Observations (b) Repeated experiments Henri Fayol (1841 - 1925): Graduated from the National School of Mines in Saint Etrenne in 1860
Fayol’s 14 principles of management
1. Division of Work. Specialization allows the individual to build up experience, and to continuously improve his skills. Thereby he can be more productive. Small task, Competent, Specialization, Efficiency, Effectiveness
2. Principle of Authority and Responsibility Authority means power to take decisions. Responsibility means obligation to complete the job assigned
3. Principle of discipline: General rules and regulations for systematic working in an organization.
4. Principle of unity of command: Employee should receive orders from one boss only
5. Unity of direction: All the efforts of the members and employees of the organization must be directed to one direction that is the achievement of common goal.
6. Subordination of individual interest to general interest: Subordination of individual interest to general interest the interest of the organization must supersede the interest of the individuals.
7. Principle of remuneration of persons: Employees must be paid fairly or adequately to give them maximum satisfaction
8. Principle of centralization and decentralization: Centralization refers to concentration of power in few hands. Decentralization means evenly distribution of power at every level.
9. Principle of scalar chain: Means line of authority or chain of superiors from highest to lowest rank
10. Principle of Order: Principle of Order It refers to orderly arrangement of men and material a fixed place for everything and everyone in the organization
11. Principle of Equity: Principle of Equity Fair and just treatment to employees.
12. Stability of tenure of personnel: Stability of tenure of personnel No frequent termination or transfer.
13. Principle of Initiative: Principle of Initiative Employees must be given opportunity to take some initiative in making and executing a plan
14. Principle of Esprit De Corps: Principle of Esprit De Corps Means union is strength.
ELEMENTS OF ADMINISTRATION: POSDCORB”
• Planning
• Organizing
• Staffing
• Directing
• Co-ordinating
• Reporting
• Budgeting
SCOPE OF ADMINISTRATION
Political: Functions of the administration includes the executive –legislative relationship.
Defensive: It covers the hospital protective functions.
Economic: Concerns with the vast area of the health care activities.
Educational: Its involves educational administration in its broadest senses.
Legislative: It includes most not mealy delegated legislation, but the preparatory work done by the administrative officials.
Financial: It includes the whole of financial, budget, inventory control managements.
Social: It includes the activities of the department s concerned with food, social factors.
Local: It concerned with the activities of the local bodies.
INDIAN CONSTITUTION
Introduction
The majority of the Indian subcontinent was under British colonial rule from 1858 to 1947. This period saw the gradual rise of the Indian nationalist movement to gain independence from the foreign rule. The movement culminated in the formation of the on 15 August 1947, along with the Dominion of Pakistan. The constitution of India was adopted on 26 January 1950, which proclaimed India to be a sovereign democratic republic.
Evolution of the Constitution Acts of British Parliament before 1935
After the Indian Rebellion of 1857, the British Parliament took over the reign of India from the British East India Company, and British India came under the direct rule of the Crown. The British Parliament passed the Government of India Act of 1858 to this effect, which set up the structure of British government in India.
Government of India Act 1935
The provisions of the Government of India Act of 1935, though never implemented fully, had a great impact on the constitution of India. The federal structure of government, provincial autonomy, bicameral legislature consisting of a federal assembly and a Council of States, separation of legislative powers between center and provinces are some of the provisions of the Act which are present in the Indian constitution.
The Cabinet Mission Plan
In 1946, at the initiative of British Prime Minister Clement Attlee, a cabinet mission to India was formulated to discuss and finalize plans for the transfer of power from the British Raj to Indian leadership and providing India with independence under Dominion status in the Commonwealth of Nations. The Mission discussed the framework of the constitution and laid
down in some detail the procedure to be followed by the constitution drafting body. Elections for the 296 seats assigned to the British Indian provinces were completed by August 1946. The Constituent Assembly first met and began work on 9 December 1946.
Indian Independence Act 1947
The Indian Independence Act, which came into force on 18 July 1947, divided the British Indian territory into two new states of India and Pakistan, which were to be dominions under the Commonwealth of Nations until their constitutions were in effect.
Constituent Assembly
The Constitution was drafted by the Constituent Assembly, which was elected by the elected members of the provincial assemblies. Jawaharlal Nehru, C. Rajagopalachari, Rajendra Prasad, SardarVallabhbhai Patel, MaulanaAbulKalam Azad, Shyama Prasad Mukherjee and NaliniRanjanGhosh were some important figures in the Assembly. In the 14 August 1947 meeting of the Assembly, a proposal for forming various committees was presented. Such committees included a Committee on Fundamental Rights, the Union Powers Committee and Union Constitution Committee. On 29 August 1947, the Drafting Committee was appointed, with DrAmbedkar as the Chairman along with six other members. A Draft Constitution was prepared by the committee and submitted to the Assembly on 4 November 1947.
Parts Parts are the individual chapters in the Constitution, focused in single broad field of laws, containing articles that address the issues in question.
Preamble
Part I - Union and its Territory
Part II - Citizenship.
Part III- Fundamental Rights
Part IV - Directive Principles and Fundamental Duties.
Part V- The Union.
Part VI- The States.
Part VII - States in the B part of the First schedule (Repealed).
Part VIII - The Union Territories
Part IX - Panchayat system and Municipalities.
Part X - The scheduled and Tribal Areas
Part XI - Relations between the Union and the States.
Part XII - Finance, Property, Contracts and Suits
Part XIII - Trade and Commerce within the territory of India
Part XIV - Services Under the Union, the States and Tribunals
Part XV - Elections
Part XVI - Special Provisions Relating to certain Classes.
Part XVII - Languages
Part XVIII - Emergency Provisions
Part XIX - Miscellaneous
Part XX - Amendment of the Constitution
Part XXI - Temporary, Transitional and Special Provisions
Part XXII - Short title, date of commencement, Authoritative text in Hindi and Repeals
Federal Structure
The constitution provides for distribution of powers between the Union and the States. It enumerates the powers of the Parliament and State Legislatures in three lists, namely Union list, State list and Concurrent list. Subjects like national defense, foreign policy, issuance of currency are reserved to the Union list. Public order, local governments, certain taxes are examples of subjects of the State List, on which the Parliament has no power to enact laws in those regards, barring exceptional conditions. Education, transportation, criminal laws are a few subjects of the Concurrent list, where both the State Legislature as well as the Parliament has powers to enact laws.
Changing the constitution
In 2000 the National Commission to Review the Working of the Constitution (NCRWC) was setup to look into updating the constitution of India.
Judicial review of laws
Judicial review is actually adopted in the Indian constitution from the constitution of the United States of America. In the Indian constitution, Judicial Review is dealt under Article 13. Judicial Review actually refers that the Constitution is the supreme power of the nation and all laws are under its supremacy. Article 13 deals that 1. All pre-constitutional laws, after the coming into force of constitution, if in conflict with it in all or some of its provisions then the provisions of constitution will prevail. If it is compatible with the constitution as amended. This is called the Theory of Eclipse.
2. In a similar manner, laws made after adoption of the Constitution by the Constituent Assembly must be compatible with the constitution, otherwise the laws and amendments will be deemed to be void-ab-initio. In such situations, the Supreme Court or High Court interprets the laws as if they are in conformity with the constitution.
HEALTH CARE DELIVERY SYSTEM IN INDIA
Introduction
Health is the birth right of every individual. Today health is considered more than a basic human right; it has become a matter of public concern, national priority and political action. Our health system has traditionally been a disease-oriented system but the current trend is to emphasize health and its promotion.
Selected health care definitions:
Health: According to WHO, health is defined as ―a dynamic state of complete physical, mental and social well-being not merely an absence of disease or infirmity.‖
Health care services: It is defined as ―multitude of services rendered to individuals, families or communities by the agents of the health services or professions for the purpose of promoting, maintaining, monitoring or restoring health.‖
Definitions of health care delivery:
1. Health care delivery system refers to the totality of resources that a population or society distributes in the organization and delivery of health population services. It also includes all personal and public services performed by individuals or institutions for the purpose of maintaining or restoring health. -Stanhope(2001)
2. It implies the organization, delivery staffing regulation and quality control.
J.C.Pak(2001)
Philosophy of Health Care Delivery System:
Everyone from birth to death is part of the market potential for health care services.
The consumer of health care services is a client and not customer.
Consumers are less informed about health services than anything else they purchase.
Health care system is unique because it is not a competitive market.
Restricted entry in to the health care system.
Goals/Objectives of Health Care Delivery System:
1) To improve the health status of population and the clinical outcomes of care.
2) To improve the experience of care of patients families and communities.
3) To reduce the total economic burden of care and illness.
4) To improve social justice equity in the health status of the population.
Principles of Health Care Delivery System:
1. Supports a coordinated, cohesive health-care delivery system.
2. Opposes the concept that fee-for-practice.
3. Supports the concept of prepaid group practice.
4. Supports the establishment of community based, community controlled health-care system.
5. Urges an emphasis be placed on development of primary care
6. Emphasizes on quality assurance of the care
7. Supports health care as basic human right for all people.
8. Opposes the accrual of profits by health-care-related industries.
Functions of Health Care Delivery System:
1) To provide health services.
2) To raise and pool the resources accessible to pay for health care.
3) To generate human and physical sources that makes the delivery service possible.
4) To set and enforce rules of the game and provide strategic direction for all the different players involved.
Characters of Health Care Delivery System:
1) Orientation toward health.
2) Population perspective.
3) Intensive use of information.
4) Focus on consumer.
5) Knowledge of treatment outcome.
6) Constrained resources.
HEALTH CARE DELIVERY SYSTEM IN INDIA
In India it is represented by five major sectors or agencies which differ from each other by health technology applied and by the source of fund available. These are:
I. PUBLIC HEALTH SECTOR
A. Primary Health Care
Primary health centres. Sub- centres.
B. Hospital/Health Centres
Community health centres. Rural health centres. District hospitals/health centre. Specialist hospitals. Teaching hospitals.
C. Health Insurance Schemes
Employees State Insurance. Central Govt. Health Scheme.
D. Other Agencies
Defence services. Railways.
II. PRIVATE SECTOR
A. Private hospitals, polyclinics, nursing homes and dispensaries.
B. General practitioners and clinics.
III. INDIGENOUS SYSTEMS OF MEDICINE
Ayurveda
Sidda
Unani
Homeopathy
Naturopathy
Yoga
Unregistered practioners.
IV. VOLUNTARY HEALTH AGENCIES
V. NATIONAL HEALTH PROGRAMMES
ORGANIZATION AND ADMINISTRATION OF HEALTH SERVICES IN INDIA AT DIFFERENT LEVELS.
India is a union of 28 states and 7 Union territories. Under the constitution states are largely independent in matters relating to the delivery of health care to the people. Each State, therefore, as developed its own system of health care delivery, independent of the Central Government.
Health administration at the central level The official organs of the health system at the national level consist of 3 units:
1. Union Ministry of Health and Family Welfare.
2. The Directorate General of Health Services.
3. The Central Council of Health and Family Welfare.
I. Union Ministry of Health and Family Welfare Organisation The Union Ministry of Health and Family Welfare is headed by a Cabinet Minister, a Minister of State, and a Deputy Health Minister. These are political appointment and have dual role to serve political as well as administrative responsibilities for health. Currently the union health ministry has the following departments:
1. Department of Health
2. Department of Family Welfare
3. Department of Indian System of Medicine and Homoeopathy
a. Department of Health
It is headed by a secretary to the Government of India as its executive head, assisted by joint secretaries, deputy secretaries, and a large administrative staff.
Functions Union list
1. International health relations and administration of port-quarantine
2. Administration of central health institutes such as All India Institute of Hygiene and Public Health, Kolkata; National Institute for Control of Communicable Diseases, Delhi, etc.
3. Promotion of research through research centres and other bodies.
4. Regulation and development of medical, nursing and other allied health professions.
5. Establishment and maintenance of drug standards.
6. Census, and collection and publication of other statistical data.
7. Immigration and emigration.
8. Regulation of labour in the working of mines and oil fields and
Concurrent list
The functions listed under the concurrent list are the responsibility of both the union and state governments. The centre and states have simultaneous powers of legislation. They are as follows:
1. Prevention of extension of communicable diseases from one unit to another.
2. Prevention of adulteration of food stuffs.
3. Control of drugs and poisons.
4. Vital statistics.
5. Labour welfare.
6. Ports other than major.
7. Economic and social health planning
8. Population control and family planning.
Department of Family Welfare
It was created in 1966 within the Ministry of Health and Family Welfare. The secretary to the Government of India in the Ministry of Health and Family Welfare is in overall charge of the Department of Family Welfare. He is assisted by an additional secretary and commissioner, and one joint secretary. The following divisions are functioning in the department of family welfare.
1. Programme appraisal and special scheme
2. Technical operations: looks after all components of the technical programme viz. Sterilization/IUD/Nirodh, post partum, maternal and child health, UPI, etc.
3. Maternal and child health
4. Evaluation and intelligence: helps in planning, monitoring and evaluating the programme performance and coordinates demographic research.
5. Nirodh marketing supply/ distribution
Functions a. To organize family welfare programme through family welfare centres. b. To create an atmosphere of social acceptance of the programme and to support all voluntary organizations interested in the programme. c. To educate every individual to develop a conviction that a small family size is valuable and to popularize appropriate and acceptable method of family planning d. To disseminate the knowledge on the practice of family planning as widely as possible and to provide service agencies nearest to the community.
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