A colleague recently asked me a difficult question in the course of a discussion about the increasing complaints against hospitals in the country. He wanted my view on how hospitals could be run in a satisfactory manner and what should be the qualifications of the high-level administrators in the health directorate and hospitals.
There is no magical solution to the problem. The issue needs detailed study and patient implementation of a number of principles. Significant change has to be made in the method of selecting the directors or administrators at various levels in the health sector. I believe that the authorities should stick to some basic principles that govern the appointments to top posts.
The first major principle is that each administrator should know precisely what his duties are. The duties of the director/head of the unit, head of department, assistant director and associate director, executive director etc. should also be equally clearly and precisely defined.
Another significant point is that there should be a fixed pattern for the progression in the administrative ladder. This will guarantee that a higher administrator has actual experience at each level of lower management. For instance, a person in the lower levels of administration should only be promoted after two years to the next highest position and so on all the way to executive management.
An undesirable practice observed these days is the appointment of an executive director in a huge establishment without his having the least idea of the problems at the lower levels. Without first-hand knowledge of the issues at the lower levels, the executive directors are bound to make mistakes.
The third standard should be that a director has the opportunity to acquire certain skills, knowledge, and experience before becoming a higher administrator.
He can acquire these skills as a department head or by attending certain training programs. Academic qualifications should not be the only yardstick for the appointment of a top administrator.
A written test and an interview for selections of top administrative positions are not enough. A higher administrative position calls for wide-ranging experience as well.
There are more than 200 hospitals and about 2,000 health centers, apart from other health institutions, and they require dozens of high-level managers under the Ministry of Health.
It is high time that the ministry took steps to lay down some criteria to guarantee that the directors or managers have genuine administrative and managerial skills.
Administrators should not be appointed in an arbitrary or whimsical manner.
The appointing authorities should not be influenced by personal bias or other personal considerations. Everyone close to a topmost official need not be a good administrator. An admirable companion at social occasions is not necessarily fit for a managerial position.
Everyone who strives to become a manager need not be a good manager. The selection should be made on the basis of foolproof criteria to be laid down after detailed studies.
It would be better in my view to entrust the responsibility of formulating the criteria for managerial selection to experienced management establishments such as the Institute of Public Administration.
The institute would be able to fix the duties of every officer in the administrative hierarchy and also the ways to improve his skills.
The institute should also conduct both theoretical and actual training programs, which each manager should pass in order to be qualified for his position.
