I interact with many administrators of public hospitals, and a fair number of these are honest and efficient. The disturbing thing is however, the extent to which most administrators are unaware and untrained in all aspects of hospital and public health management: from infection control to inventory maintenance.

It is difficult to see how an administrator can achieve optimum results without basic management tools, no matter how good the intentions.

Process improvements to reduce wastage of precious resources can be implemented and sustained only if adequately trained administrators man the hospital and impart this training to all the ground staff. This is the most cost effective measure of improving quality in our public hospitals. All administrators should have a thorough working knowledge of lean operations, finance, human resource management, information technology and epidemiology.

The central government should lay a basic syllabus to which every state adds its state-specific modules for an eighteen month diploma/degree in hospital and public health administration which is mandatory for all administrators’ right from community hospital administrators onwards. The course structure should incorporate five to six three-week internships with defined projects and outcomes: in a community to map community needs, a Primary Health Centre and Community Health Centre, a District Hospital, a government teaching hospital and a large private hospital.

We also need to have Management Development Programmes of Public Health for central and state Health Ministry officials arranged in institutes like TISS.

This investment shall provide the best returns in medium to long term: building and maintaining chassis makes sense if we also invest in the engine and wheels.