Observations by Shri Ashok U. Lavasa, December, 2002.

Mr. Ashok U. Lavasa, a member of the Indian Administrative Service (IAS) - Haryana Cadre, visited the Institute from 16-18 December, 2002. By this time, he had completed his posting as Joint Secretary to Government of India in the Department of Economic Affairs. During the period of his visit, he was on leave preparatory to taking up a course of study at the National Defence College, Delhi. During his visit to the IHS, Shri Lavasa examined institutional documents, and interacted with the Faculty and Staff.

The following is a verbatim reproduction of Shri Lavasa's observations about the Institute, from the email sent by him, to Dr. Prasanta Mahapatra, the then Director, IHS.

Date: Fri, 20 Dec 2002 11:40:05 +0500 (GMT)
From: Sh Ashok Lavasa

1. I visited the Institute of Health Systems (IHS) at the invitation of the Institute to associate myself as a Visiting Fellow. During my 3-day stay at the Institute I had interaction with the Faculty members as well as other members of the staff. I also spoke at some length to the Director about the activities of the Institute of Health Systems and his vision of its future. I also got a chance to discuss the affairs of the Institute with the Chairman.
2. Most of my discussions with the staff revolved around the work that they had undertaken in this Institute, the ongoing projects and the proposals that they had either submitted or were working on their preparation. I also asked them about the organization's culture, their sense of satisfaction with their current responsibilities, and their perception of the Institute's future and its strengths and the areas of improvement. Of course, part of my discussion regarding the Institute's future pertained to the impending departure of the present Director whose tenure would end next year. Without elaborating on my discussion on this issue, I would like to state that everyone that I spoke to, without any exception, exuded confidence in the Institute's capability of surviving the departure of the present Director. I think this bodes well for the Institute's future.
3. There is wide appreciation for the role that Dr.Mahapatra has played in building this Institute and the great knowledge and experience that he brings to bear in his work. He has toiled hard to develop a professional culture. Indeed, most people that I spoke to mentioned teamwork as one of the strengths of the Institute. During my limited interaction with them, and by seeing the Institute at work in the last three days, one could sense team spirit at work. There is an air of informality and yet everybody goes about his business in right earnest. Going through the manuals that I saw and based on my discussion, I found that one of the several strengths of IHS is the system it has evolved for its own working. This is true of its internal administrative procedures as well as the systems that guide its research activities, its consultancy work and its training programs.
4. It would appear that the faculty here is fairly involved in their work and understand the nature of their work and the stage that IHS is in. It seems that they share its mission and are willing to rough it out during this phase of its evolution. This spirit and dedication could be the pride of any organization. The challenge is to sustain this zeal and shared goal identification. This would be one of the most formidable tasks for the Institute with the change in its leadership. The succession, of course, raises a few complex questions:
   • Does the future of the Institute require the continuance of the present Director who is also its founder or is it prepared for a change of guard?
   • Is there enough potential within for the reins to be handed over?
   • Will the search have to be extended outside?
   • Should Dr.Mahapatra continue at all cost?
   • These are some of the questions that pose themselves. In fact, I posed them to some of the staff during my interaction. As I pointed out earlier, everyone is aware of his impending departure and, therefore, prepared for the changeover, perhaps in the belief that it is an irreversible situation.
5. Considering that he has devoted a lot of his time in the last 12 years and brought IHS to where it is today, perhaps the present Director should disengage himself in that capacity. But he has a vision for IHS that is also shared by the Governors and other members of the Institute, as also the fact that he has worked towards the realization of that mission, it would be important for him to continue to be associated with IHS. The shape and form that association takes could be left to his judgment and the wisdom of the Board of Governors. But I do feel that the search for the successor should begin in right earnest. I dare say that the future of IHS quite critically depends on the role that the next Director would play in guiding the destiny of this Institute.
6. IHS is at a critical juncture. From an organization of Rs 4 lac it has grown to an organization that has handled more than Rs 100 lac last year. Its staff strength has increased. The space that it occupies has grown considerably. Its ambience is professional. Its culture is inspiring. Its reputation has spread. It has handled important projects. It has sourced funds from external agencies. It has worked outside Andhra Pradesh. It has a faculty that is multi-disciplinary and well qualified. It is well administered. It has a Director who has established his credentials in various fields and combines the merits of a professional administrator, a qualified doctor and health economist. All in all, here is a professional outfit engaged in areas that have universal relevance and are of great concern and priority for developing countries. This is the greatest strength of the Institute of Health Systems. Much of its progress would depend on how it exploits these strengths and how it positions itself to take advantage of its unique situation and the environment that it finds itself in.
7. It is obviously difficult to say to what extent IHS has realized the stated objectives. The core objectives of the Institute of Health Systems are (a) development of skills in interdisciplinary areas and (b) to carry out operations research to arrive at solutions appropriate to local needs. However, by the body of work the Institute has undertaken it would be seen that it has consistently striven towards the realization of its goals. Now that the Institute has established its academic credibility and research capabilities, it is time that IHS enters a new phase of its growth. This is a phase of consolidation and securing of more business. Even if it doesn't appeal to the purist ethics of a research organization like IHS, the time has come for the organization to think of a business strategy for the next decade.
8. The initial phase of any organization like IHS does require the entrepreneurship and devotion that the present Director has shown and the dedication and the hard work with which the staff have discharged their responsibilities. However, the labor of love cannot, and should not, be an eternal expectation. Neither is it fair nor reasonable. Beyond a point, those that toil would like to see their efforts bearing fruit, and their hard work contributing to the growth and stability of the organization that they are working for. They would like to grow with the organization. It is this aspiration that the management must understand and chalk out a strategy that can lead IHS to financial stability. It goes without saying that this would not compromise the intellectual integrity of the Institute's objectives and character.
9. So what does IHS do to pursue this path?
   • First of all, the management must recognize this as a priority.
   • It should set up a team to think business.
   • While pursuing the path of being an academic institution and possibly, a center of excellence, it should work towards developing its utility for Government. Good or bad, Government continues to be the single largest entity as a spender in Health as well as Public Health areas. It is the Government that has the policy function as well as the responsibility of delivering its services to the remote areas and perhaps to the largest segment of the population. This would mean that the training and consultancy capabilities of IHS must be strengthened and exploited to the hilt.
   • The above would entail contact with agencies like Army Medical Corps and the Central Medical Establishment that controls the Medical services in the three wings of the defense services. For example, acquiring greater skills in hospital administration may be a crying need that IHS could cater to.
   • Similarly, Railway Medical Services and the Municipal Health Services could be another target group.
   • Given the recognition that it already has in Andhra Pradesh, it should expand its activities in the southern states to begin with. That doesn't mean that it is confined as a regional organization. This would be in addition to, and not at the cost of, the opportunities that it may have in other parts of the country.
   Given the importance that Health sector enjoys with the donor and the multilateral funding community, the Institute certainly has a big opportunity in finding ways in which it can become a part of implementing externally funded projects.
   • Further, the work that IHS is doing is also relevant to the other developing countries, especially those in our neighborhood. Its association with external agencies may enable it to develop itself as a Regional Resource Center.
   • The above would require that the procedure and requirement of these funding agencies are carefully examined and steps initiated for IHS to fit this bill. This may even require an international collaboration or tie up.
   • The burden of disease study done by the Institute for a state or two could be replicated at the national level if Government of India could be persuaded to realize the benefits of the study.
10. The above are my preliminary views regarding where IHS stands today and where it could go from here. The Institute has done some pioneering work. Without a single exception everyone that I spoke to believed that it has a future. Nobody, of course could think of what the Institute would be like 50 years from now. But certainly, many had an idea and would like to work for making it a national level research organization and a resource center in the next 10 years. The sectors that IHS has been working in would grow in importance as India moves up the economic development scale. These are sectors in which Government would continue to play a vital role and in which private sector's role would grow in importance, degree, and impact.
11. The ever-increasing pressure of urbanization and its relentless inevitability would compel public policy makers to address the issues connected with Heath and Public Health, which is where the role of an organization like the Institute of Health Systems assumes greater importance. The way IHS positions itself and builds on its strengths would determine its future. Most of the senior faculty did not have an idea of the capacity utilization of the Institute. IHS needs more WORK, which can bring it more REVENUE, even if it doesn't line up its balance sheet. It is not the Director alone who should find more avenues for the Institute. The senior faculty must combine in them the virtues of researchers and the dynamism of market makers. However, considering the fact that the Director would be leaving shortly, he would do a signal service to IHS if, in his balance period, he expends his energies in procuring as many long-term assignments as he could for the Institute. He has the stature, the goodwill, the verve, the capability and the perseverance- it is only that this burden must start weighing on him as much as the urge to establish its academic credentials has weighed on him hitherto.

View/download copy of Shri Lavasa's complete email message dated 20&38209;12&38209;2002.

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