Healthcare and the BBMP

Though belated, the decentralised Covid-19 battle had clearly shown the efficacy of a bottom-up approach. Primary Health Centres (PHCs) were clearly at the core of this strategy. But the proposal to delink public health from the Bruhath Bengaluru Mahanagara Palike (BBMP) runs counter to a proven process, violating what the 74th Constitutional Amendment mandates.

In the works is a separate public health directorate with lesser involvement of BBMP, and another parastatal agency for Solid Waste Management (SWM). As the pandemic third wave looms menacingly, is it not time to reboot Bengaluru’s governance more holistically by empowering the BBMP, a democratically elected body that reflects the aspirations of the public and is thus accountable?

The law is clear. Public health is a key function listed for devolution to municipalities (BBMP in Bengaluru’s case) under the 12th schedule to the Constitution (Article 243W of 74th Constitution Amendment Act, 1992, 74th CAA).

Performance audit

But an audit report by the Comptroller and Auditor General of India (CAG) had drawn attention to big implementation gaps in what the law says. Tabled in the Karnataka Legislative Assembly in September 2020, the performance audit showed that urban local bodies (ULBs) had full authority only over three out of 18 functions supposedly devolved to them.

The three functions were: Burials and burial grounds; cremations, cremation grounds; Cattle pounds; prevention of cruelty to animals and Regulation of slaughter houses and tanneries.

In case of public health and allied responsibilities, while BBMP and the Hubbali Dharwad Municipal Corporation were the only ULBs in Karnataka to run maternity homes, the function was largely limited as the Department of Health and Family Welfare played a significant role, notes Srikanth Viswanathan, Chief Executive Officer (CEO) of Janaagraha, commenting on the performance audit report.

“No other organisation has the kind of reach that BBMP has (in terms of healthcare). The pandemic requires a response at the point of contact. The Palike is uniquely positioned to provide that without being dependent on a government department,” says a senior official associated with drafting the audit report.

The State department, along with ULBs undertook immunisation / vaccination programmes. The BBMP, like all ULBs in Karnataka, was responsible for cleaning and disinfection of localities affected by infectious disease, solid waste management and control and supervision of public markets.

Kept out of planning

Beyond healthcare, sanitation and other key areas, the report also found that the ULBs, and by implication the Palike was not involved in the planning and regulation of basic utilities. In Bengaluru city, for instance, BBMP has no say in the matters of water supply, a key function managed by the Bangalore Water Supply and Sewerage Board (BWSSB).

The official, preferring anonymity, observes, “The ULBs, including BBMP, do not have a level of autonomy to discharge those functions. At every step, if you have to go to the government for approval, it impacts efficiency. The stranglehold of the government is so strong.”

Unlike other city corporations in the State, the Palike did constitute the Ward Committees as mandated by the CAA. These panels, headed by nodal officers in the absence of elected corporators, have already taken baby steps in the decentralised battle against the pandemic second wave.

Empowered ward panels

But, as the official points out, the committees should be involved at every stage of the planning and execution. “These panels will know the pain points, and where to prioritise the funds.”

Questions had cropped up over the manner in which the ward committees were first constituted by the corporators. It is expected that once the new BBMP Council comes into effect after the Palike polls, a fresh set of ward committees will be constituted with enhanced transparency in membership.

However, the audit report flags an area of concern: The BBMP elections. Observes Srikanth, “Elections to BBMP were often not conducted regularly every five years. The State delayed the delimitation process, which in turn delayed council elections. This happened in 2009 and 2015.”

The Council’s tenure expired in September 2020. “However, elections have been further delayed owing to delays in the delimitation process and citing the introduction of the new BBMP Act, which increased the number of wards from 198 to 243.” Urban planners have been articulating the need to bring development authorities under an elected municipal body. The audit report had reiterated this, indicating that even the Bangalore Development Authority (BDA), along with slum improvement, should be under the Palike. However, the government is yet to amend the respective Acts to execute it.