Issues of Autonomy and Democracy in AIIMS

In its golden jubilee year, AIIMS, the premier national medical institute, was in the news for quite some time, though for all the wrong reasons. The power-struggle between Dr. Venugopal and Dr. Ramadoss has been given an ideological colour, and has been portrayed by the media as an epic battle between institutional and academic autonomy versus political and bureaucratic autocracy. But the issue of autonomy and democracy need to be traced far deeper: we cannot forget that thousands of poor patients come from all over the country to AIIMS, and in the past few months, it is these patients who were left hapless in the wake of the hiking of user charges, the anti-quota stir, and the flash strike that followed the dismissal of Dr. Venugopal.

It is an open secret that Dr. Venugopal (a cardiac surgeon credited with the first heart transplant in our country) was instrumental in patronizing within his institute the most powerful of anti-quota agitations witnessed anywhere in the country. This has had ugly repercussions: there have been shocking and shameful revelations that SC/ST students in AIIMS hostels were being subjected to casteist abuse and were forced to live in ghettos in separate wings. On the issue of user charges, Dr. Venugopal, who today champions the banner of autonomy and cries foul when it comes to his own removal, was a zealous votary of the UPA Government's anti-people intervention in an AIIMS policy matter. He proactively pushed the huge hike in the user charges in AIIMS, and as a result, procedures that had previously been free of charge, were charged to the tune of upto Rs. 15,000 and Rs. 30,000! (Courtesy: Medicos Forum for Equal Opportunities)

 In fact, before the outbreak of the anti-quota agitation, the Faculty Association had, through a resolution demanded the removal of Dr.Venugopal for his undemocratic acts, and had written to President Kalam against the complete absence of “transparency and accountability” in his regime. However Dr. Venugopal was not removed then on these charges.

As regards Ramadoss' claim that he wanted to end the autocracy of Dr. Venugopal, the fact of the matter is that he was just interested in substituting Dr Venugopal's autocracy with his own, and wished to run AIIMS as his own fiefdom. He never found it necessary to act when the faculty was demanding action against Dr.Venugopal on legitimate grounds. He was all in support of Dr. Venugopal on the issue of user charges. He did not take action against Dr. Venugopal for patronising an apartheid regime in the hostels in his institute. Instead of all this, Ramdoss chose to remove him when the latter's autocratic functioning became a hindrance to his own. He was removed on the charge that he “publicly alleged Government interference in AIIMS's internal matters.”

Now the question arises: should a person like Dr. Venugopal, who despite all his professional competence, had lost the confidence of the AIIMS community because of his undemocratic acts, patronized an apartheid regime and encouraged forces inimical to social justice, be allowed to preside over the institute? Equally valid is the question, should a Health Minister be allowed to retain or dismiss the Director of an autonomous institute as and when it suits him, and run a premier institute like AIIMS as his fiefdom?

The answer to the above dilemma lies in the real autonomy and democratisation of the decision-making process in the institute, which would mean that no Director could become an autocrat and also no Government could appoint or dismiss a Director at its sweet will. Let a person be appointed and continue as Director only on the basis of the popular consent of the AIIMS community.

Let us not forget that the dismissal of Dr. Venugopal by Ramdoss, and his appointment, with exceptional terms of reference violating established norms, by Sushma Swaraj (the then Health Minister), were both a product of the same undemocratic institutional mechanism. So what is really needed is a radical restructuring of the entire decision-making process. The Institute Body, which is the highest decision-making body, has no member with voting rights from the entire AIIMS community (students, resident doctors, nursing staff, faculty, employees etc...). The overwhelming majority of IB members are Government nominees. Without changing the composition of this body to ensure democratic participation of the AIIMS community, all talk of autonomy becomes hollow rhetoric and hypocrisy.

To uphold the long-cherished values of academic freedom and autonomy is perhaps more urgently needed today, in the era of globalisation and liberalization, as the State is determined to orient institutions of knowledge and social service in an anti-people and anti-national direction, solely guided by the profit motive of big capital, foreign as well as domestic. And thus, in the long run, what is at stake is not just the fate of a Venugopal or a Ramadoss, but some very basic issues affecting the life of our people and society.

The Vaniathan Committee, appointed by the government to address the issue of autonomy, once again has no democratic representation or participation from the AIIMS community. Will it dare to address these fundamental issues, or will it just be an eyewash to hoodwink the popular outcry in favour of democratisation, and more importantly to use this opportunity for further commercialising and privatising this premier institute in the name of making it financially self-reliant and global?

- Lal Bahadur Singh