IASbaba’s Daily Current Affairs – 29th July, 2016

IASbaba's Daily Current Affairs Analysis, IASbaba's Daily Current Affairs July 2016, National, UPSC

IASbaba’s Daily Current Affairs – 29th July, 2016

NATIONAL

TOPIC:

General Studies 2

Issues relating to development and management of Social Sector/Services relating to Health, Education, Human Resources.
Government policies and interventions for development in various sectors and issues arising out of their design and implementation.

General Studies 3

Science and Technology- developments and their applications and effects in everyday life
Basics of cyber security
Awareness in the fields of IT

Digitised records and patient rights

E-Health initiative

A health branch of Digital India project to provide quality health care to the citizens through use of ICT
E-health seeks transparency in health care delivery, elimination of structural opacity and bypassing of multiple intermediaries
It also aims to connect specialized health professionals with the patients in far flung area, creating e-accessibility of services
Need: centralised information databases will allow health and research experts to engage in disease surveillance and better understanding of state of public health of the nation.

E-health threats

Cyber threat is a real menace of the digitised world.
Data theft and hacking has become a routine
The threat of electronic data misuse is on the rise with sensitive data having limited or no protection
In such scenario, when health care is being encouraged for digitisation, along with its advantage, it is necessary to acknowledge threats and take required precautions.

Medical data

It is sensitive in nature and contains details such as bodily functions, physical anatomy, sexuality, a history of substance abuse, psychological issues or any other diagnosis or prognosis.
Patients expect full anonymity of their medical health from the third parties or even close relatives.
The patients may share the ‘chosen’ information for self-benefit and not to reveal entirely
External Fallout of leak: social isolation or discrimination
Internal Fallout of leak: Patients might not reveal true or complete information, leading to inaccurate medical treatment
Observed in the west:
- Non-physicians improperly viewing e-health data of celebrities without any legitimate reason
- Health records sold on e-bay.
- Stealing medical records from computer and laptops
Medical info for sale: As per report, medical information has more worth than financial information as they can be misused to buy drugs and medical equipment for resale and also making false insurance claims.

Digitalising health records

In last few years, Indian government has taken initiatives to digitise patient records
The benefits include
- Streamlining interaction between doctors and patients
- More accurate diagnosis and therapy due to complete medical history availability
- A completer repository of up-to-date health data which will avoid repeated medical investigations and reducing paperwork
The government is in process to establish Integrated Health Information Platform (IHIP) à to ensure the interoperability of health records in any corner of the country
To develop IHIP, a National e-Health Authority (NeHA) shall be developed.
- It will encourage adoption and promotion of e-health standards
- It will enforce the laws and regulations relating to the privacy and security of patient health information and records.
- The process has already begun to update infrastructure in district and sub-district hospitals under the National Health Mission
In 2013, government had notified the Electronic Health Record Standards (EHRS)à to introduce a uniform system for the maintenance of Electronic Medical Records/Electronic Health Records by healthcare providers in the country. It included
- standards for interoperability
- guidelines for hardware
- networking and connectivity
- specifications on data ownership of electronic health records
- data privacy and security.
Recently, attempts have been made to introduce new forms technology in EHRS and upgrade it with international best practices.
Hence, EHRS is being revised and opened for public comments

Changes required in EHRS

Drafting of EHRS
- Unsatisfactory drafting of the standards. Expert opinion, involvment of cyber security experts and suggestions of all other stakeholders should be taken into consideration for a sturdy EHRS.
- Legal issues need to be addressed pertaining to revised standards in light of prevalent international best practices
Consent
- At present, sensitive information can be collected without any identified purpose or consent of the patient.
- Only when the data of the person is used for a specific purpose, the patient’s consent is taken.
- A general consent of the next of relative of the patient is considered sufficient when the data is used in “treatment, payments and other healthcare operations”
- What is required: a notice and consent requirement before or at time of collection of sensitive data like passwords, financial information, physical, psychological and mental health condition, sexual orientation and biometric information of the patient.
Stricter data regulation
- More stringent standards required against the present status of availability of all recorded health data to health care providers on ‘required on demand’ basis.
Revocation of data
- As per current standards, a patient cannot ask to delete data once recorded.
- It is recorded for his lifetime and preserved after three years of his death
- What is required: a provision for revocation of consent where the patient has the right to amend the data on grounds other than correcting errors.
Data leak
- In case of privacy breach, the patient is not informed about it.
- The health care providers are not accountable for such security lapse which may harm the patient mentally, socially or physically.
- What is required: A ‘privacy officer’ to notify the patient within a specified time and also provide the course of remedy available.

Conclusion

Need for a robust EHRS

The EHRS is expected to be implemented by the end of 2016.
Need is to rectify the loopholes in standards

Improving the IT Act

EHRS will be prevailed by the Information Technology Act, 2000 (IT Act), and consequently the safeguards it incorporates.
However, the IT Act and its relevant rules have been subject to criticism for being vague and unfocussed.
The government is expected to mitigate the IT Act flaws by strengthening EHRS

Giving teeth to NeHA

It is a centralized electronic healthcare record repository which will contain comprehensive health information of all citizens
NeHA will deal with issues relating to privacy and confidentiality of patient’s e-health records.
For a sustainable, effective and enforceable EHRS, NeHA has to be vested with sufficient power to implement and enforce it.

Hence, in light of digitisation security concerns, a nationwide system should be implemented only when adequate safeguards are in place to ensure privacy of patients and data security.

Connecting the dots:

“Security of medical records is essential to maintain the good health of the country.” Do you agree? Support with your reasons.

NATIONAL

TOPIC: General Studies 2

Government policies and interventions for development in various sectors and issues arising out of their design and implementation.

Welfare schemes for vulnerable sections of the population by the Centre and States and the performance of these schemes; mechanisms, laws, institutions and Bodies constituted for the protection and betterment of these vulnerable sections

Social Issue – Child labour and related issues

A law against children?

Child Labour (Prohibition and Regulation) Act

Parliament has passed the Child Labour (Prohibition and Regulation) Amendment Bill, 2016. The bill was first passed in Rajya Sabha and later in Lok Sabha during Monsoon session of Parliament.

It seeks to amend the Child Labour (Prohibition and Regulation) Act, 1986 to widen the scope of the law against child labour and stricter punishments for violations.

But will it?

Currently, children under the age of 14 are banned only from working in hazardous industries. There was no bar on the employment of children between 14 and 18 years.
Now, the proposed amendments prohibit all work, hazardous or otherwise, for children under 14, who now also enjoy the constitutional right to free and compulsory education.
And for adolescents between 14 and 18 years, whose labour was entirely lawful until now, the law prohibits their employment in work scheduled as hazardous.
It makes child labour a cognizable offence attracting a jail term of up to two years and penalty up to fifty thousand rupees.
The Bill has a provision of creating Rehabilitation Fund has also been made for the rehabilitation of children.

Until here, the amendments made seem good and meant to strengthen legislative framework that prohibits children from employment.

However, on closer scrutiny, the reality of what is being offered is the reverse of what appears on paper.

Amendments proposed

Ban on hazardous adolescent work drastically reduced to three

Initially 83 works or activities were identified as hazardous and were banned for children under the age of 14. But now this number has been reduced from 83 to only 3.
e. apart from mining and explosives, the law only prohibits processes deemed hazardous under the Factories Act 1948.
In other words, the amended law prohibits only that child work which is considered hazardous for adult workers, without recognising the specific vulnerabilities of children.

Permits children below 14 years to work in non-hazardous “family enterprises”

The amended law permits even children under 14 years to now work in non-hazardous “family enterprises” after school hours and during vacations.
The family is defined to include not just the child’s parents and siblings, but also siblings of the child’s parents. And a family enterprise includes any work, profession or business in which any family member works along with other persons.
In effect, this proviso accomplishes the very opposite of what it claims to do. Instead of ending child labour, it actually makes lawful once again a large part of child work that was earlier unlawful.
It is estimated that around 80 per cent of child labour is in work with family members. This is in farms, forests, home-based work such as bidi rolling, carpet weaving, making of bangles and handicrafts, home-based assembly tasks, domestic work, eateries, roadside garages, and street vending.
The amended act legalises the bulk of child labour while claiming to do the opposite.

What the government has missed?

Under the garb of family-run enterprises, children will also be allowed to work in industries like zari, bangle and carpet making, beedi making, brick kilns, diamond cutting, even scavenging.
The truth is that a number of these industries rely on the small nimble fingers of children and perpetuate a system that thrives on bonded labour, or at best very poor wages.
The government argues that these amendments are being made in response to the socio-economic realities of the country and to allow children to learn traditional crafts after school hours.
A sobering study points out that while combining school and work is a reality for poor children in India, the likelihood of children who work for over 3hours dropping out of school is estimated to be as high as 70%.
In the country where the traffickers passes on as a “Mama” (uncle) or a “Mausi” (aunt), where is the question of state actually being able to monitor the number of hours a child actually works, even if he is actually working in the family enterprise?
Once again it will be the girl child who will be the 1^st to be pulled out of school and put into the workforce, as will children from economically weaker section and marginalized section of society – the very children most at risk and whom the Act is largely designed to protect.
Not only will these amendments not help eliminate child labour, but will also in all likelihood, deny our children their rights under the RTE Act, possibly creating the perfect preconditions for some of them to take to juvenile crime.

Conclusion:

The argument that has long held sway is that child labour, however unfortunate, is inevitable as long as households remained poor. Only after parents escape poverty will their children be able to enter school. What these claims ignore is that the reverse is far more true. That child labour is indeed a major cause of persisting poverty. That if a child is trapped in labour instead of being able to attend fully to her schooling, she will never be able to escape the poverty of her parents. The child of a sanitation worker, rag-picker, domestic worker or casual labourer is likely to be trapped in the professions of her parents unless she is able to access quality education.
We should not be the generation that will preside over a system when the state dropped the ball – and our children and we pay the price for it, under the garb of doing right for them.
Economic development, investment, women and child welfare and job creation should be given their rightful place in budgetary allocation. Amidst the furore over the recent juvenile crimes and release we should be able to think of such positive steps so that another child is not turned into a criminal because of avoidable circumstances.

Connecting the dots:

Critically analyse recent amendments made to India’s child labour law.
Do you think the existing legal and institutional support is adequate to end the menace of child labour in India. Critically comment.