Reforms of many kinds have been at the top of government agendas worldwide for centuries. Broadly speaking, they aim to enhance citizens’ lives by lowering the cost of services, reducing bureaucracy, and curtailing corruption. Reforms also involve broadening the bouquet of services provided, as well as improving their quality, while keeping the cost to the exchequer at a minimum.
While the concept of reform is age-old, the nature of reform has historically been supply-centric —how government services are accessed and administered. What we are seeing now is the opportunity to change the lens of reform, centered not around service supply, but around the customer of government services. This “citizen-centric reform” has a truly transformative power due to the availability and affordability of an array of digital technologies.
Access to huge sets of data can help isolate problems and develop targeted solutions. Government initiatives can now reach the remotest of regions nearly instantly because of ultra-fast connectivity at fractional cost and time. Empowered with these disruptive tools, governments around the world can rethink how they engage with and support their citizens to improve overall quality of life and access to services.
Several nations are already starting to seize the opportunity, taking decisive steps towards transforming governance. A few years back, Australia embarked on a journey to reform citizen services provided by its Department of Human Services (DHS). The DHS provides over 200 services including social-security benefits, medicare, child support, and disability support.
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The DHS collaborated with The Boston Consulting Group (BCG) to formulate a ten-year vision and define three broad objectives: to make it easier to access services; to deliver better outcomes for citizens; and to deliver services more efficiently for taxpayers. The core of the reform involved new ways of segmenting and streaming customers, as well as expanding online services, lean operations, and the use of technology. The DHS leveraged apps and integrated platforms to increase convenience for Australia’s citizens.
The healthcare sector has experienced a similar push. Around the world, policy makers and healthcare companies are warming up to the idea of Value-Based Healthcare, which attacks spiraling costs by focusing on patientcentric outcomes. Sweden’s healthcare system has been a pioneer in overcoming the obstacle of timely and reliable data. For example, its registry for acute coronary care now collects data covering almost 80 percent of all patients. Sharing this data with clinicians has led to a cycle of innovations. Indeed, between 1998 and 2009, Sweden’s average 30-day mortality rate for patients who suffered acute heart attacks decreased by a dramatic 65%. Overall, Sweden has among the best healthcare outcomes in Europe, with similar excellent performance in healthcare spending. Sweden’s example shows that improved quality can be achieved with lower costs.
As the world gradually adopts some of these reforms, there is a tremendous opportunity for India to be at the forefront. Reforms approached through the effective use of technology have the potential to break the “iron triangle” of Affordability, Access, and Quality for the first time across many parts of government. The Jan Dhan Yojana has brought marginalised members of the population into the banking system, while Aadhaar has given billions of Indians a digital identity. The telecom revolution places India among the leading internet nations in providing ubiquitous high-speed connectivity. With a strong technology foundation, India can now target citizen-centric reforms in critical areas.
Indeed, as healthcare is one of the most complex issues of our time, and as large-scale change is always difficult, India’s healthcare system faces many challenges. These include insufficient infrastructure and public spending, as well as inequity in access. On the demand side, poor education levels, low awareness of new-age but common diseases, and a belief in traditional social practices have led to significant dilution in healthcare consumption.
The effective transformation of healthcare systems requires closer and more efficient cooperation among the public, private, and civil sectors. Technology has the power to allow India to potentially leapfrog healthcare system evolution by decades. For example, there is a clear opportunity to augment the existing technology stack, digitise health records, and use predictive algorithms to focus on prevention and early detection. The shortage of doctors and specialists must be addressed with the development of new digital health platforms.
Mobilising a large and diverse community of stakeholders can pave the way for India to take advantage of high impact, mutually reinforcing innovations that are cost-effective and scalable. Beyond healthcare, the Haryana government, in association with BCG, has taken bold steps to transform the educational system in India. Technology has not only played a major role in reducing corruption and bureaucracy, but has emerged as a potent force in improving the quality of education. In fact, the Aadhar-based identification of more than two million government school students has helped eliminate fake enrollments, potentially plugging sizeable fund leakages and freeing up funds for uniforms, scholarships, and other benefits.
Simultaneously, online employee services have become more transparent. They are being deployed to transform bureaucratic procedures for approximately 100,000 employees. In addition, technology-based, in-class interventions are being piloted to improve learning outcomes while allowing communication and capacity building at scale.
Overall, India has a wide array of social safety-net programs for its citizens, ranging from areas such as food security and employment guarantees for women to child development. Such programs are supported by huge infrastructure, large workforces, and complex supply chains. What they often lack is transparency — and therefore, effectiveness and efficiency. The same principles of transformation that Haryana has used for the education sector can be applied to any large-scale, citizenoriented system in the country to achieve broad-based, transformational results.
Ultimately, it is safe to say that technological change is accelerating at an unprecedented pace and will change the world as we know it. This dynamic change, combined with rising consumer expectations, creates a major opportunity for governments to initiate needed reforms. India can holistically embrace the power of citizencentric reforms and make a concerted move towards realising its extraordinary promise.