UPSC Insights SECURE SYNOPSIS : 5 June 2025

NOTE: Please remember that following ‘answers’ are NOT ‘model answers’. They are NOT synopsis too if we go by definition of the term. What we are providing is content that both meets demand of the question and at the same

General Studies – 1

Topic: Population and associated issues

Q1. Discuss the projected demographic trends of senior citizens in India up to 2047. What are the implications of these trends on social infrastructure? Suggest how the upcoming National Policy can respond to these projections. (15 M)

Difficulty Level: Medium

Reference: TH

Why the question:
A new national policy on senior citizens is in the draft stages with the Union Ministry of Social Justice and Empowerment, government officials said.

Key Demand of the question:
The answer must analyse India’s elderly demographic trends up to 2047, assess the impact of these trends on healthcare, housing, and other social infrastructure, and propose policy-level responses aligned with emerging needs.

Structure of the Answer:

Introduction
Briefly highlight India’s demographic transition and rising elderly share, setting context with a relevant fact or projection.

Body

• Demographic trends up to 2047 – Rising old-age share, feminisation of ageing, urbanisation, dependency ratio shifts, and household structure changes.
• Implications for social infrastructure – Geriatric healthcare, pension systems, housing, transport, old-age homes, and community design.
• Policy-level responses – Data-driven planning, digital inclusion, regulation of care homes, NGO role, intergenerational bonding initiatives.

Conclusion
Conclude with a forward-looking line on building a rights-based, age-inclusive policy vision for India @100.

Introduction
India is entering an era of demographic ageing where the elderly will account for nearly one-fifth of the population by 2047, demanding a paradigm shift in welfare planning and infrastructure design.

Body

Demographic trends of senior citizens up to 2047

1. Rising elderly share: Senior citizens will constitute around 20% of India’s population by 2047.
   • Eg: As per MoSJ&E 2025 draft policy discussion, the elderly population will rise from 8.6% (2011 Census) to 12.16% by 2026, and further to ~20% by 2047.
2. Feminisation of ageing: A higher number of elderly women, especially widows, will emerge due to longer life expectancy.
   • Eg: NSO Elderly in India 2021 shows women outlive men by an average of 2.5 years, widening the gender gap among the aged.
3. Urbanisation of elderly: Migration trends are leading to growing numbers of urban elderly living alone.
   • Eg: Census 2011 showed over 15 million elderly were living alone, and the number has increased with rural-urban youth migration.
4. Growing dependency ratio: India’s old-age dependency ratio will increase significantly, straining working-age support systems.
   • Eg: As per UN World Population Prospects 2022, India’s dependency ratio will rise from 17% (2020) to over 35% (2050).
5. Changing household structure: Joint families are disintegrating into nuclear units, increasing institutional and state dependency.
   • Eg: LASI 2020 (Longitudinal Ageing Study in India) noted a rise in elderly without familial support, especially in urban states like Maharashtra and Delhi.

Implications on social infrastructure

1. Healthcare and geriatric care: Surge in non-communicable diseases will require robust geriatric health systems.
   • Eg: National Health Profile 2023 showed over 52% of elderly suffer from hypertension, arthritis, or diabetes.
2. Old age homes and assisted living: Rising demand for state-regulated and affordable elder-care homes.
   • Eg: Under IPSrC, only 708 NGOs operate elder homes, grossly inadequate for the projected demand (MoSJ&E, 2025).
3. Transport and mobility infrastructure: Age-inclusive urban planning with barrier-free access will be essential.
   • Eg: Smart Cities Mission guidelines (2021) encourage “elderly-friendly public infrastructure”, but implementation remains uneven.
4. Social security and pensions: Pensions need universalisation and inflation-adjustment.
   • Eg: Indira Gandhi National Old Age Pension Scheme covers only those under BPL; universalisation recommended by V.M. Rao Committee (2020).
5. Housing and community spaces: Safe, affordable housing with proximity to healthcare and social hubs will be crucial.
   • Eg: Delhi’s ‘Savera Grih’ model provides free housing, meals, and healthcare to destitute elderly, supported by CSR and government aid.

Policy responses in the upcoming National Policy

1. Data-driven planning: Use population projections and ageing indices for decentralised planning.
   • Eg: National Policy 2025 draft incorporates NITI Aayog’s Elderly Vulnerability Index for state-level policy customisation.
2. Integration of digital inclusion: Enhance digital literacy and access for the elderly in e-governance, health, and banking.
   • Eg: Senior Citizen Portal aims to provide services and grievance redress; MoSJ&E 2025 suggests wider roll-out with trained volunteers.
3. Mandatory standards for elder care homes: Enforce uniform norms for infrastructure, quality, and accountability.
   • Eg: Maintenance and Welfare of Parents and Senior Citizens Rules (2009) lack binding provisions for private elder care institutions.
4. Community and intergenerational initiatives: Promote shared spaces, intergenerational bonding, and active ageing.
   • Eg: ‘Adopt a Gran’ initiative by NGOs in Kerala facilitates student–senior bonding to reduce loneliness and isolation.
5. Institutional role of CSOs and local bodies: Formalise NGO partnerships and delegate implementation to panchayats/ULBs.
   • Eg: Draft policy proposes inclusion of NGOs and senior citizen associations in policymaking and feedback loops (MoSJ&E, June 2025 meeting).

Conclusion
India’s future as a humane and inclusive society will be judged by how it treats its elderly. The upcoming national policy must shift from a welfare lens to a rights-based, decentralised and dignity-focused framework rooted in demographic realism.

Topic: Urbanization, their problems and their remedies

Q2. “Public transport in Indian cities suffers not from lack of awareness but from lack of reliability”. Examine the validity of this statement and propose corrective strategies. (10 M)

Difficulty Level: Easy

Reference: DTE

Why the question:
In light of recent mobility reports (CSE, 2025) showing stagnant or declining public transport ridership despite rising environmental awareness, highlighting reliability as the main barrier.

Key Demand of the question:
The question requires examining why public transport remains underused despite awareness, with a focus on reliability issues, and then suggesting actionable strategies to enhance commuter trust and service uptake.

Structure of the Answer:

Introduction:
Mention the paradox of high awareness but low usage, hinting at systemic inefficiencies in service delivery.

Body:

• Point out service gaps such as low frequency, overcrowding, network limitations, poor integration, and longer journey times.
• Suggest solutions like revised benchmarks, multimodal integration, last-mile infrastructure, performance-based funding, and use of commuter data.

Conclusion:
Assert that behavioural shift depends on institutional reliability and system trust, not on awareness campaigns alone.

Introduction:
Despite growing awareness of its environmental and economic value, public transport in Indian cities fails to attract users due to inconsistent service, lack of integration, and poor commuter experience.

Body

Public transport suffers from lack of reliability

1. Infrequent and unpredictable services: Irregular frequency makes public transport unviable for time-bound commuters.
   • Eg: 50% of Delhi bus stops have average waiting times exceeding 10 minutes .
2. Declining service efficiency and fleet inadequacy: Limited fleet expansion leads to overcrowding and reduced access.
   • Eg: Bus fleet of 19 STUs grew by just 4.6%, while ridership dropped 5.8% between 2014–2019
3. Lack of integrated planning and interchange connectivity: Fragmented corridors increase travel time and reduce ridership.
   • Eg: 15 of 16 metro cities in India have only corridor-based systems, limiting coverage (IIT Delhi, 2023).
4. Longer total journey time: Poor interchange planning and congestion lead to time delays in multimodal transport.
   • Eg: Peak-hour speed in Delhi drops by 56% in evenings, delaying buses and commuters
5. Low user comfort and security: Overcrowding and poor infrastructure create a deterrent, especially for women.
   • Eg: Delhi Transport Corporation reported a 40% drop in female ridership between 2016–2022 (DTC internal study).

Corrective strategies to improve reliability

1. Set and monitor service-level benchmarks: Regular frequency, reduced waiting time, and uptime targets must be enforced.
   • Eg: MoHUA’s Service Level Benchmarks (2017) must be revised to include frequency, uptime and occupancy targets.
2. Expand last-mile connectivity infrastructure: Walkability, cycling lanes and formal feeder modes should be funded.
   • Eg: Bangalore’s metro now includes e-auto integration and walking paths to boost access (BMTC, 2024).
3. Strengthen multimodal and network planning: Transit plans must ensure seamless integration of modes and schedules.
   • Eg: Surat’s Unified Mobility Plan links buses, BRTS and feeder autos via a common mobility card (UMTA Surat, 2023).
4. Link public transport funding to reliability indicators: Incentivise state transport undertakings to improve commuter metrics.
   • Eg: 15th Finance Commission proposed conditional urban grants tied to mobility performance metrics.
5. Promote data-driven service design: Use real-time commuter feedback, GPS and AI to optimise routes and frequency.
   • Eg: Ahmedabad BRTS deploys real-time passenger data to reduce bus bunching and optimise schedules.

Conclusion:
The challenge is not commuter apathy but system inefficiency. Only a reliable, accessible and efficient transport system can win back urban commuters and drive a sustainable modal shift.

General Studies – 2

Topic: Welfare schemes for vulnerable sections of the population by the Centre and States and the performance of these schemes;

Q3. What are the main reasons behind the continued incarceration of poor undertrials in India? Suggest short- and long-term reforms to address this systematically. (10 M)

Difficulty Level: Medium

Reference: NIE

Why the question:
MHA’s recent reminder on the underutilisation of the Support to Poor Prisoners Scheme, and the alarming undertrial figures highlighted in the India Justice Report 2025.

Key Demand of the question:
To identify the systemic, legal, and economic reasons behind the prolonged detention of poor undertrials and propose targeted short- and long-term reforms to address these issues structurally.

Structure of the Answer:

Introduction:
Give a brief, sharp line on how poverty and delay have turned prisons into holding cells for the underprivileged, violating Article 21.

Body:

• Reasons for continued incarceration: Mention lack of bail access, legal aid gaps, procedural delays, and judicial backlog.
• Short-term reforms: Focus on scheme implementation, legal aid strengthening, and real-time tracking.
• Long-term reforms: Include structural reforms like bail legislation, judiciary expansion, and community bond systems.

Conclusion:
End with a forward-looking line on reformative justice being impossible unless liberty is delinked from financial status.

Introduction:
The undertrial crisis in India is not just a legal failure but a systemic denial of liberty rooted in poverty, delayed processes and institutional apathy.

Body

Reasons for continued incarceration of poor undertrials

1. Inability to furnish bail bonds: Poor prisoners often lack sureties or funds to post bail even when granted.
   • Eg: As per India Justice Report 2025, over 25% of undertrials remain in custody despite being granted bail due to non-payment of sureties.
2. Lack of legal aid awareness and access: Many undertrials are unaware of free legal aid or do not receive effective counsel.
   • Eg: NCRB 2023 shows only 13% of prisoners accessed legal aid lawyers; most lacked consistent representation.
3. Delays in police investigation and filing of chargesheets: Undertrials suffer long detention due to slow case processing.
   • Eg: In the Satender Kumar Antil v. CBI (2022) case, SC highlighted how delays in chargesheet filing prolong custody.
4. Judicial backlog and systemic delay: Courts are overburdened, leading to prolonged pre-trial detention.
   • Eg: As per NJDG 2025, over 4.7 crore cases are pending in Indian courts, with 71% of prison population being undertrials.
5. Discretionary and inconsistent application of bail norms: Courts often deny bail for similar offences due to subjective standards.
   • Eg: The Law Commission 268th Report noted inconsistent bail practices as a key cause of pre-trial injustice.

Reforms to address the issue

1. Short-term reforms

1. Operationalise the Support to Poor Prisoners Scheme: Actively identify eligible inmates and disburse funds for bail/fines.
   • Eg: MHA’s 2023 scheme remains underutilised despite funds allocated via NCRB and clear SOPs issued.
2. District legal aid clinics inside jails: Regularly monitor undertrials and assist with bail applications.
   • Eg: Delhi Prisons Legal Aid Model shows success in weekly paralegal interface and bail filing.
3. Mandatory bail review hearings for long-term undertrials: Periodic judicial review for those detained beyond prescribed limits.
   • Eg: SC direction in Hussainara Khatoon v. State of Bihar (1979) led to speedy trial being recognised as a fundamental right.
4. Digitisation of undertrial data with tracking: Real-time prison-court coordination to track eligibility and avoid delays.
   • Eg: ePrisons project by MHA enables real-time prisoner data tracking and flagging of long-term detentions.

Long-term reforms

1. Codify uniform bail norms through legislation: Reduce judicial discretion and ensure equity in pre-trial release.
   • Eg: Recommended by Criminal Justice Reforms Committee (Madhava Menon, 2007) for structured bail guidelines.
2. Increase judicial capacity and special bail benches: Appoint more judges and create fast-track bail courts.
   • Eg: Justice Ramana’s 2021 recommendation to increase judge strength from 21 to 50 per million population.
3. Community bail bond and public surety schemes: Use of state/NGO-verified sureties for indigent accused.
   • Eg: Telangana’s pilot bail bond pooling scheme (2022) showed success in reducing undertrial numbers.
4. Strengthen undertrial review committees (UTRCs): Regular monthly meetings with measurable accountability.
   • Eg: NCRB Guidelines 2023 recommend active tracking of undertrial cases through District Legal Services Authorities.

Conclusion:
India cannot afford a justice system where liberty is priced by economic status. True criminal justice reform must begin by dismantling the structural barriers that keep the poor locked behind bars without conviction.

Topic: Issues relating to development and management of Social Sector/Services relating to Health, Education, Human Resources

Q4. The future of higher education lies not in a single model but in dynamic, decentralised networks that evolve with societal needs. Examine the features of an ecosystem model for tertiary education. Assess its potential to transform the future of education delivery and learning outcomes. (15 M)

Difficulty Level: Medium

Reference: TH

Why the question:
Due to declining enrollment in general education and foundational disciplines, and the push under NEP 2020 for holistic and adaptable institutions, there is renewed focus on ecosystem-based models for tertiary education.

Key Demand of the question:
The question asks to explain the core features of an ecosystem model for higher education and evaluate how such a model can transform education delivery and learning outcomes in the current societal and industry context.

Structure of the Answer:

Introduction
Mention the need for flexible, adaptive higher education models in the context of NEP 2020 and changing learner preferences.

Body

Changing nature of higher education networks – Highlight shifts in institutional roles and learner expectations.

Features of the ecosystem model – Suggest elements like collaboration, flexibility, feedback loops, and modular learning.

Transformation potential – Show how it improves access, quality, relevance, and learner autonomy.

Conclusion
Emphasise that education ecosystems are essential to align learning with societal needs, lifelong learning goals, and employability.

Introduction

India’s goal of achieving 50% GER by 2035 under NEP 2020 calls for moving beyond rigid institutional structures to dynamic education ecosystems that adapt to evolving learner needs and industry relevance.

Body

Dynamic networks and evolving needs in higher education

1. From single-purpose to multi-mission institutions: Education must combine academic learning with skilling, research, and entrepreneurship.
   • Eg: The MCC-MRF Innovation Park links departments with incubators and industry-driven upskilling modules.
2. Expansion of alternate learning pathways: Certificates, online modules, and micro-credentials are gaining legitimacy.
   • Eg: As per Inside Higher Ed (2024), 65% US adults believe certification suffices for a good job.
3. Millennial focus on ROI and outcomes: Youth demand employability, entrepreneurship, and visible returns from education.
   • Eg: NIRF 2024 shows higher placements in institutions with strong industry-academia interfaces.
4. Shifting industry needs require modularity: Rapid tech change demands continuous curricular updates.
   • Eg: India Skills Report 2024 stresses hybrid skillsets in AI, design thinking, and data analytics.
5. Localised and community-responsive learning: Education models now align with local economies and social needs.
   • Eg: Kerala Knowledge Economy Mission integrates higher education with local gig platforms.

Features of an ecosystem model for tertiary education

1. Multi-actor collaboration without hierarchy: Diverse actors including universities, startups, and NGOs function in synergy.
   • Eg: NEP 2020’s cluster approach encourages collaborative institutional networks.
2. Academic-industry feedback loops: Real-time input from industry helps shape curriculum and pedagogy.
   • Eg: AICTE 2023 mandates internships and live projects in undergraduate education.
3. Interconnected yet independent roles: Institutions play flexible, complementary roles without rigid ranking.
   • Eg: Smelser’s multi-campus model envisages interdependent learning ecosystems.
4. Continuous curriculum innovation: Ongoing feedback ensures pedagogy reflects current needs.
   • Eg: Hackathons at MCC Innovation Park collect industry pain points to design student projects.
5. Lifelong and flexible learning pathways: Entry-exit options allow diverse learners to engage over time.
   • Eg: Academic Bank of Credits enables credit mobility across institutions and modes.

Transformative potential for education delivery and outcomes

1. Learner-centric modular delivery: Students gain autonomy to personalise academic journeys.
   • Eg: Platforms like SWAYAM and NPTEL allow self-paced, credit-worthy learning.
2. Stronger employability and job alignment: Ecosystem models reduce the industry-academia disconnect.
   • Eg: NSDC–Tata STRIVE integrates vocational skilling into higher education.
3. Boost to innovation and entrepreneurship: Learning becomes practice-oriented and problem-solving driven.
   • Eg: ARIIA 2024 rewards institutions for patents, incubators, and startup support.
4. Improved access and social inclusion: Ecosystem approach allows decentralised access to underserved groups.
   • Eg: Odisha’s Community Colleges (2023) take tertiary education to tribal and rural regions.
5. Agility in adapting to societal shifts: Flexible ecosystems evolve with environmental, economic, and technological changes.
   • Eg: UNESCO’s Futures of Education (2022) stresses the role of lifelong, adaptive learning systems.

Conclusion

To future-proof India’s higher education, institutions must evolve into ecosystems of learning, innovation, and inclusion—capable of responding to society’s fast-changing needs while delivering value-driven outcomes.

General Studies – 3

Topic: Infrastructure, Inclusive growth and issues arising from it.

Q5. Connectivity is no longer a privilege but a prerequisite for economic justice in Northeast India. Examine how recent infrastructure initiatives are addressing regional isolation. Evaluate why improved connectivity alone may not guarantee inclusive development. (10 M)

Difficulty Level: Medium

Reference: IE

Why the question:
Numbers back story of a ‘rising Northeast’, but Centre must address structural challenges

Key Demand of the question:
The question requires analysing recent infrastructure initiatives that reduce isolation in the Northeast and critically evaluating why such efforts alone cannot lead to inclusive development unless complemented by institutional and social measures.

Structure of the Answer:

Introduction
Start with a sharp line showing how connectivity is now central to development justice and strategic integration in the Northeast.

Body

• Mention major infrastructure projects addressing regional isolation through rail, road, air, waterways, and digital access.
• Explain the limitations of connectivity in ensuring equity — like ecological risk, lack of grassroots participation, urban-rural divide, and exclusion of local institutions.

Conclusion
End by suggesting that infrastructure must go hand-in-hand with institutional reform and ecological inclusion to achieve long-term justice.

Introduction
Connectivity is redefining the developmental paradigm in the Northeast by linking historically excluded regions to national supply chains, governance platforms, and strategic corridors. However, without institutional safeguards, such growth may remain unequal.

Body

How recent infrastructure initiatives are addressing regional isolation

1. Railway modernisation for mobility and commerce: Revamp of key stations connects underserved regions to national markets.
   • Eg: Under Amrit Bharat Station Scheme, 103 railway stations in the Northeast are being redeveloped.
2. Tunnels and highways for all-weather access: Enables year-round movement across difficult terrain and border areas.
   • Eg: Sela Tunnel (Arunachal Pradesh), operationalised in 2024, connects Tawang with Tezpur via NH13.
3. Digital backbone for remote connectivity: Expands e-governance, banking, education, and healthcare access.
   • Eg: BharatNet Phase II covers over 3,000 villages in the Northeast with optical fibre (MeitY, 2024).
4. Air connectivity for mobility and perishables: Reduces travel time and aids export of regional produce.
   • Eg: Hollongi Airport (2022) improved access to Arunachal; supports cargo handling of organic pineapples and spices.
5. Inland waterways for regional integration: Revives traditional trade routes and reduces logistics cost.
   • Eg: National Waterway 2 on Brahmaputra River supports trade with Bangladesh and Assam hinterland (Ministry of Ports, 2023).

Why improved connectivity alone may not guarantee inclusive development

1. Digital exclusion in tribal areas: Connectivity doesn’t ensure access due to device, skill, and language barriers.
   • Eg: NITI Aayog SDG Index 2023 ranks Nagaland and Meghalaya lowest on digital inclusion metrics.
2. Displacement without consent: Projects can trigger alienation when imposed without local consultation.
   • Eg: Manipur tribal protests (2022) over highway expansion cited violation of FPIC norms under UNDRIP.
3. Ecological degradation from unplanned development: Infrastructure in biodiversity hotspots worsens environmental fragility.
   • Eg: Kaziranga flyover project faced stay from Guwahati High Court (2023) due to elephant corridor concerns.
4. Urban-rural development skew: Benefits of connectivity often accrue to urban centres, leaving remote areas underserved.
   • Eg: Guwahati and Shillong absorb most tourism and trade gains, while tribal belts lack last-mile access (MoDoNER data 2024).
5. Weak local institutional capacity: Panchayats and ADCs lack capacity to leverage or regulate rapid development.
   • Eg: Sixth Schedule councils often excluded from infrastructure planning, leading to overlaps and friction (MHA Report 2023).

Conclusion
Connectivity is a necessary catalyst, but without community participation, ecological foresight, and governance reform, it cannot translate into inclusive development. Northeast India’s rise must be rooted in justice, not just infrastructure.

Topic: Conservation, environmental pollution and degradation, environmental impact assessment

Q6. India’s worsening environmental and health indicators reflect a deeper crisis of developmental planning. Analyse the interlinkages between climate shocks, public health gaps and the growing economic vulnerability of the population. Suggest an integrated policy roadmap. (15 M)

Difficulty Level: Medium

Reference: DTE

Why the question:
The State of India’s Environment 2025 report, which shows alarming trends in displacement, emissions, pollution, and health burdens — pointing to structural planning failures.

Key Demand of the question:
To explain how climate shocks, poor health systems, and economic insecurity are interlinked and to suggest a unified development policy that addresses these combined vulnerabilities.

Structure of the Answer:

Introduction:
Mention recent environmental data (2024–25) that reflects systemic risks and breakdown in sectoral planning.

Body:

• Climate shocks and public health: How extreme weather aggravates disease and health infrastructure gaps.
• Climate shocks and economic vulnerability: How floods, pollution, and warming threaten livelihoods and deepen poverty.
• Policy roadmap: Propose climate-resilient, health-integrated, and inclusive development models.

Conclusion:
Call for data-driven, equity-oriented governance that treats climate-health-economy as a single continuum.

Introduction

The 2025 report by Centre for Science and Environment (CSE) highlights that India’s multiple crises—environmental, health, and economic—are not isolated but deeply interconnected, revealing gaps in long-term development planning.

Body

Interlinkages between climate shocks and public health gaps

1. Extreme weather and disease outbreaks: Climate events increase vector-borne and water-borne diseases, overwhelming weak health systems.
   • Eg: In 2024, 88% of the days saw extreme weather events, leading to flood-linked leptospirosis and diarrhoea spikes in Assam and Bihar.
2. Displacement-induced health crises: Climate-linked migration disrupts access to healthcare, nutrition, and sanitation.
   • Eg: 5.4 million people were internally displaced in 2024, with Assam accounting for nearly half.
3. Air pollution and NCD burden: Climate-linked urban smog raises respiratory diseases amid limited public health capacity.
   • Eg: 13 capitals including Delhi had unsafe air 1 in 3 days since 2021; Delhi’s life expectancy reduced by 8 years .
4. Public health system inadequacy: Climate shocks expose infrastructural gaps in rural and urban health provisioning.
   • Eg: India faces 36% shortage of Community Health Centres and 80% shortfall in specialists (NITI Aayog, 2023).

Interlinkages between climate shocks and economic vulnerability

1. Informal livelihoods disrupted: Agriculture, construction, and informal services suffer from erratic climate, leading to income loss.
   • Eg: Real incomes of salaried and self-employed workers declined between 2017 and 2023.
2. Asset destruction from disasters: Floods and heatwaves destroy homes, land, and tools, deepening poverty cycles.
   • Eg: Floods accounted for two-thirds of displacement in 2024 and caused over ₹30,000 crore in damages.
3. Out-of-pocket health expenses rise: Poor access to public health forces spending, pushing families into debt.
   • Eg: 45% of total health expenditure is out-of-pocket; in Uttar Pradesh, it exceeds 65% (National Health Accounts, 2023).
4. Job insecurity worsens vulnerability: Informal workers lack social security or climate insurance.
   • Eg: Over 73% of India’s workforce is informal; only 20% of women are employed full-time (PLFS 2023-24).

Integrated policy roadmap for resilient development

1. Mainstream climate-health planning: Adopt Health in All Policies (HiAP) approach integrating climate risks.
   • Eg: Lancet Countdown 2024 recommends health-climate integration in local planning; Kerala initiated health risk mapping for heat zones.
2. Strengthen rural and urban health systems: Invest in infrastructure, digital health, and mobile outreach in vulnerable regions.
   • Eg: 15th Finance Commission suggested performance-linked health grants for primary care strengthening.
3. Build climate-resilient livelihoods: Promote climate-smart agriculture, green employment, and risk insurance for informal workers.
   • Eg: Mahatma Gandhi NREGS Climate Resilience pilots in Maharashtra and Odisha for floodproofing and dryland farming.
4. Develop disaggregated climate vulnerability databases: Prioritise real-time data collection on health, income and migration.
   • Eg: CSE 2025 called for more granular data to target interventions; NITI Aayog’s SDG dashboard should include climate-health indicators.
5. Legal and institutional reform: Revise Environment Protection Act, empower State Disaster Management Authorities, and ensure Centre–state coordination.
   • Eg: T.S.R. Subramanian Committee (2014) stressed on environmental governance reform and decentralisation.

Conclusion

India’s development blueprint must now align with climate, health, and equity imperatives. Investing in climate-resilient public systems and data-driven governance is not just adaptation—it is survival.

General Studies – 4

Q7. In public healthcare, ethical failure is not just clinical — it is also administrative and moral. Examine the layers of ethical responsibility in cases of medical negligence in public hospitals. (10 M)

Difficulty Level: Medium

Reference: NIE

Why the question:
Probe ordered after five patients die at Odisha hospital due to alleged medical negligence

Key Demand of the question:
The question requires an analysis of how ethical failures in public hospitals go beyond clinical errors to include administrative and moral aspects, and an examination of the multiple layers of ethical responsibility in such cases.

Structure of the Answer:

Introduction:
Briefly highlight how public healthcare systems are morally bound to uphold more than just medical competence.

Body:

• Discuss clinical errors, administrative dysfunction, moral indifference, lack of transparency, and absence of institutional learning.
• Cover ethical duties of doctors, hospital administration, health departments, the state under Article 21, and societal obligations.

Conclusion:
Emphasise the need for integrated ethical accountability at all levels to ensure dignity, justice, and trust in public healthcare.

Introduction:
Medical negligence in public hospitals often reflects not just individual error but a deeper ethical collapse across professional, administrative, and institutional domains — eroding public trust and human dignity.

Body

Ethical failure beyond clinical lapses

1. Clinical misjudgment and breach of non-maleficence: When care is compromised due to haste or error, the ethical duty to avoid harm is violated.
   • Eg: In the Odisha SLNMCH case (2025), five ICU patients reportedly died after being administered emergency injections, raising concerns about risk assessment.
2. Administrative neglect and systemic irresponsibility: Poor procurement, staffing gaps, and absence of SOPs reflect ethical failure in governance.
   • Eg: In the Gorakhpur BRD case (2017), oxygen supply disruption caused by delayed payments exposed serious institutional mismanagement.
3. Moral indifference and absence of compassion: Ignoring the emotional and informational needs of patients’ families reflects failure in humane values.
   • Eg: In Koraput (2025), families protested over lack of communication and support after the deaths, leading to police deployment.
4. Lack of ethical transparency and delayed disclosure: Suppressing information or delaying response violates the principles of truth and accountability.
   • Eg: Public clarifications in hospital death cases, including Odisha 2025, were issued only after public unrest, not proactively.
5. Failure to institutionalise ethical learning: Repeated failures without policy reform or ethics audits show lack of moral introspection.
   • Eg: MoHFW (2023) found over 70% of public hospitals lack functional ethics committees or adverse event protocols.

Layers of ethical responsibility in public hospital negligence

1. Doctors’ duty to care under professional ethics: Medical staff must ensure competence, consent, and prioritisation of patient welfare.
   • Eg: NMC 2023 guidelines stress continuing education and ethical medical decision-making, especially in critical care.
2. Hospital administration’s role in institutional ethics: Leaders must ensure systems for emergency readiness, staffing, and patient safety.
   • Eg: In BRD Hospital, lack of internal alert mechanisms and logistical planning contributed to avoidable child deaths.
3. Health departments’ regulatory and ethical oversight: Departments must ensure compliance with ethical norms, audits, and redress mechanisms.
   • Eg: The K. Sujatha Rao Committee (2018) recommended district-level ethics units and institutional accountability mechanisms.
4. State’s constitutional obligation under Article 21: Ensuring accessible, safe healthcare is a part of the right to life and state accountability.
   • Eg: In Paschim Banga case (1996), SC ruled that the state is liable for failure to provide timely medical care.
5. Society’s moral duty toward truth and reform: Beyond monetary aid, ethical closure requires acknowledgment, justice, and systemic change.
   • Eg: ₹10,000 compensation to Koraput victims (2025) was seen as insufficient without structural or moral redress.

Conclusion:
Ethical healthcare is not a matter of individual intent alone — it demands institutional courage, administrative ethics, and moral commitment to preserve dignity, justice, and the right to life.

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