How a policy is made and carried out

A ramp to better health care. Smt. Shanti Devi, aged 72, reaches a hospital and finds only stairs to the outpatients' department: no ramp, no handrail. A man in a wheelchair cannot get in at all, and a visually impaired person cannot find the departments because the building has no Braille signs and no tactile paths to follow. Patients raise the issue with the hospital and local representatives; a disability rights group spreads the word in newspapers and on social media, and the district administration asks the PWD and the Health Department to inspect. After consulting doctors, staff, architects, groups working with persons with disabilities, senior citizens and residents, a plan is made; the government approves funds for ramps, lifts, handrails, tactile paths, accessible toilets and clear signs. Now older people, pregnant women, children, patients and persons with disabilities can all use the hospital.

That is how a policy moves from a problem to action. The policy cycle (Fig. 4.5) has these stages:

• Desirability: what need or problem must be addressed?
• Prioritising: which issues come first?
• Formulation: consult stakeholders, draft the policy, check the cost.
• Adoption: frame the laws and the rules and guidelines.
• Implementation: put it into action through officials, local bodies, civil society, private organisations and citizens.
• Monitoring: measure progress, keep people accountable, find what is going wrong.
• Evaluation: judge the results and impact, and collect feedback - which starts the cycle again.

Skip a step and things go wrong: plant one lakh trees but never check that they are watered, and most die.

NEP 2020: a policy built by consulting people. India's previous education policy was from 1986. Work on a new one began in 2015; in 2017 an expert committee chaired by the scientist Dr K. Kasturirangan started drafting. The draft was opened to everyone for feedback: the consultation reached 676 districts, 6600 blocks, 6000 urban local bodies and 2.5 lakh Gram Panchayats, and about 2 lakh suggestions came in. Many were included, and the Union Cabinet approved NEP 2020 in July 2020.

Policy, programme, scheme. A policy gives the direction (what the government wants and why). A programme shows the path (the plan). A scheme is the action that brings benefits to people. Example: the National Health Policy 2017 aims at good-quality health care for all; its programmes include strengthening the health system and preventive care; its schemes include AB-PMJAY (health insurance for hospital care), health and wellness centres, Janani Suraksha Yojana and Mission Indradhanush (immunisation).

Coordination is the key. In a country as big as India, a policy succeeds only if many levels work together. Khelo Bharat Niti 2025, India's sports policy, shows this:

• the Central Government gives the framework and funding;
• state governments host national games and build facilities, aiming to be a 'Model Sports State';
• districts try to become 'Model Sports Districts', and blocks hold regular events to find talent;
• sports institutions provide coaching and equipment; private organisations give sponsorship and fund research on nutrition and equipment;
• families and citizens encourage children, especially girls, and specially abled students to play.