Do UTCs teach us anything?

THE creation of Urban Transformation Centres (UTCs) is an innovative solution to the delivery of government services. It decentralises departments such as the Road Transport Department and the National Registration Department, bringing them closer to the people.

I am told that Tan Sri Irwan Siregar, the secretary-general of the Ministry of Finance, is the architect of this ingenious public service delivery design.

The UTC case illustrates how the state can reach the people in simple but tangible ways. Although the UTC concept now seems obvious and unworthy of special mention, the government had not thought of it earlier.

What are the important take-aways from the UTCs?

First, it points out that public service delivery can be decentralised. Second, working hours can be made flexible to suit the needs of the public rather than to have it the other way. (The UTCs are open till late in the evening.)

Third, UTCs are situated in locations that are at the hub of activity and well-served by public transport.
Finally, they are an illustration that more can be done with a little creative thinking and a small cost outlay.
The main principles behind the UTCs can be applied across other domains.

To take an example, the Ministry of Health could try to figure out how it could apply these essential ideas to the provision of healthcare services.

Consider the following:

» Can health and dental clinics be placed within UTCs? (This is already the case in some UTCs.)

» Can these clinics be further decentralised and their reach increased?

» What can be done to lower the cost of medical and dental treatment?

» What can be done to reduce the long queues at existing facilities?

In seeking solutions to the above some developments should be taken into account.

It should be noted that there is an influx of institutions that offer degrees in medicine and dentistry. There is a corresponding increase in the supply of doctors and dentists. These events should be harnessed to bring down the cost of health services.

As it stands, quite the reverse may happen. When fresh graduates find it difficult to find placements within public hospitals they will decide to pursue careers outside their training. Consequently, private universities will scale down their offerings in these courses. Intending students will choose not to study medicine or dentistry.

These factors will bring down the supply of health professionals. This is not what we want.

Some alternative solutions can be examined. The state could, perhaps, create smaller centres that provide healthcare services. Thus, absorbing human capital that will otherwise be wasted and increasing the reach of healthcare facilities.

Another solution could be to offer credit and business planning support to help budding professionals to set up their own clinics.

The state could act as a franchisor of healthcare services. These franchised clinics could be located in residential areas or in shop lots.

It may also be possible for the state to collaborate with private universities to extend its treatment facilities. This will reduce the burden of handling increasing patient numbers for public hospitals. At the same time these professionals can be given gainful employment and the private hospitals will have more training facilities at their disposal.

None of the above ideas have been tested for practicability.

I have no experience in healthcare management. Hence, my suggestions could be flawed when it comes to their implementation. I only wish to emphasise that innovative solutions to difficult problems must always be explored. It may help to think of these problems as mathematical problems, much like a set of equations in mathematical programming.

The objective remains, it is to increase the distribution of healthcare services while recognising costs as a constraint.

The solution cannot come from shrinking the supply of doctors and dentists. It is, therefore, pointless to arbitrarily derecognise qualifications in an attempt to reduce the number of graduates. Neither is it fruitful to complain that public hospitals cannot bear the burden of training the increasing number of medical graduates.

None of this means that the standards of medical education and training should be compromised. To the contrary, standards should be kept high. Neither should the first response be to offer excuses for state withdrawal from healthcare provision.

The UTCs suggest that it is within the capacity of civil servants to come out with creative solutions that positively affect the rakyat.

Hopefully, the UTC case will inspire more lateral thinking on public service delivery.

Dr Shankaran Nambiar is a senior research fellow at the Malaysian Institute of Economic Research. Comments: