TENTH JOB AS LEAD PARTNER
AND CONSULTANT IN EMRI-3
With Satyam Computers Ramalinga Raju
and CEO Venkat Changavalli
Professions, Checkered Career,
and Lessons-15
Vanam Jwala Narasimha Rao (October
10, 2026)
The process was quick in some
states and slow in others, mainly due to bureaucratic hurdles. To counter them
was also a challenge. CEO Venkat either guided me in such situations or
together we had drawn a perfect strategy. Everywhere the process involved
visits of either side’s representatives, discussions between EMRI and top
administrators of the cadre of Chief Secretary and or Chief Minister, formal or
informal project proposals including financial implications, tender suiting to
the state’s requirement in terms of bidder’s capacity and capability to provide
service and finally appointing EMRI as nodal agency after necessary approvals
and clearances.
Transparency, accountability, and
citizen friendly principle was the process that was adapted. On the
occasion of either signing the MoU or launch in every state the Chief Minister,
the Health Minister, the Chief Secretary and other senior Government officials
from Police, Fire and Medical departments were present with few exceptions.
Even in subsequent launches to true to the spirit of PPP presence of Government
partners was ensured. And it was a lifetime learning to me.
For instance, there was no hard
and fast rule that, the governments, to follow in choosing a non-profit
organization to partner with it for providing services in PPP framework either
in the health sector or in the social sector. Nor there were any standard
guidelines in this regard. What I closely observed in EMRI was that, except in
few cases where government resorted to open tendering, most of the partnerships
revealed that the government and the private partner, when chosen to consult
each other, formally or informally, before venturing into partnership
agreements, the results were encouraging.
However, in such partnerships,
charismatic leadership and vision of the persons from both sectors, played a
critical role. There were also compelling circumstances and relationships based
on trust that were critical in triggering PPP initiatives. Either the
government may approach the private organization or the private organization
may work hard to convince the political and administrative leadership in the
government.
While in EMRI and later on
observing EMRI after leaving it, my learning was that, a competitive process of
selecting the private partner for PPP framework was less effective than an
invited or negotiated partnership. While competing to win the deal, the private
partner’s primary concern would invariably be to quote less to become the
lowest bidder, whereas the government side officials’ main concern would be to
meet procedural requirements than meeting beneficiaries’ needs. Tendering
process in government would be adapted to choose the lowest bidder, which
technically may be correct but in the long run leads to failures.
Though it may be economical
initially, the trend later would be up-ward revision of costs and if government
disagrees, then the level of quality and effectiveness comes down. Resorting to
transparent and competitive process may be useful for commercial projects but
not in social sector where reaching the poor is a priority rather than pricing
of services. Hence either prior negotiations with the potential partner or a
tender where eligibility conditions are tailor-made or the prior experience of
the private partner to be used as a basis for choosing would be ideal for the
success of PPP.
My experience has been that,
partnerships would be formed between organizations but succeed only because of
individuals who are strong leaders and who champion the partnership projects
with vision, energy, and enthusiasm. If it is the CEO-EMRI and his team from
the private side, it has been either the Minister concerned or the Secretary
concerned or a combination of both from each and every state who championed the
cause. In most of the states the Chief Ministers pro-actively pushed the
project. PPP is different from privatization and Partnership is not meant to be
a substitution for lesser provisioning of government resources nor an
abdication of Government responsibility.
When I was working in EMRI,
‘National Health Systems Resource Centre (NHSRC)’ Expert Advisors deputed by
Government of India’s NRHM, after a detailed study of EMRI-108 model in
November 2008, observed that, ‘It undoubtedly a historic landmark in the provision
of health care in the nation. To its credit goes the achievement of bringing
Emergency Medical Response on to the agenda of the nation. Its tremendous
popular appeal made it possible for it to emerge as one of the leading
innovations.’
The Study team observed that, in
the Indian context, the much discussed and successful PPP (Public Private
Participation) Model for ERS was the 108 Ambulance Emergency Services being
managed and operationalized by EMRI. The team admired the tremendous gratitude
and praise of the family members, of the emergency victim, in first person, for
the timely arrival of this ‘Angel of Mercy’ which was most convincing
and moving and made the service very popular. By then, eleven states have
already signed MOU with EMRI for running the ERS and 9 out of them were in
operationalization. I being the Lead Partner of PPP felt immensely happy and proud
with this observation.
What follows is not merely an
account of events or a chronicle of institutional milestones, but it is a lived
narrative from within one of India’s most consequential Public Private
Participation Experiments in social impact. Seen through the lens of policy,
leadership, crisis, conviction, and compromise, this account captures the
making, testing, and transformation of EMRI and the 108 Emergency Ambulance
Services, an initiative that touched millions of lives. It bears witness to how
visionary intent, political will, professional integrity, and human fragility
intersected within the framework of a Non-Profit PPP. Above all, it reflects my
own journey as a participant, observer, and active custodian of that
partnership, standing at the confluence of governance, ethics, and execution.
In the Independent History of
India, among all the policy decisions taken over the past sixty years, the most
crucial one is the ‘Not for profit Public Private Partnership.’ More than
economic liberalization, more than globalization, more than the communication
revolution, and more than many such policies, this process has gradually been
gaining acceptance across all sectors. In accordance with the ideological
framework of Prime Minister Manmohan Singh, this PPP Model was introduced into
the healthcare sector as the ‘Rajiv Arogyasri’ Scheme.
It was infused with life,
strengthened, given a fresh interpretation, and shaped into a guiding model for
the entire nation, an achievement that entirely belongs to the late Chief
Minister Dr YS Rajasekhara Reddy. Under that umbrella, the 108 Emergency Ambulance
Services, which attained the highest level of importance, were especially dear
to Rajasekhara Reddy. While working at EMRI, which were the most cherished
among all the schemes dear to Rajasekhara Reddy, I had the opportunity to meet
him as frequently as possible.
In every meeting, his personality
and sense of dedication were clearly evident, reflected unmistakably in every
word he spoke. As a result of the decisions, he took during those meetings and
the directions he issued to officials, lakhs of lives were saved, not only in
the state of Andhra Pradesh, but also in other states that drew inspiration
from the scheme implemented there. I still vividly remember January 8, 2009.
Every word spoken by the Chief Minister Rajasekhara Reddy that day, and every
assurance he gave, continues to echo in my memory. On the previous day,
Ramalinga Raju, the Great Founder Chairman of EMRI, had been sent to jail in
connection with the Satyam Computers scandal.
Within a span of twenty-four
hours, Rajasekhara Reddy immediately convened a meeting, summoning EMRI
officials and conducting a meticulous review of the delivery of the 108
Emergency Services, in the presence of senior officials from the Medical and
Health Department and Finance Minister Rosaiah. This review was not held to
find faults or to reprimand us. In fact, since Raju had already announced his
resignation as EMRI Chairman, the CEO Venkat Changavalli and his leadership
team were in a state of uncertainty, anxious about the possible disruptions and
challenges that might arise in providing emergency services in the immediate
future.
Rajasekhara Reddy issued clear
and unequivocal instructions to government officials as well as to the EMRI
management that, even if the sky were to fall, 108-Ambulance Services must not
be allowed to stop under any circumstances. He stated that, if necessary, the
government was prepared to increase its contribution to operational expenses
from the existing 95 percent to a full 100 percent. Finance Minister Rosaiah
and EMRI CEO Venkat Changavalli however, pointed out that, complete funding
would run contrary to the very concept of PPP, and could invite criticism. The
proposal was put on hold. In the months that followed, for three to four
months, Rajasekhara Reddy remained busy with the elections.
{{From my Forthcoming Book
PROFESSIONS, CHECKERED CAREER,
AND LESSONS
(From Librarian to CPRO to CM
KCR)
A Journey from Khangi School to
Center for Excellence}}
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