ECHS: Health care at crossroads?

Sent: Tuesday, June 02, 2009 5:00 PM
Sirs,
I was in a dilemma for a long, whether to express my opinion on ECHS or not? And if decide to express, then in what form? Having shredded uniform 25 years back I would like to express my view without any reservation. Some of this is my personal experiences some realised while working in ESM organization. Let it be a healthy discussion.

First I must say it is a very good scheme, but very badly implemented. Good for few but worst for the majority. Majority residing in the area where polyclinics are not located. Or even if located in same town, it is at a distance of 30-40 kms. In town where polyclinics are located, there the problems of ESM are less. Polyclnics at present are in less than 200 places in the country. Where as there more than 550 districts in the country. For some it is at a distance of 600-700kms. What benefit he can have of this ECHS? Those residing in Delhi and north are not aware of the reality. They have polyclinics, MH and number of empanelled hospitals with easy access to command HQS, Stn HQ and ECHS polyclinics. It is the plight of others where polyclinics are not located. I would surely agree that probably strength of ESM is not adequate for establishing polyclinic. The problem of ESM of this area can be addressed very well if those in the chair adopts a human approach and has a consideration for the unfortunate ESM and desire to work and take up the matter with appropriate authority. I have few suggestions.

(1) On joining of ECHS scheme the very first loss to veteran is stoppage of FMA. ESM of far flung area firstly does not get the medical facility within a reasonable distance. On top of it he has to surrender a meager sum of Rs.100/- which he is being paid if not a member of ECHS. This needs to be reviewed. ESM can continue drawing FMA till such time a polyclinic is opened within say a distance of 50 kms of his/ her residence. If I recollect correctly this FMA is out of pocket allowance granted to ESM for their day to day medicines and treatment at MH. Hence discontinuation of FMA is not correct. Other central Government servants receive this FMA as well aand are covered under CGHS. Then why this injustice to ESM?

(2) A special drive be undertaken by all Command HQS to get at least 2-3 hospitals empanelled in each district. For this they should depute 2-3 persons who are well conversant with ECHS rules like filling up the forms, CGHS approved charges and so on. They should go to all the places from where a local ESM organization has forwarded name of a hospital for empanelling. Empanelment of hospitals will give some relief in emergency to ESM residing in area where polyclinic is not available. If possible at each district HQs where sufficient number of ESM are not available veteran officer/ hon offr/ Sub maj can be appointed as officer i/c polyclinic and local polyclinic with the help of empanelled hospital.

My experience is that hospitals are not coming forward for empanelling as they are not well conversant with filling of the form/ claim etc. We had proposed one very good hospital for empanelment at Surat about 3 yrs ago. A team from Vadodara/ command Hqs also had inspected this hospital. Hospital had filled up the form for empanelment and draft of Rs.2500/- handed over. Till date no progress. Form missing. Report of expert team not traceable. Rs.2500/- credited to regimental fund. Can any one take up the matter with Army HQ/ Southern Command to investigate? The same hospital is still ready but we have not received any help from Stn HQ at Vadodara to fill up the form.

Recently Director of Medical Services of Army HQ has issued a directive and stopped issue of medicines for more than one month at a time. Explanation given is not digestible. Has the gentleman issuing directive aware of the agony individual has to under go if he has to get medicine every month? I know a case where a widow of a PBOR has to start her journey a day in advance to reach in time for receiving medicine. The expense, time spent on journey and energy expended is much higher then the one months medicine. I do not know why an out station ESM cannot be issued medicine for three months, if recommended by the specialist? We in services believe in withdrawing the privileges than to extend a helping hand.

In emergency, policy says, member of ECHS can get admitted in any hospital and get treated. But within 2 working days must communicate about admission to parent polyclinic. It is next to impossible for the officer, to get through polyclinic in normal circumstances. How can we expect PBOR or their family to get in touch when in Emergency. For this I feel organization should have TOLL free BSNL/ MTNL number on All India basis and ESM can record admission and give his requisite information. Subsequently action as required can be initiated by the polyclinic like intimating ECHS member the requirement for claiming reimbursement, forward him form etc to fill up.

I request every one who are in the ECHS administrative loop give TOP priority to ECHS as it has not reached more than 50%-60% of ESM.
Sqn Ldr Bankim Sutaria (Retd)