ECHS: Present status and hang- ups

ECHS Scheme

Financial Outlay. Government accorded sanction for Capital Budget 122 Crores as one time sanction and Revenue Budget 354.50 Crores Per annum.

Man Power At Central Organisation, Regional Centres and Station Headquarters. Man Power at Central Organisation, Regional Centres and Station Headquarters will be met from within existing resources of Service Headquarters. 61 Officers and 249 PBORs sanctioned for Central Organisation and Regional Centers. In addition 122 Station Headquarters have been provided Manpower from the existing resources of Service Headquarters.

Infrastructure and Manpower at Polyclinics is based on type of polyclinics on dependent population-(type A/B/C/D and Mil/Non Mil). Type A 20,000 or more Type B 10,001 – 20,000 Type C 5,001 – 10,000 Type D 2,500 – 5,000. Recruitment of the manpower for the proposed Polyclinics would be done on contractual basis. Following Equipments and Manpower has been provided at Polyclinics:

Medical Equipments. X-Ray machine, Ultrasound, Lab Auto Analyzer, Dental Equipments (including Chair), Physio therapy (Standard Set), ECG Maghine, Monitor Defibrillator and other small Equipments and Laboratory equipments.

Other Equipments. Generator, Air Conditioners, Ambulances and Light Vehicles.

Medical Facilities and Manpower. Medical Officers, Medical Specialists, Gynecologist, Dental Officers, Officer-in-Charge, Nursing Assistant/Nurse, Lab Assistant, Dental Hygienist, Receptionist/Care taker, Driver, Peon, Safaiwala and Female Attendant.

Present Status
01. Polyclinics. All 227 Polyclinics established and all are operational. 60 out of 227 polyclinics are functioning from the newly constructed buildings.
02. Membership. 5.5 Lacs ESM pensioners have already joined the scheme out of 20 Lakhs ESM Pensioners eligible.
03. Empanelment of Private Hospitals. 1002 Private Hospitals/Nursing Homes/Diagnostics Centres/Dental Clinics/Laboratories has been empanelled with ECHS TILL DATE. In Delhi and NCR 67 Private Hospitals have been empanelled.
04. Smart Cards. Imperative for medicare. It normally takes two months to obtain Smart Cards on submission of application. In interim the receipt issued on submission of application by Station Headquarters/Director ECHS(Navy) is valid for two months till receipt of Smart Cards for availing entitled medicare.
05. Supreme Court Judgment. Supreme Court has given judgment regarding exemption of ECHS Contribution for Pre-1996 Retirees. Armed Forces Veterans who are drawing pension form Controller of Defence Accounts and who have retired before 01 Jan 1996 are exempted from payment of contribution under Ex-Servicemen Contributory Health Scheme. However, they have to apply for membership on the prescribed application form attaching all relevant documents except the MRO. The issue of refund of contribution to those Pre- 01 Jan 96 Retirees, who have become ECHS members, is sub-judice and action will be taken as per the ruling given by the Govt. Present satus is unknown!
06. Medical Treatment to ex-servicemen who have not joined ECHS. The ECHS has been operational wef. 01 Apr 2003. The Ex-servicemen who have retired prior to 01 Apr 2003 have the option of joining the scheme and thereby avail the medical benefits. Despite having issued clear instructions on the subject in the past, there seems to be doubt regarding the status of ESM who have not joined the ECHS. It is intimated that the AFV who have not joined the ECHS will continue to be treated in service hospitals subject to availability of beds and facilities. AFV are not entitled to transfer/referral from one service hospital to another.
07. No Reimbursement. No reimbursement applicable directly to ECHS members except for non empanelled private hospital bills on lifesaving grounds. Reimbursement approved only by MDECHS. KSB/INBA is not considering reimbursement to ex-servicemen pensioners for serious diseases as hitherto due to paucity of funds. Es-servicemen pensioners advised to join ECHS earliest. AFV to forward medical reimbursement cases to Kendriya Sainik Board directly through ZSB/RSB and not to NHQ/DGMS(N)/PDNPF/PDESA as KSB will not reimburse claims submitted directly from NHQ. Non pensioners ex-servicemen and families, will continue to be provided with financial support for medical treatment by KSB through Armed Forces Flag Day Funds for serious ailments. Financial assistance up to 90% for sailors and 75% for Officers provided by KSB and balance reimbursement considered by Secy INBA/PDNPF.
08. Ex-Servicemen Non Pensioners. Not entitled for any medicare in ECHS/Military Hospitals.

Teething problems
•One major problem that is being faced is lack of publicity in non-military stations where ESM are living in far-flung regions and remote villages.
•The ones already aware have put on the “wait and watch” attitude and are reluctant to change their existing way of life.
•The “smart Card” is still in infancy and the distribution is slow; the electronic system may have its own hangup initially. The system not exploited for networking and indenting of drugs and monitoring load on Polyclincs nationwide.
•Medical and paramedical personnel are not coming forward to take up employment, as it is contractual in nature and the remunerations are not commensurate with qualifications. In addition to this, the QR is not attracting competent professionals. There are no Ex- MNS employed for no precise reasons.
•There is an additional load on already busy military hospitals for indenting, empanelment, processing of bills, technical preparation and purchase of drugs. Additional logistic support is needed for smooth conduct at polyclinics.
Conclusion
ECHS is one of the many initiatives taken jointly by Government and Armed Forces to alleviate the socioeconomic needs of retired pensioners of the Armed Forces. It is a comprehensive Medicare scheme on lines of already existing CGHS for government employees and a major venture in social security for the benefit of ex-servicemen from Armed Forces within easy reach of their place of residence. The goals are laudable but in practise the great majority of ESM are feeling the heat on shortages in the Polyclinics of manpower, medicines and equipment. The Polyclinics locations are lopsided and everyone is heading towards the Metropolis which means skewed load on Polyclinics!
ECHS Bulletin (not updated)