The ex-servicemen contributory health scheme (ECHS) was approved by Government of India on 30 December 2002 and launched with effect from 1 April 2003. ECHS is an adjunct to existing infrastructure of Armed Forces Medical Services. It is an entirely public-funded scheme underwritten by the Ministry of Defence, Government of India. ECHS is a comprehensive health care scheme to cater to the needs of pensioners of Armed Forces within easy reach of their place of residence including in far-flung areas. The main purpose is to be able to manage efficiently the needs of 20 lakh ex-servicemen pensioners population and their dependents totaling to one crore beneficiaries. Retired Armed Forces Pensioners so far did not have any Medicare scheme, which would parallel the one available to other Central Government employees. The existing Army Group Insurance (AGI) and Air Force Group Insurance Scheme (AFGIS) had many limitations and covered only small number of diseases.
Polyclinics
GOI/MOD has initially sanctioned 227 polyclinics spread all over India, which are to be constructed by 31 March 2008.
Configuration. The configuration depends on the population of ex-servicemen (ESM) in that area. The different types of polyclinics will differ in terms of manpower. Types A and B will have a medical specialist, a gynaecologist and an extra medical officer as compared to types C and D.
Medical equipment and manpower. Polyclinic in military stations are supported by local military hospitals for both equipment and manpower.
Drugs and consumables. In military stations, indents are generated from polyclinics and the collections made through senior executive medical officer. He can use enhanced financial powers for not available (NA) items through Director General Local Purchase (DGLP) fund. In non-military stations, officer-in-charge polyclinics send demand through empanelled druggist. The bills submitted every 15 days are charged through station commander. Ceiling limit for local purchase by OIC polyclinic depends on type of polyclinic and ranges from 30,000 per month for types C and D polyclinics to 50,000 for types A and B. The financial power range from 20,000 to one lakh depends upon the rank of the SEMO/Commander.
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 hang-up initially.
Medical and paramedical personals are not coming forward to take up employment, as it is contractual in nature and the remunerations do not commensurate with qualifications. In addition to this, the QR is not attracting competent professionals.
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.
Dr Deswal B S
Department of Community Medicine, Armed Forces Medical College, Pune - 411 040, Maharashtra, India
For more information email: deswal_bbir@rediffmail.com
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