ECHS Handbook: Demystifies Itself

Dear Veterans,
Directorate of Personal Services, Air HQ, has brought handbook incorporating every facet of the ECHS. It is an aide memoir for the veterans.
Yash Pal Diwan
HAND BOOK ON EX-SERVICEMEN CONTRIBUTORY HEALTH SCHEME: click here

Pay and Allowances: Serving Officers

FAQ's for Serving Officers
Replies to FAQs have been provided with reference to the extant orders on the subject and practice being followed regarding the same. Difference in interpretation of rules, if any, may be referred to the Army authorities through staff channels. In case you notice any difference between these FAQs and the PCDA (O) handbook, please write back to PCDA (o).
FAQ's for Serving Officers: Click here
Click here for ECHS FAQ's
ECHS compendium of Government Letters

ECHS: Letter to Chairman Oversight Committee

Dear General Raviraj,
I was delighted to speak with you on 27 Jun 2012 and to know you were heading a Committee to bring about improvement in the functioning of the ECHS. I would have been happier still if your charter included the possibilities of closing it down for at least those for whom it has become a pain in the neck.
On raising the Association the first essential thing we thought for Veterans was ASSURED MEDICAL FACILITY at Govt expense. During the first ten years we made many suggestions to the Govt about it but when we found a flaw in it we withdrew it, till we arrived at a flawless medicare policy scheme. This scheme was to be fully financed by the Govt.
It took me another ten years to get it sanctioned by no less a person than the Hon'ble PM himself on 26 Jul 2001. After its approval it was passed onto the Service Headquarters by the MOD with directions to produce the best scheme under those parameters and it would be fully financed by the Govt. The Govt was prepared to give that scheme within months.
Then our Service Headquarters came into play and denied us the best. I called it the greatest tragedy of life because my twenty years effort was destroyed , this time not by oft accused hostile bureaucracy but by our own Service Headquarters. When this was being destroyed I went and cried to the Chiefs and got course correction done three times, but finally the AG prevailed by deceit leaving us to curse our luck when we have to avail this facility.
What finally was dumped on us was a third rate copy of the outdated civil scheme of the CGHS. This scheme is basically a flawed scheme. No amount of flogging this dead horse is going to work. Your charter is therefore absolutely daunting and I sympathize with you.
Before the Scheme was launched the AG and the newly appointed MD of ECHS made a presentation at the USI telling us how good it was. I asked for perrmission to speak during the presentation,but was not allowed. Then I made out a paper and distributed to over 500 officers during the presentation. What I wrote then was true then and continues to be true even now. I am attaching that paper for you to go through now (not attached HERE being scan copy in pdf format). Will come back with more later.
This paper was presented to the COSC when they invited me for presntation to them on 25 Nov 2003 and to the Defense Parliamentary Committee several times. They all agreed with me but wanted to see its functioning for some time before reconsidering the decision. Now afer ten years we have not only seen its functioning but also suffered enough. Its time to act before it is too late. I will keep sending you some mails which would give you the immensity of the problem. Warm regards
Lt Col Inderjit Singh
Chairman AEIWA

ECHS is primed to work for Senior Officers and not for Veterans who are human beings

ALL INDIA EX SERVICES WELFARE ASSOCIATION
To: Maj Gen Raviraj Oberoi
Chairman ECHS and Oversight Committee For Poly Clinics
New Delhi
Dear General Raviraj,
I write to you about two recent cases that have been brought to my notice about the contemptuous treatment meted out to the Veterans by the staff of these ECHS Poly Clinics. The first one is from SURAT, Gujarat and the second is from Mandi Himachal Pradesh. Hony Capt Skatter Singh(Mob : 09978885445/09879999347) called from SURAT,Gujarat today and the other one was sent to me by our associates for help. I was about to write to the Chiefs when I got the information about your activities. I thought it better to write to you as I felt that that would serve dual purpose. One of getting it sorted out faster and two awareness for you about the difficulties being faced by the Veterans on account of this basically flawed scheme.
FIRST CASE
Hony Capt Skatter Singh has settled at SURAT in Gujarat since 2009 from Nagpur, Maharashtra. He has changed ECHS his own card (Reg No.-PN0075727) and that of his wife from Nagpur to Vadodara ECHS. His wife, Jasbir Kaur got major heart attack on 23rd June, 2012 afternoon. There being no poly clinic there at SURAT, he took his wife under trying circumstances to a private Hospital named CARE Hospital–The Heart Institute where they were able to save her life. She is still in ICCU and in recovering condition. He has been under serious pressure with the thought of having to pay the mounting medical bill in advance. As on date, he has already paid 4.5 lakhs for treatment. As his wife is still in ICCU, the medical bill will touch approximately 7 to 8 lakhs before her discharge from the Hospital.
Hony Capt Skatter Singh has therefore been in touch with Col Joshi, mob 09898907508, OIC of Poly Clinic at Baroda for help since 23rd June’2012. All that he needs from Col Joshi is an assurance to the Hospital that the bill will be paid by them. Instead of helping him, he is referring him to the Secretary ZSB Surat who has no authority to give an assurance on behalf of ECHS. He also wants Hony Capt Skatter Singh to first pay the bill and then claim it. The bill will go up to Rs. 7 to 8 lakhs, which the JCO does not have.
This is one case that has come up to me. There are many such cases that I do not have because people can not reach me. While you suggest means to overcome such problems in future, I appeal to you to kindly sort this one out now which I am sure you easily can with the authority vested in you I would be grateful.
SECOND CASE
This is the Press Release of the beleaguered Veterans that appeared in the news papers and also on a Veterans blog sent to me by them. By this Scheme all Veterans of lower ranks that includes officers, even after retirement are condemned to suffering from the hiearchial set up of the Armed Forces. This would have been overcome by the Medicare Policy Scheme and all Veterans would have got proper treatment and respect not because of being a senior officer but because he is a human being in distress. If there has been a default on the part of he Insurance company they would have been sorted out by the District level Committees itself rather than wait for an OSC to come from AHQ.
ECHS Polyclinics, Mandi: June 17, 2012
Apart from complaining of step-motherly treatment at all levels, the Honorary Commissioned Officers’ Welfare Association (HCOWA), Baldwara, has accused the ECHS polyclinics at Mandi and Sarkaghat of ignoring treatment of ex-servicemen in ECHS polyclinics. Talking to The Tribune on the sidelines of a meeting of the HCOWA held at Baldwara, Capt Jagdish Chand Verma, president of the association, said: “Honorary officers are being discriminated at all levels. We have no option other than moving a petition at the the Army Fast Track Court Bench in Chandigarh against discrimination. ”He said the government had no policy for honorary officers’ legitimate entitlements under government schemes.He said the staff posted at ECHS polyclinics in Sarkaghat and Mandi behaved in a high-handed manner, making even ailing ex-servicemen go from place to place. He charged the ECHS polyclinic staff at Mandi and Sarkaghat with harassing ex-servicemen. He cited the example of Baldwara ex-serviceman Sunder Singh (90) who travelled a distance of 70 km on May 23, 2012 get treatment at the Mandi polyclinic for severe pain in his abdomen. He was not attended to at Mandi and directed to Sarkaghat. But the Sarkaghat polyclinic too failed to treat him. As his pain persisted, he travelled back and got treatment at a private hospital where he was operated upon. Verma said the association had taken this matter with the Army Headquarters. He added that the association supported the demand for “one rank, one pension”.“We will step up stir unless all demands are not met with before the Assembly election in the state, members added. The state Sainik Welfare Board and the ECHS authorities claimed that they were not aware of the issues raised by the association.
CONCLUSION
I am very pleased to state that around Metros and some major cities where a large number of senior officers are settled the Poly Clinics are serving very admirably. This is so becaause of their influence they have got all problems sorted out. Such clinics however serve less than 10% of the Veterans. Unfortunately whenever an exercise like yours is done the opinions of such senior officers are asked and they praise it to the hilt and glory and every body thinks it is all hunky dory. Nobody has the time and energy to go to rural areas and find out the problems. I am sure that you would cater for this infirmity while writing your report and take appropriate measures in recommending the right solution to end this misery of the old and infirm Veterans who desperately need relief and succor. MY EXPERIENCE OF THIRTY YEARS SAYS, THE MEDICARE POLICY SCHEME IS THE ONLY ANSWER AND SOONER WE BRING IT IN THE BETTER. FOR THOSE WHO ARE SATISFIED WITH THE PRESENT SET UP CAN BE GIVEN THE OPTION TO CONTINUE WITH THE PRESENT SCHEME. I WOULD LOVE TO MAKE A PERSONAL APPEARANCE TO LAY THREADBARE THE WOES OF THE VETERANS TO THE OVERSIGH COMMITTEE IF THEY SO DESIRE.
Regards
Yours Sincerely
Lt Col Inderjit Singh
Comment: Kudos to Col Inderjit. He has hit the ECHS malady on its head. ECHS is a total failure for the vast majority of the Veterans. I have seen the whole Polyclinic is geared up for treatment of retired general's from the time of the receipt of a phone call to the ECHS; Ambulance despatched, reception arranged and red carpet treatment meted out. whereas the rest of the Veterans look on with wonderment and keep waiting for their painful turn. This happens in all Polyclinics. The Senior Officer syndrone is very much prevalent and Crores of Rupees (almost 50% budget) are spent only on less than 2% Senior Officers. The older traditional system since the British times which have proved more effective than what ECHS today embodies, that is, the treatment of Veterans by the Military Hospital. We need to revert to the old system and all ECHS and manpower should be placed under the administrative, financial and technical control solely with the MH. The Station HQs presently controlling the Polyclinics is a miserable disaster and total failure- as it only breeds sychopancy- corruption in recruitment of civilians and provisioning of Medical Stores and Empanellment of Civil and Private Hospitals where bribes influence the outcome. The circuitious rules and combersome procedures presently enacted are ideal for corrupt to breed and operate incognito and very difficult to identify the culprits who are out there to cheat the system at the expense of veterans. This system is akin to all Military scams like Adarsh, BEML Tatra Trucks, Sukhna and a host of others scams like them...I hope and pray that the Polyclinic Oversight Committee does not lose sight of the basic flaws of ECHS!

Deplorable State of Tirunelveli ECHS

THE STATE OF ECHS POLYCLINIC AT TIRUNELVELI: Is INS Kattaboman Sinking?

This is a Polyclinic situated in a Non Military Station in South Tamil Nadu. This is a Type ‘C’ clinic. This was established in the year 2004. For the past eight years, this clinic has been running smoothly under the control of Station HQ Thiruvananthapuram. Problems started mounting after it was taken over by INS Kattabomman. (A naval unit situated nearby)
The main problems are:
1. Two empaneled hospitals (Shifa Clinic and Galaxy Hospital) are refusing to admit ECHS members, because of the large amount of their bills not paid for a very long period. The O i/c ECHS Polyclinic helpless in this regard.
2. There is only one Medical officer, against the vacancy of four. There is no Medical specialist (MD) for more than two years in this clinic. Other medical officers (One Dentist and one Medical officer have resigned). So far no action is being taken to appoint medical officers.
3. There is acute shortage of medicine in the clinic. Since the Station HQ INS Kattabomman is not procuring the medicine in time, funds allotted for the medicine to the tune of Rs.30 lacs have been surrendered in the past.
4. In the absence of any empanelled hospitals in the city, the ECHS members are suffering a lot. There is no other empanelled hospital nearby.
The situation is very bad. The ECHS administered by the Indian Army, should not let it go in this way. The ECHS members and the Polyclinic Staff including the O i/c ECHS Polyclinic are very much upset over the condition prevailing now.
It is requested that the Regional Centre, Chennai and the ECHS Central Organisation Delhi to take immediate action on this issue and save the ECHS members. If the situation continues, this clinic will have to be closed without any notice. Please save our members and the Scheme.
-- Posted By Muthukrishnan to indianexserviceman at 3/16/2012 11:07:00 AM
Comment: Why Naval Ships have to administer ECHS Polyclinics? There is a ocean of difference between administering sea based ships and land locked ECHS which is to cater to the health and well being of EX Servicemen. Probably a better idea would be to shift the ECHS to a Naval Ship and perhaps matters will liven up!

Pune ex-servicemen get a raw deal

ECHS runs out of funds and bogged by bureaucratic hurdles
Published: Tuesday, Mar 6, 2012, 12:10 IST
By Soumabha Nandi | Place: Pune | Agency: DNA
Retd Colonel Shashi Anand’s wife’s treatment was halted at the Jehangir Hospital last week. According to Anand, the hospital official denied his wife further treatment as they had not been paid the bill of the ex-servicemen contributory health scheme (ECHS). “Under the ECHS scheme, an ex-serviceman and his family members are entitled to cashless treatment in the hospitals.
However, my wife’s treatment was halted by the hospital authorities as they claimed that they have not received the payment from the army yet, and hence will not carry out further cashless treatments,” said Anand, who has now shifted his wife to Command Hospital.
Like Anand, most of the ex-servicemen are facing difficulties in getting treatment in private hospitals. The ECHS beneficiaries are denied treatment in these hospitals as bills under the scheme have not been paid by the army. According to sources, the outstanding to be paid to hospitals surpasses Rs3 crore.
However, the hospital officials maintained that they have not stopped treating ECHS beneficiaries, provided they pay the amount from their pockets.
Jehangir Hospital confirmed that even as they have stopped giving cashless treatment to ECHS beneficiaries, the treatment will not be disrupted if the patients agree to pay the bills which have been set in concession rates.
“In spite of serious issues related to payments we have not stopped treatment. We are settling directly at the concessional ECHS tariffs rates with those patients desirous of seeking treatment at Jehangir Hospital, until the issue is resolved,” Jehangir Hospital spokesperson told DNA.
The ECHS officials maintained that the payment of bills is a lengthy process and the hospitals should be patient enough regarding the issue as it is a matter of ex-servicemen.
“The payment of bills goes through a lengthy hierarchical order, where the payment beyond 5 lakh extends up to the ministry of defence.
“The paperwork sometimes take some time, hence the hospitals should cooperate with us as the bills will eventually be paid to them,” zilla sainik welfare officer (Pune) Major (retd) Milind Tungar told DNA. ECHS (Pune) staff officer, Col Abhay Raj Sharma told DNA that the non-payment of bills is a temporary phase and meetings have been held with the hospitals to solve the issue. “The hospitals should bear with us and wait for the financial year to end. The solution to the problem is a lengthy process and hence they need to be patient. The bills will be paid to them in the recent future,” he told DNA.
Courtesy- DNA Report

ECHS catching up with the digital era and networking

Finally ECHS has its own website. Please click link below:
ECHS Live Website Feb 2012
It includes email ids of Region Centres and tele numbers of ECHS functionaries. There is also a click on for Claim status. This should be a Great help.
Please send in your suggestions for improvement to ECHS, with cc to me if you wish.
Its really a GREAT site. DO visit. You will find answers to all your queries. Cheers. And lots of Good Health.
With Warm Regards,
Col RP Chaturved

ECHS Helpline. Now call 080-4300-4300 or 1800-103-8666 for any ECHS query. You can also SMS your ECHS query on 09741494300.
Click here for ECHS Newsletter

Comment: What is lacking is an online complaint and suggestion facility which can easy be incorporated.

Armed Forces Covenant Bill

The Sunday Standard> A Bill that arms the supreme sacrifice by Ritu Sharma Last Updated : 18 Dec 2011 09:37:37 AM IST
NEW DELHI: A soldier’s sacrifice may no longer be in vain. A Bill on military covenant— the nation’s promise that soldiers and their families will be cared for in return of their sacrifices— will soon be introduced in Parliament.
The Indian armed forces are among one of the largest volunteer forces in the world. With their life so fraught with risk, the Armed Forces Covenant Bill plans to honour the “unique service” given by the members of the armed forces and their families.
The British Armed forces got its Military Covenant law this year. The Indian Armed Forces Covenant Bill is awaiting Parliament to resume normal functioning to be introduced.
“The country needs to demonstrate its commitment to the well-being of the members of our armed forces and their families. This Bill underlines the country’s commitment and moral obligation towards them,” Rajya Sabha MP Rajeev Chandrasekhar, who will pilot the Bill, told The Sunday Standard.
The proposed Bill envisages “pledging of commitment” that soldiers— both retired and serving —and their families will be provided with medical support, education; good quality and affordable accommodation; a comprehensive compensation system; maintenance for disabled soldiers and bereaved families; reservation in civilian jobs particularly related to security and more. It also entails the government set up the Armed Forces Grievances Redressal Commission, comprising senior judges and top army brass to oversee that the provisions of the law are fulfilled.
“The Bill will also require the Minister of Defence to present an Annual Covenant report to Parliament every year on the progress of improvements in key areas including healthcare, housing and education,” Chandrasekhar added.
The serving officers see the idea of making military covenant a law as a distant dream but hope that the legal pledge on the part of the country will go a long way in buoying the spirits of the soldier.
“In the present scenario where corporate culture is taking toll on the recruitment in the armed forces, the legalisation of military covenant will boost the trust of army men that his family and loved ones will be taken care of if he is gone. This would enable him to discharge his duties with ultimate fearlessness,” a serving officer said.
A Bill that arms the supreme sacrifice

ECHS Indisposed- lack of funds and infrastructure

ECHS indisposed
Private hospitals await crores in dues
Tribune News Service
Chandigarh, December 13
All may not be well with the much-hyped Ex-Servicemen’s Contributory Health Scheme (ECHS), a welfare initiative launched by the Centre for providing comprehensive medicare to veterans and their dependants.

While some new measures are being implemented to streamline the functioning of the ECHS, some issues like large outstanding payments to private hospitals empanelled under the scheme and modifying some procedures for availing treatment need urgent redress.

With outstanding payments mounting, some private hospitals are reluctant to entertain veterans and there have been instances where they have been turned away. Over the past few years, several reputed hospitals across the country have opted out of the scheme over procedural delays and deferred payments.

Among the largest private hospitals in the tricity, Fortis in Mohali, for instance, is reported to have outstanding payments amounting to Rs 30 crore since 2004. Silver Oaks, another private hospital, has outstanding dues of Rs 8.9 crore for the past four years.

Mukut Hospital, Sector 34, is awaiting payments of Rs 4.5 crore for the past two years and-a-half. Bills worth several lakhs each by laboratories and diagnostic centres are still to be cleared.

“The verification process for bills is long and tedious, involving several establishments and hierarchical levels,” Hemendra Jain, the official dealing with ECHS as Silver Oaks, has said.

There are 30 empanelled hospitals, diagnostic centres and laboratories in the tricity and 1,400 across the country. Going by the dues, outstanding payments nationwide may run into hundreds of crores, according to the ex-servicemen’s association.

Some issues also pertain to the functioning of the polyclinics that are directly operated by the ECHS. This includes heavy patient load and inadequate infrastructure.

To cater to a clientele of about 35 lakh, including 11 lakh ex-servicemen and 24 lakh dependants, and to operate 227 polyclinics, along with medical and paramedical staff and medical supplies, the ECHS has a budget of Rs 1,000 crore.

According to a study done by the Indian Ex-Servicemen’s Movement recently, the per capita expenditure under the ECHS is Rs 2,700 compared to Rs 5,100 from the Central Government Health Scheme for civilian retirees.

Sources at Western Command Headquarters claim that ECHS bills of private hospitals are being cleared within two weeks and payments of about Rs 20 lakh are being disbursed every day. A weekly roster has been developed, under which a particular day is devoted to dealing with bills of specific hospitals.

Sources at the headquarters admit that complaints and suggestions from the ECHS clientele keep coming in and various problems at the functional level are being sorted out from time to time.

They have also hinted at some policy changes and overhaul of the ECHS system, with a new managing director assuming charge of the ECHS. Maj-Gen A George has been posted from Chandi Mandir as the new ECHS head on a short notice.

Some measures like automating polyclinics to cut down manual administrative processes and releasing payments to private hospitals online within 10 days are being devised. Universal smart cards, that can be used to avail treatment at any polyclinic instead of only the user’s parent polyclinic, are also being issued.
ECHS indisposed Tribune report

ECHS: Helpline- हेल्पलाइन

ECHS Helpline
1. In our continuous efforts to make ECHS services more efficient, transparent and responsive for our veterans we have implemented a 24 x 7 helpline supported by a dedicated call centre.
2. This exclusive helpline has two numbers toll number is 080-4300-4300 and toll free is 1800-103-8666. The call centre provided solutions to our Ex-servicemen on all types ECHS queries like enrollment/ empanelled hospital/ treatment procedure/ claim/ policy etc. The helpline is acting as a single point contact to answer the ECHS queries of ESM effectively.
3. In addition, ECHS Helpline is also welcoming ESM queries through SMS on their dedicated number 09741494300, wherein ex-servicemen can ask their query through normal text and send a SMS to get a response on the same through SMS.
4. We are enhancing the spectrum of our ECHS Helpline by introducing the Ambulance and Bed Boarding Services in the immediate future. With introduction of ambulance service the Helpline will be able to provide Ambulance to the ex-servicemen in case of an emergency. The provisioning of ambulance will be payable by the veteran utilizing it. To call the ambulance ESM has to register his demand at 080-4300-4300.
5. With the introduction of Bed Boarding System, the Ex-servicemen would be able to get the updated information on available beds in the empanelled hospitals of ECHS.
6. All these facilities would now be available throughout India through a single number support i.e. 080-4300-4300.
7. You are requested to give these facilities and telephone numbers wide publicity amongst your members.
(Gulshan Chadha)
Lt Col
Jt Dir (Est)
For MD ECHS

पूर्व सैनिक अंशदायी स्वास्थ्य योजना हेल्पलाइन
1. हमारे दिग्गजों के लिए ईसीएचएस सेवाओं को और अधिक कुशल, पारदर्शी और उत्तरदायी बनाने के लिए हमारे सतत प्रयासों में हम 24 x 7 एक समर्पित कॉल सेंटर द्वारा समर्थित हेल्पलाइन लागू किया है.
2. यह विशेष हेल्पलाइन दो संख्याओं टोल नंबर 080-4300-4300 है और टोल फ्री 1800-103-8666 है. कॉल सेंटर के सभी प्रकार पर हमारे भूतपूर्व सैनिकों के लिए समाधान / नामांकन पैनल अस्पताल में इलाज / / प्रक्रिया / दावा नीति हेल्पलाइन आदि की तरह ईसीएचएस प्रश्नों एक एकल बिंदु संपर्क के रूप में काम कर रहा है ईएसएम के ईसीएचएस प्रश्नों का जवाब प्रभावी ढंग से प्रदान की.
3. इसके अलावा, ईसीएचएस हेल्पलाइन भी उनके समर्पित नंबर 09741494300 पर एसएमएस के माध्यम से ईएसएम प्रश्नों का स्वागत करते हुए, जिसमें पूर्व सैनिकों के सामान्य पाठ के माध्यम से अपनी क्वेरी पूछने के लिए और एक एसएमएस भेजने के लिए उसी पर एसएमएस के माध्यम से एक प्रतिक्रिया प्राप्त कर सकते हैं.
4. हम निकट भविष्य में एम्बुलेंस और बिस्तर बोर्डिंग सेवा शुरू करने से हमारे ईसीएचएस हेल्पलाइन के स्पेक्ट्रम में वृद्धि कर रहे हैं. हेल्पलाइन एम्बुलेंस सेवा की शुरूआत के साथ एक आपात स्थिति के मामले में पूर्व सैनिकों के लिए एम्बुलेंस प्रदान करने में सक्षम हो जाएगा. एम्बुलेंस का प्रावधान यह उपयोग के दिग्गज द्वारा देय होगा. एम्बुलेंस ईएसएम कॉल 080-4300-4300 पर उसकी मांग रजिस्टर है.
5. बिस्तर बोर्डिंग प्रणाली की शुरूआत के साथ पूर्व सैनिकों को ईसीएचएस के पैनल में शामिल अस्पतालों में उपलब्ध बेड पर अद्यतन जानकारी प्राप्त करने में सक्षम हो जाएगा.
6. इन सभी सुविधाओं को अब एक ही नंबर समर्थन यानी 080-4300-4300 के माध्यम से पूरे भारत में उपलब्ध होगा.
7. आप अपने सदस्यों के बीच इन सुविधाओं और टेलीफोन संख्या व्यापक प्रचार देने का अनुरोध कर रहे हैं.
(गुलशन चड्ढा)
लेफ्टिनेंट कर्नल
संयुक्त दीर (स्था.)
एमडी ईसीएचएस के लिए

ECHS: Bureaucratic hurdles sans Automation- Veterans health a Casualty

Letter to MD ECHS
From: vinay shankar
Date: Tue, Jun 14, 2011 at 6:13 PM
Subject: ECHS issues
To: mdechs@yahoo.com

Dear Gen,
I sent an sms expressing my desire to talk to you. Since I did not receive any response I am sending this mail. I have for a variety of reasons been a reluctant user of the ECHS facilities. However a few months ago I decided that since this is a entitled facility I am being foolish by not availing of the ECHS. In this context I wish to share my two recent experiences:

First Experience
My wife was admitted in the RR at about midday last week. The consulting physician wanted an urgent CT scan done on her. Since this facility was not available with the RR and it would take about 2-3 days to get a slot at the Base Hospital I was advised to go down to the ECHS office located within the RR premises. Met the OC of the ECHS. He saw my ECHS card and said that I would have to go to the Gurgaon Polyclinic since that was my dependency. I pointed out that if I were to go to Gurgaon at that time by the time I reached the ECHS timings would be over. He then telephoned the OC of the Base Hospital ECHS and requested him to do the needful. I reached the Base Hospital ECHS by about 1345h. Had to wait for the lunch break to be over. Managed to meet the OC by about 1405h. He immediately ordered his staff to do the necessary paper work. Must concede it was done in quick time and an ambulance from the clinic where I was supposed to go was also arranged. The place was Star Diagnostics in Tilak Nagar. The OCs staff also advised me to carry the complete case sheet in addition to the Form that they had provided. Later when I was on my way to the RR I looked at the Referral Form that the ECHS had given me. It curiously had a stamp to indicate that the choice of Star Diagnostics was mine. You can draw your own inference on this. At no time was I given options from which I could choose. When taking my wife from the RR I asked the Duty NO for my wife's case sheet. She firmly indicated that that was not required and the Polyclinic form would be enough. At the Star Clinic the moment the receptionist was handed over the ECHS form her attitude became somewhat discourteous. She asked for the case sheet and when I said that I do not have it she responded to say that then the test cannot be done. After about half an hour's telephonic back and forth she agreed to the test provided I committed to bringing the case sheet when we went to collect the report. I again responded that I will bring it if the hospital authorities agree to giving me the case sheet. Altogether we found the attitude of all the staff at the Star Clinic that gave one the feeling of being talked down to, as if every one was doing you a favour. Again before going to collect the report we asked for the case sheet. As expected that was declined. Consequently after a fair amount of haggling and complaining we managed to obtain the report. To say the least the experience was quite harrowing.

The Second Experience
In May I had gone to the ECHS to get a referral to have my eyes checked for cataract. I was given the form for Eye Q Hospital at Gurgaon. Again without being offered options. Due to various commitments I could not visit the Eye Hospital since then. This morning when I went to the hospital I was told that the validity of the referral is only for a week and that I will have to obtain a fresh one. From the Eye Hospital I went down the office of the OC ECHS Gurgaon. Entered his office wished him 'good morning and then sat down. The OC did not deign to acknowledge my greetings. After his staff left the office he turned to me with an inquiring look. I placed the referral papers in front of him and pointed out that though the form does not any where indicate a time limit the Hospital had declined to accept the form. He aggressively asked why had I not gone immediately after obtaining the referral. I explained that some unexpected commitments had cropped so I could not go and also pointed out that the stipulation of one week should have been pointed out to me. Now he rudely responded to say that it was my responsibility to have found out. Before leaving his office I also pointed out that he could consider responding to greetings from visitors since he had not acknowledged my 'good morning'. He did not take that well either. I fully understand the complexity and the challenges of running this organisation. Yet I believe it is my duty to bring to your notice what users experience.
With regards,
LT Gen (retd) Vinay Shankar

ECHS FAQ's

Frequently Asked Questions
FAQs on ECHS

full screen link click here

General HL Kakria Takes Over as DGAFMS
Lt Gen HL Kakria has taken over as the Director General, Armed Forces Medical Services (DGAFMS). Before taking charge as the DGAFMS yesterday, Lt. General Kakria was working as the Director General, Medical Services (Army).
An alumnus of GSVM Medical College, Kanpur, Lt Gen Kakria joined the Army Medical Corps on February 14, 1972. A Post-Graduate in General Surgery and Orthopaedics from the Pune University, the General officer has been a renowned surgeon, teacher and an academician. He has published numerous research papers in various National and International journals. He was awarded the Major General Amir Chand award in 1990 for the best research work in Orthopaedics on Knee Joint injuries. An Executive Member of 'Bone and Joint Decade '(BJD) 2000-2010, Lt Gen Kakria has attained global recognition for his pioneering work in joint replacement and spinal surgery.
During his illustrious career spanning over 39 years, Lt. General Kakria has held key positions including Commandant, Base Hospital Delhi Cantt., Commandant of Artificial Limb Centre, Pune and Commandant of Command Hospital (Southern Command), Pune. He has also held the staff appointment of Major General (Medical), HQ Southern Command and later became the Commandant of AMC Center & College. Appointed DGMS (Army) & Colonel Commandant on June 1, 2010, Lt. General Kakria has been awarded the Vishisht Seva Medal in 1992, Bar to Vishisht Seva Medal in 2002, Ati Vishisht Seva Medal in 2009 and Param Vishisht Seva Medal in 2011. DM/PK (PIB Release ID :72444)
General HL Kakria Takes Over as DGAFMS

ECHS: If a system is working don't touch it

I went to Noida polyclinic this morning. It is today, by far one of the best in the country. This transition has come about with the untiring efforts of Col Bhardwaj, the OC Polyclinic, over the past two years. Comfortable sheltered waiting areas, TVs, helpful staff emulating the OC who insists we come inside and sit down, before giving everyone a patient hearing. Waiting time everywhere has come down considerably. Things move smoothly. Really good. I learnt today that the Colonel leaves this assignment over next fortnight, since he has finished his contract of two years. I wonder if he would consider staying on. He tells me that is against policy. Really? I know for one, I and a lot many Noida ESM will be sorry to see him go. AND his successor has a tough task cutout for him to match the standards of courtesy, efficiency and administrative acumen of Col Bhardwaj.I saw a large crowd waiting to see Medical Specialist. L-O-N-G queues of impatient patients waiting for Darshan of the sole Medical Specialist. Earlier not too long we had two/ three.

Dr (Mrs) Agarwal, the other medical specialist had left some time ago, on superannuation at age 65. When Brig Tiwari expired soon after, she was reappointed and moved in. Queues could now progress faster. Now, moved in the Line of Communication Hqs. We all know the appointment of Doctors is 'Area Hq' Turf. SO, how could MD ECHS make this appointment, Area Hq wanted to know. They asserted their power and could prevail. Dr Agarwal is now out. We are back to the one medical specialist.

The above narrations point to a sad lack of development of the 'service industry' ethos in Fauji organizations that need to be more supportive of the needs of the USER, rather than the insistence on protocol, processes and of course egos. It is nobody's case that the present OC OR Dr Agarwal are indispensable. Only that a 'case by case' study of the situation needs doing. Shortly, we would be expanding the Polyclinic, the erstwhile MI room building has already been vacated and adjustments seem to have started. In the event, having the OC continue the good work would have been a good idea. I don't find it necessary, but must state that Col Bhardwaj is neither known to me earlier than my association with him after I started functioning as Coordinator of the IESM ECHS Division, nor is he going to pay me to write this.

Dr Agarwal. Ditto. If she was a surgeon I would perhaps feel her hand may quiver during a serious stage of an operation. But as Medical specialist, age 65 does not sound too high. Maybe she should have served us another year or two, till we found adequately skilled replacement. Why should there be a gap in the service. And I believe the GOC Delhi Area needs to be requested to review the decision. Again, I can't recall meeting Mrs Agarwal. I don't know her.
Would someone be able to take this forward? Thanks.
I am reminded of an advise I received from my Director when I joined the corporate the first time. "If something is working, Don't touch it".
With Warm Regards,
Col RP Chaturvedi

Dear Friends,
Jai Hind.
We the ESM at Noida, request your help in ensuring that the contents of this email reach the authorities concerned.
Thank you.
Vande Matram
In service of Indian Military Veterans
Chander Kamboj

Suggestions for Streamlining functioning of ECHS Polyclinics

I am forwarding this shocking mail for knowledge of the ESM community about the devil within. Pls share this with maximum people so it can perhaps reach the villains in this story through their friends. Names in this mail should identify who is who; and who did what.
For some of us the Sarkari Custodian attitude never goes away. We LIKE to sit on what is actually entrusted to us for others to benefit from. It is little wonder that origin of most of our problems lies in internecine rivalries/ perceived rankings/ priorities etc, forgetting that at the end of the game, the King and the Pawn go back to the same box. And the 'box' IS indeed the future destination of even the chess pieces in play.

From: rajeeve lochan
Date: Thu, May 12, 2011 at 8:51 AM
Subject: ECHS
Cc: Col RP Chaturvedi

Dear Brigadier,
As I am proceeding to USA to be with my son on the night of 19th May, yesterday (11.05.11) I visited ECHS Polyclinic Meerut and approached the seniormost medical officer (Maj Ambuj Goel) and requested for 90 days medicines, he informed that though the orders have been received but they have not been implemented and I should contact the O I/C polyclinic (Col D V Singh). He informed me that medicines for the purpose of going abroad are not authorised/permitted.
He mentioned that medicines for 90 days can only be given to patients of T B, Hypertension and Diabetes and that it has to be approved by the Commandant.
The medical officer made out a prescription and I went to the Commandant (Brig Pareek), I sent the prescription through his P A for counter signatures, first he called for the book and after that he called me and explained to me his financial difficulties and then he informed me that since I was residing locally why I need medicines for 90 days, I informed him that I was proceeding to USA for 6 monthe but I am requesting medicines only for 90 days which is permitted under the rules. Of course he did not take a minute and signed the prescription.
I request confirmation if for proceeding abroad the medicines are authorised or not.
We keep criticising babus and the bureaucracy but I think we in the Armed Forces have more bureaucracy than any where else.
May I have your reply pl. With warm regards.
Wg Cdr Rajeeve Lochan (Retd)

Payment of Medical Allowance
Dear sir,
I ex mwo holding ECHS card face lot of problems as the nearest ECHS centre is aproximately 110km from my native and the nearest city Ajamgarh which is hardly 30km has good hospitals where i can have the benefit of medical services privately. But to avail the facility from ECHS Faizabad i have to spend rupees 150 as a bus fare and minimum Rs.100 for lodging and boarding. Also, I have to waste two days for my normal treatments at the age of 65 this all becomes problem some to me. Hence, i am compelled to take the treatment from local doctors. I request you sir that my medical allowance may please be paid to me.
Thanking you,
RA Shukla.

Streamlining of functioning of ECHS Polyclinics
Some Suggestions

There is a need for officers and staff in ECHS Polyclinics to further improve the delivery of service to ESM beneficiaries. There should be a constant and conscious effort to redress most of the grievances and problems of these beneficiaries at the Polyclinic level so that there is no inconvenience caused to them forcing them to approach higher authorities for redressal of their grievances. The entire staff at the dispensary level have to ensure a polite, positive and responsible attitude to make the service delivery better. The Officer In-charge must make every effort to ensure this user friendly environment. Complaints of rude/ impolite behavior need to be checked and stern action taken by OIC.

It is well established that ECHS ESM beneficiaries need to be provided better service. Senior Veterans among the beneficiaries deserve special attention and response. It is re-iterated that senior pensioners need to be given out of queue treatment and service at each activity level. This system is generally not being enforced at the Polyclinic level. OIC's must ensure compliance of these instructions. All seniors of above 60 years need to be given this special privilege.

OIC's should personally make rounds of the dispensary particularly during peak hours to ensure that there is proper environment and ESM beneficiaries particularly seniors are being treated promptly.

The Station HQ responsible should convene the meetings of ESM Associations/ Organisations once in two months along with OIC Polyclinic for feedback and initiating remedial measures without fail.

A complaint/suggestion/feedback Box with details like number of complaints received and disposed etc. under a seal and lock will be kept at each Polyclinic and will be opened by the Officer In-charge in the presence of at least two members of the Advisory Committee when the Advisory Committee meeting is being held and necessary action taken by the Advisory Committee with regard to complaints/ suggestions/ feedback thus received and, wherever required, the matter will be referred to higher authorities for necessary action.

Stn HQ staff/ duty officers should conduct at least five surprise inspections of the Polyclinics in cities in a month and report the outcome of the inspection indicating the areas such as punctuality, availability and behavior of officers/ staff, special care for ESM/ Seniors, deficit areas/ complaints and also the good work done in each of the dispensaries inspected, by way of a confidential monthly d.o. letter to DG ECHS without fail on or before 10th of the succeeding month;

It is seen that a large number of beneficiaries go to the Polyclinics for taking repeat medicines. Authorization of repeat medicines should be done by any of the Medical Officers, apart from the Officer In-charge. Preferably the OIC must be the senior most Medical Officer. Non medical officers must be designated as Administrative Officers.

Stn Cdr should personally monitor and ensure that the empanelled hospitals etc. do adhere to the terms & conditions. They should also supervise the services, if any, being provided by the private parties in their zones such as dialysis, dental services etc.

Militry Hospitals must be requisitioned for all assistance and services for treatment of ESM by the respective Polyclinics before seeking civilian assistance.

ECHS Empanelled Hospitals

List of Empanelled Hospital and New Empanelment procedure: Government Orders
Dear Friends,
1. I spoke to MD ECHS on the Empanelment of super specialty Hospitals across the country. He has informed that the procedure of empanelment has been simplified vide Govt letter No 22B(04)/2010/US (WE)/D (Res) Govt of India Min of Def New Delhi dated 18 Feb 2011 (Copy enclosed for reference Please).
2. All NABH accredited hospitals will be considered deemed empanelment with Ex-Servicemen Contributory Health Scheme ECHS ie they will not be required to apply for NABH assessment but can directly apply to Central organization for processing the application for empanelment.
3. Let us circulate this information to as many as possible and encourage good super specialty hospitals to get empanelled with the ECHS.
4. The list of empanelled hospitals across the country forwarded by MD ECHS is circulated for information please.
With Regards,
Jai Hind
Yours Sincerely,
Maj Gen (Retd) Satbir Singh, SM
Vice Chairman, IESM
List of Empanelled Hospitals: NABH
New Employment Procedure- Page 1
New Employment Procedure- Page 2
New Employment Procedure- Page 3

ECHS Empanelment Riders
Dear Sir,
This new empanelment procedure looks great on paper.But it has many short comings.
Please see the attached list of NABH hospitals country wide and you will see only 73.
The procedure and fees for getting the accreditation are also enclosed. The fees would be from 1.6 Lakh for upto 100 bedded hospital to Rs 3.3 lakh for 301 + bedded hospitals. In addition they would have to bear the expenses of travel/lodging and boarding of the inspection team. In addition to this the hospital will have to pay ECHS Rs 100 for application fee + 1.0 Lakh as EMD+ Performance Bank Gaurantee of Rs 10 lakhs. So even a NABH hospital will have to spend additional Rs 11 lakh to be on ECHS panel.
I wonder how many hospitals in small towns will be in a position to lock up 11 Lakh for 3 years to provide subsidized service to ECHS which has a small membership base.
It is worth a re-look at the grand scheme with a fine comb.We do need to augment our hospitals in Smaller towns and that is where the new policy pay be an hindrance.
Of course I am no expert but a common man's reading does not make this scheme very attractive. I as a doctor with may be 25 or 50 bed hospital common in small towns would not be willing to put away 11 lakh.
For consideration, debate and may be a suitable reply to MD ECHS.
Best Regards,
Ravi
Cdr Ravindra Waman Pathak
Member Governing Body and Pension Cell IESM

National Accreditation Board for Hospitals & Healthcare Providers: NABH
CGHS Empanelment Scheme
Kindly note that QCI recommendation regarding particular hospital/ diagnostic centre does not mean automatic empanelment by CGHS. QCI will keep on adding to the list as and when recommendation for individual hospital/diagnostic centre is finalised
List of Hospitals/ Diagnostic Centres
List of Hospitals/ Diagnostic Centres under Continuous Empanelment Scheme

ECHS- MOD's Enhanced Cargo Handling System?

ECHS Seminar under ageis Western Command
Wednesday, 06 April 2011
CHANDIGARH: A two day All India Seminar on Ex-Servicemen Contributory Health Scheme (ECHS) concluded Wednesday under aegis of HQ Western Command. The Seminar was attended by over 40 senior officers from Army, Navy and Indian Air Force as well as a number of veterans.
Lt Gen SR Ghosh, GOC-in-C Western Command inaugurated it. The Seminar assessed the present functioning of the scheme at grass-root level, and identified areas which need special attention and evolve various measures to make the scheme more efficient and user friendly.
The ECHS was launched in April 2003 with the aim of providing Medicare and healthcare to veterans of the three services and to their families/ dependants. More than 36 lakh ex-servicemen, including their dependants are being covered under this scheme through 227 Defence Polyclinics and 1355 empanelled private hospitals of eminence throughout the country.
The number of Polyclinics would be increased to 426 by 01 Apr 2013, in order to take the Medicare to the country’s remotest areas as well as to Nepal.
Seminar on ECHS held at Western Command

Gen VK Singh COAS inaugurated Basantar Sainik Aramgrah at Panchkula
Punjab Newsline Network Tuesday, 05 April 2011
Gen V K Singh, COAS and Lt Gen S R Ghosh, GOC-in-C, WC having a look around the newly constructed Basant Sainik Aramgrah at PanchkulaCHANDIGARH: General VK Singh, Chief of the Army Staff (COAS) visited Chandimandir Tuesday and discussed operational and training issues with Lt Gen SR Ghosh, GOC-in-C Western Command.
An important facet of his visit was the inauguration of the Basantar Sainik Aramgrah in Sector 2 Panchkula. The COAS dedicated this 56 room complex to the gallant veterans of the Indian Army who had devoted their lives in the service of the nation. The Aramgrah will provide much needed transit facilities to both outstations veterans and serving soldiers coming to the Tricity for medical treatment or for various other requirements.
The Army Chief also met the participants of a two day Tri Service Seminar on the Ex-Servicemen Contributory Health Scheme (ECHS) conducted by HQ Western Command. He complimented all the participants for their dedication and commitment to make the ECHS a success towards providing medical care to the Veterans staying in far flung areas. He also listened to the problems of Ex- Service men during the inaugural function.
Gen V K Singh , COAS also laid the foundation stone of Basantar Senior Veterans' Enclave in the campus of the Basantar Sainik Aramgrah, Panchkula.
Basantar Sainik Aramgrah at Panchkula

OIC Polyclinic plays SMART card trump?
Apr 26, 2011 by sankhyan
I am writing this from Faridabad. ECHS polyclinic in Faridabad has became a rehabilitation centre for retired Commissioned Officers. They come to polyclinic and sit with any Doctor of their choice without their turn and remain sited (seated) their for a lot of time. No one in the polyclinic has dared to object them. Every person visiting ECHS polyclinic is a patient. Ill person has no discrimination. But the officials at polyclinic Faridabad has discrimination of a Commissioned Officer and Other ranks. If some one try to object the matter with OIC he threatens to suspend his ECHS Card.
ECHS Complaints

Tailpiece: How many Polyclinics provide working torch lights for their Medical Doctors?

Army Research and Referral Hospital Retrogrades ESM Health Care

Reference: Army Research and Referral Hospital Retrogrades ESM Health Care
Dear Gen (MD ECHS),
pl refer to above mail a copy of which has been endorsed to you. Being intimately involved in ECHS matters I would like to fully endorse the views of Gen Satbir. As I have said repeatedly the instances of mil hosps across the Country treating ESMs as an unwelcome load is more than adequately proven. The reasons are also well known . The armed forces medical fraternity feels that, the General Staff has appropriated to itself a function that legitimately belongs to them. This turf war between the two is unfortunately affecting the veteran population. What both sides to this unfortunate conflict fail to realise is that every serving soldier is 'a soon to be' veteran. What mil hosps fail to realise is that unlike the past where mil hosps were mandated to treat veterans based on availability of facilities and the OC hosps discretion, the situation today is quite different. Veterans today have contributed to the Scheme and can therefore demand medical cover from anyone tasked to provide cover under the scheme, which includes, empanelled hosps AND MIL HOSPS. We already have some ESMs approaching courts and tribunals in this matter. The next most unfortunate step will be ESMs going to Court against the Service hierarchy. THAT WILL BE A VERY TRAGIC DAY but will give our Babu hierarchy another reason to celebrate. Could these views please be passed on to the Chief and AG.
Regards
Brig Sateesh Kuthiala.

Date: Fri, 6 May 2011 09:28:07 -0700
From: mdechs
To: kuthiala
Dear Brig Kuthiala,
Last month of Apr saw ECHS being the focus of deliberations:
#5&6 Apr-at Chandigarh attended by reps of the three services, AG, Army Cdr, MG-IC-Adms of all Army Commands etc.
#Chief of COSC took up pending ECHS issues with Hon'ble RM.
#25 Apr-Improving Medicare in ECHS-attended by Secy ESW, Secy Def FInance & ECHS.
#26 Apr-Meeting with MoD chaired by COAS & Def Secy.
#27 Apr-Managing ECHS- agenda during Army Cdrs' Conf.
#28 Apr-Improving ECHS-review by RRM.
Also on 5 Apr ECHS 24X7 Helpline was launched by Army Cdr Western Comd.
COAS gave absolutely unambiguous directions to entire hierarchy. Armed Forces own ECHS, are the greatest stakeholders and would do all to improve and sustain it. Central Organisation is closely monitoring implementation of the COAS directions.
Offg DG AFMS is aware of the issues raised and has promised full support to ECHS including opening of ECHS wings in MHs where required.
On specifics now, You would recall that AHRR had as per earlier load appreciation only offered to treat ESM for Cardiology, Joint Replacement and Eye. Oncology treatment had not been made available and was ltd to consultation only. Brig AK Dhar and his specialty is overloaded and serving soldiers have to register at the reception and then at malignancy centre and thereafter wait for at least 2 to 3 hours in their turn.
What is not at all correct that for surgery patient has to get drugs and consumables from ECHS. We will resolve the issue immediately. Nothing is required to be carried (just recd a call confirming this from AHRR).
Navy and AF have been insisting on treating ECHS members in their own hospitals. Based on the request from the environment, we had to request them not to so insist as ECHS patients prefer treatment in hospitals nearer home rather than travelling to far away in heartless cities with no support. To enable full capacity utilisation of service hospitals for treating ESM, ECHS has started augmenting them with addl doctors. Gen Mathews (ex Comdt AHRR) has joined at Kochi. Hopefully more would join. Not for the compensation but for service to their brethren.
We are trying to improve things, pushing through odds. Team ECHS is constantly at work. Join in. All are welcome!
Regards
MD ECHS

From: brig sateesh kuthiala
Sent: 07 May 2011 09:49
Dear Brig Kamboj,
please see trailing mail (Gen Satbirs letter, my follow up and MDs response). Whereas there are problems and improvement is an ongoing process; what is heartening is the fact that we have an extremely caring and supportive Central Org ECHS. Whereas I can see that all questions with regards to Gen Satbirs letter have not been addressed specially with regards to why Army Hosps who have accepted to cater to ESMs cannot provide TOTAL treatment from consultation to post discharge care as required, I am of the opinion that we continue to give feed back and given the present totally positive response, matters will continue to improve. I am also aware that there are a number of veterans who feel that there are faults in the present org structure and micro management will not take us too far; we also need to look at the matter from the Service HQs point of view. Our top Services hierarchy is as committed to this cause as anyone can be. Those of us who have served at the Army HQ level and dealt with the MOD know only too well how Babudom and Netagiri function. These two roadblocks are a 'GIVEN' in any effort that we may make towards improvement in OROP-Pensions-Medicare and every other matter. So we will just have to 'Bash on Regardless'
May i request you to pass this on as a package to the environment.
Brig Sateesh Kuthiala (Retd)

Ex Servicemen Contributory Health Scheme Expansion

Expansion of Ex-Servicemen Contributory Health Scheme (ECHS)
The Union Cabinet has approved (a year ago) establishment of 199 additional New Polyclinic including 17 mobile military medical facilities alongwith 15 New Regional Centres and re-organisation of Central Organisation ECHS. Authorising additional 67 officers and 270 ESM Staff at 15 New Regional Centres, Central Organisation ECHS and 2263 additional contractual employees for 199 new polyclinics will enhance quality of medicare provided to Ex-Servicemen.

Financial implications towards creation of infrastructure will be about Rs 141 crore. This will entail a capital expenditure of Rs 118.52 crore towards cost of land, construction and medical equipment. An amount of Rs 22.25 crore of expenditure will cover purchase of furniture etc, and IT hardware. On the recurring side, an expenditure of Rs 43 crore per annum is envisaged.

The expanded network envisages 426 polyclinics in 343 districts of the country which will benefit Ex-servicemen residing in remote and far flung areas. The expanded network envisages coverage of about 33 lakh beneficiaries.

Background: The ECHS was introduced with effect from 01 April 2003 to provide comprehensive medical coverage of Ex-servicemen Pensioners, war window and dependents by establishing 227 polyclinics at Stations with ex-servicemen population above 2500 through out the country.

A large segment of Ex-servicemen are staying at locations where there is no ECHS Polyclinic within a radius of 200/ 300 km causing great inconvenience in accessing medical facilities. To address this 199 polyclinic will be established in those places with minimum ex-servicemen population of 1500.

At present Ex-servicemen residing in remote areas where the ex-servicemen population is less than 2500, face a lot of inconvenience in reaching the polyclinics due to distant location varying from 200 to 300 km from their place of residence. The expansion of ECHS will provide easy access to health facilities for such ex-servicemen and their dependents.
Expansion of Ex-Servicemen Contributory Health Scheme (ECHS)

Provision Of Ex-servicemen Contributory Health Scheme Polyclinic at Churu
Military Engineer Services
Bikaner - Rajasthan - 01 April 2011 10:56:04 IST Commander Workers Engineer of Military Engineer Services, Bikaner invites tenders notice for provision of ex-servicemen contributory health scheme polyclinic type C at Churu.
Details
Tender Value INR 21,75,000/-
Project Period 6 Months
EMD INR 43,500/-
Category Recreational & Entertainment Classes
Products Health Consultant
Document Fees INR 500/-
Date 30-Mar-2011
Contact Information/ Contact Person- Commander Workers Engineer
Military Engineer Services Bikaner - Rajasthan India
Website http://www.mes.gov.in

Army Research And Referral Hospital retrogrades ESM healthcare

Lt Gen Mukesh Sabharwal, PVSM, AVSM*, VSM
The Adjutant General
Adjutant General’s Branch
Integrated HQ of MoD (Army)
Room 280, South BlockDHQ PO, New Delhi -110011
Sub: HEALTHCARE DEFENCE VETERANS

Dear General Sabharwal,
1. On 03 May 2011, I had an opportunity to visit RR Hospital Oncology Department with a relative patient. While waiting for our turn to be seen by the doctor, I happened to read a Notice Board put up in the corridor which has compelled me to write their letter.
2. All along our Military Career, (the post retirement being part of it as the last stage), we were told that Health Care of the Defence Veteran and his/ her spouse would be taken care of by the Govt. We were told that DSSR also mentions so. The ECHS was introduced to further improve the healthcare of defence Veterans. But what is written on the Notice Board referred above, one can safely deduce that any Defence Veteran or his/ her ECHS dependent inflicted with the Cancer will find it most difficult to get the treatment and he is sure to die most probably due to harassment and exhaustion rather than by cancer. I borrowed a paper from the reception counter and copied what was written on the Notice Board. The same is as follows:

All Ex Servicemen to be registered under ECHS for treatment of cancer.

All ECHS members to come to Oncology OPD with reference for ECHS Policlinic.

ECHS members to come to OPD Days (Tuesday, Thursday, Saturday) for consultation between 0900 – 1400hrs.

All patient coming for initial or subsequent visit should get then registered in OPD.

All special investigation or Radiological investigation will be done from civil hospital through ECHS Cell.

Radiotherapy and Chemotherapy will not be provided at this hospital.

Surgery may be offered depending on availability of beds and OT slot, after permission from Commandant.

Medicines and disposable for ECHS members to be collected from ECHS policlinic.

Only patients operated at this hospital will be reviewed here. Others, who have received treatment in civil are to be followed up at the respective hospitals.
3. The analysis
(a) The individual first reports to ECHS, collects the investigation forms, goes to
investigation empanelled hospitals which is difficult to find, gets back to ECHS, collects referral form for RR, reports to RR gets registered and then reports to Oncology department. (The patient and his/her relatives are already exhausted).
(b) ECHS members can visit RR only on OPD Days ie Tuesday, Thursday,
Saturday for consultation between 0900 – 1400hrs. Coming from 50 – 60 Kms away he is late at the reception and may not get his turn that day. This is what a few in the corridor had to tell me.
(c) The notice says that all special investigations or Radiological investigations will
be carried out in civil Hospital through ECHS Cell and not in RR Hospital. The patient returns to ECHS polyclinic which has already been closed for the day. He comes to ECHS, the next day and gets referral forms for investigations, goes to civil hospitals and gets the investigation done. After a few days collects investigation reports from the civil hospital and returns to ECHS Polyclinic. Again waits for his turn, gets referral to RR Hospital and then on OPD day reports to Oncology Dept.
(d) He is seen by the specialist doctor but his ordeal does not end. If Radiotherapy and
Chemotherapy are required to be don, the Notice Board says that these will not be provided at RR Hospital. He then goes back to ECHS polyclinic, is seen by the doctor who then prepares referral for civil hospital.
(e) He then goes to the civil hospital and waits for his turn to be given future date for
the therapy.
(f) The Notice Board also says that surgery if required may be offered depending on
availability of beds and OT Slot that too after permission from Commandant. The individual then starts his journey to reach upto the Commandant to get permission. If he is lucky, to get permission, he returns to oncology department and gets the date for surgery.
(g) The problem is further compounded, the Notice Body says, Medicines and
disposables for ECHS members to be collected from ECHS polyclinic. The patient returns to his dependent ECHS Polyclinic and asks for Medicines and disposables. More often, the local purchase funds would not be available, and the individual is harassed further. He is now at the breaking point.
(h) If he is lucky to get his surgery done at RR, only then he can get himself reviewed at RR. But if he has been operated in any civil hospital, he would have to follow the same tedious procedure to get himself reviewed at the Civil Hospital since RR will not entertain him for any future complications.
5. After reading the Notice Board I looked up and prayed to the God that No defence veteran should ever get Cancer since he is sure to die due to the bureaucratic tedious system of provision of Health Care. Soldier took the oath that Nation comes first then come his comrades and his own comfort the last and accepted to sacrifice his life. But he was assured that the Nation will lookafter his needs. Alas! if the instructions on the Notice Board are any indication, a defence veteran has been left at the VILLAGE WELL AS FIRED CARTRIDGE TO DIE. Dear General Sabharwal, I must admit that my emotions over took and tears rolled down.
6. May we request you to please take up the case at the highest levels and get the system set right to ensure that super specialty care to the Defence Veterans for all type of health problems is provided through single Widow concept. Please treat this MOST URGENT.
With Regards,
Jai Hind
Yours Sincerely,
Maj Gen (Retd) Satbir Singh, SM
Vice Chairman Indian ESM Movement

ECHS: IESM addresses pressing teething problems

Maj Gen A Srivastava, VSM Dated: 10th Feb 2011
MD ECHS
Central Organisation ECHS, Opposite
AFMSD, Maude Line, Delhi Cantt

SUGGESTIONS FOR IMPROVING HEALTH CARE TO ESM THROUGH ECHS
1. This has reference to our tele conversation on the improvements required to make the ECHS more effective. Some of the issues are discussed in succeeding paras.
2. Empanelment of Suitable Super Superspeciality Hospitals. As part of their social responsibility, Superspeciality Hospitals of repute across the country need to be asked by the Govt to offer themselves to be empanelled to the ECHS to enable the ESM to avail cashless health Care facility. A recent case came to our notice, where in, wife of Hony Capt S N Sharma residing at Kanpur suffered two severe Heart attacks. To his surprise, he found that there was no superspeciality hospital empanelled at Kanpur where Cardiac Health Care was available. The Hony Officer did not have the necessary funds with him to clear the hospital bills. I had personally spoken to you about this case. He is running from pillar to post to get the advance to pay the hospital dues. Many more such cases are likely to occur. There is therefore, immediate requirement to take up this issue on priority and to empanel such superspeciality Hospital across the country. A compendium of empanelled Hospitals may please be put on website and also made available at various ECHS, Distt Soldier Board HQs and all India ESM organizations like IESM for further dissemination.
3. Construction of ECHS Polyclinic Buildings. There is requirement to construct suitable buildings catering for all modern healthcare facilities.The existing arrangements are inadequate and at many places ECHS are located at unsuitable rented accommodation. This is an important requirement for provision of efficient healthcare.
4. Authorization of Additional medical Specialist and Medical Officers. This point has been put up a number of times and deliberated upon. However, on ground very little has improved. Regional Commanders of ECHS need to be authorized to sanction additional doctors based on the accepted scale of authorization. Not more than 40 and 25 patients can be effectively seen by one RMO and a specialist doctor in a day. The scale needs to be strictly adhered to.
5. Availability of Medicines. There is need to expedite availability of prescribed medicines to the ESM. The existing system of the availability of medicines is unsatisfactory. We were informed that system of supply of medicines through empanelled civil pharmacies will be put in place. The same needs to be expedited.
6. Local Purchase of Medicines. The enhancement of local purchase powers of various types of ECHS has not yet been carried out. There is need to expedite the same. In addition, provision needs to be made to reimburse the cost of medicines which are NA in the ECHS and the ESM be allowed to buy from the market.
7. Processing of Hospital Bills. This has reference to the Govt plan to outsource processing of the Hospital Bills to ensure speedy clearance of bills. The same needs to be expedited.
8. Authorisation of Private Wards to Hony Rank Officers. Govt of India Min of Health and Family Welfare Department of Health and Family vide their letter No. S.11011/23/2009-CGHS D.I/Hospital Cell (Part I) dated 17th August 2010 Para 4.1, has authorized Private Wards in the hospitals for Civilian Govt employees with Basic Pay (without grade pay) of Rs 19540/- and above. However all Hony rank officers whose basic pay (without grade pay) is Rs 19540/- per month are auth semi private ward. This disparity needs to be removed forthwith.
9. Additional Servicing Points at the Reception and Registration and issue of Medicines in various ECHS. Over 500 ESM are visiting as OPD patients in Class ‘A’ ECHS. There is need to increase the servicing points for reception, Registration and issue of medicines. Two counters for other ranks and their families, One counter for JCOs and their families, one for officers and their families, one for Hony Officers and their families and for JCO/OR senior citizens and their families and one for senior citizens officers and their families are suggested.
10. May we have regular meetings, updates and early actions please.
With Regards,
Jai Hind
Yours Sincerely,
Maj Gen (Retd) Satbir Singh, SM
Vice Chairman Indian ESM Movement