Army officer's feet bitten by rats in hospital, probe ordered

New Delhi: The feet of a paralysed Special Forces officer was bitten by rats in the Base Hospital in New Delhi after which the Army has ordered an inquiry into the incident to fix responsibility. The young Lieutenant belonging to an elite Para (Special Forces) battalion of the force was admitted in the Army Base Hospital after he was injured in a counter-terrorist operation in Jammu and Kashmir about three weeks ago.
The incident came to light when the hospital authorities found the paralysed legs of the officer bleeding due to rat bites, Army sources said. An inquiry has been ordered into the incident and strict action would be taken against whosoever is found to be responsible for the incident, they said.
The sources said the bite wounds of the officers have been dressed and all possible attention is being paid towards his health condition. Army Base Hospital is a referral centre for several trauma-related cases of the Services personnel. A detailed report is being sought from the Base Hospital also and strict instructions have been given to maintain hygienic conditions there.
Delhi: Army officer's feet bitten by rats in hospital, probe ordered
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ECHS: Army health scheme plagued

Owes Rs 60 crore to 30 empanelled centres, including Rs 40-cr Fortis bills
Vijay Mohan
Tribune News Service
Chandigarh, June 13
A couple of weeks ago, braving the scorching summer heat, an elderly ex-serviceman travelled from Bathinda to Mohali to avail himself of treatment at a hospital empanelled under the Ex-Servicemen's Contributory Health Scheme (ECHS). On arriving here in the afternoon, he was, however, turned away on the grounds that no beds were available at the hospital.
On the matter being pursued by a local ex-servicemen's association, it was revealed that the ex-serviceman had not followed the proper referral channel and instead of being routed through the local ECHS office, he had landed directly at the hospital. This is not a singular case. Local associations taking up ex-servicemen's problems say about half a dozen cases have been brought to their notice in the past three months where ECHS patients have been turned away, ostensibly on the procedural grounds.

Almost a decade after it was launched, the ECHS continues to face functional and administrative problems. Large outstanding payments to private empanelled hospitals, complaints of senior citizens not being entertained, procedural anomalies and unavailability of medicines are among them.
Launched in April, 2003, the ECHS entitles ex-servicemen and their dependents to comprehensive medicare in service hospitals as well as the empanelled private hospitals. Prior to this, they could avail themselves of facilities only for specific high-cost surgeries or treatment for a limited number of diseases covered under the Army group insurance schemes, which provided only limited relief vis-a-vis the schemes available to the other Central Government employees.
The ex-servicemen associations have claimed that there have been instances where veterans have not been entertained by some hospitals, ostensibly due to their commercial interests. Some have also claimed that they have experienced difficulty in being admitted to a hospital in cases of minor or low-level treatment.
The representatives of private hospitals maintain that no patient is refused admission unless there is a genuine reason like unavailability of a bed or the specialist concerned. No emergency case is turned away. Another reason cited for patients being not entertained is that they have not been referred to the hospital by the designated ECHS polyclinic, which would result in administrative hassles later on. Given the quantum of ECHS patient inflow, the number of patients turned away, if unavoidable, is negligible, they say.
Many of these issues were raised at a meeting over ECHS held at the Headquarters, Western Command, Chandi Mandir, about a month ago. Besides the matter of pending bills, allegations of hospitals inflating bills also cropped up. In fact, it was reportedly a representative of a private hospital who himself pointed out that some hospitals were inflating bills.
There are 30 empanelled hospitals, diagnostic centres and laboratories in the tricity region and their total outstanding payment is estimated to be over Rs 60 crore.
In the tricity, the ECHS authorities owe about Rs 40 crore to Fortis Hospital, one of the largest private hospitals in the region. A spokesperson for the hospital said on an average 180 or 200 ECHS patients are attended to daily at the OPD while on any given day there are 25 or 30 ECHS patients in the various ICUs/CCUs of this hospital and another 55 or 75 admitted as in patients.
A senior staffer at another private hospital claimed that his institute had outstanding payments worth over Rs 15 crore. Chandigarh is a high-pressure centre where patients come from the neighbouring states. He said while bills might take up to five or six months to be cleared from the Chandigarh centre of the ECHS, those from other centres like Dharamsala take much longer. The Alchemist in Panchkula owed about Rs 1.5 crore to the ECHS authorities, he added.
Official sources at the Headquarters, Western Command, said they were ‘alive’ to the problems being faced by the stakeholders and efforts were being made to bring down the time period for releasing payments. “We have started online bill processing at five major stations, including Chandigarh, where bills can be submitted online by hospitals, which will cut down the time period,” a senior officer said.
“We are also working out a system where a hospital would give us 2 per cent discount on the bills that are cleared within seven or 10 days,” he added.
According to the hospital authorities, the verification process for bills is long and tedious, involving several establishments and hierarchical levels.
A new system of dispensing medicines is also being adopted, where the dispensaries at the ECHS polyclinics would be outsourced to private players. They would be responsible for procuring and stocking medical supplies and disbursing them as prescribed, with the cost of the supplies being borne by the ECHS as mutually fixed. A meeting between the ECHS authorities and prospective vendors to discuss the modalities of outsourcing was held in New Delhi a few days ago.
Army health scheme plagued

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 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 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: Health Care for the Veterans remains elusive

HEALTH CARE FOR THE VETERANS

The experience of veterans makes a sad reading and we owe it to them to put our heads, hearts and hands together and set the system run smoothly. Some of the possible steps may be considered..

Since clearing of hospital bills seems to be the demon we must streamline it and lay down a time limit for clearance of bills after which the bills must be deemed ‘passed’.

Pending this we have to contact both empanelled and other super speciality hospitals and seek their assistance to provide facility to veterans at subsidised rates or alternately.

The veteran pays as per the ECHS rates and himself claims the bill money paid by him. Rather tough for us to bear but can be of use when no other avenue is open.

We must allowed to consult/get diagnosis from any super specialist of our choosing by paying ourselves and get the recommended treatment /medicines through ECHS.

Diabetics seem to be the worst hit. They require regular sugar level checks..Fasting,PP,3 AM,..before dinner ,after dinner. and random as advised by the specialist. They must be given a Glucometer once in 3 years and a pack of 25 strips every 3 months to relieve their ordeal. This is the way they test in the best specialist hospitals also. For Gurgaon the diabetes specialist on panel visits Rockland for 2 hours thrice a week but a full fledged Diabetic Centre Sitaram Bhartiya Research institute is not on panel even though the offer comprehensive packages to diabetitce esp veterans.

The point requiring immediate attention is the travelling of veterans from bus stops to ECHS and back .The sick and aged have to trudge along for good 5 km or so one way and get back again in rain,sun or cold by most uncomfortable means or on foot mostly having to carry the month’s CSD stuff also..

We have to immediately provide ,to begin with amenity transport from the unit running the show and the two CSD stores from canteen profits and along with contact corporate, TATAS, MAHENDRAS etc to lend a helping hand. Let us really take care of the men we commanded.

Now Let US FACE THE BALL... GoI, MOD, RRM or PM cannot be expected to come to our resecue because we are APOLITICAL...the neuteral...
The ECHS has all the senior officers, talented and well known and eminent as members we must request them to contact the various hospitals, corporates and NGOs and seek maximum help and cooperation. This can be our only hope to find solace and do our duty towards the vaterans'.
JAI HIND
Major Mehandru (Retd)

Voluntary premature retirees entitled to disability pension

Tribune News Service Chandigarh, May 30
The Armed Forces Tribunal has held that an individual is entitled to disability pension along with regular pension even if he has taken voluntary premature retirement.

There have been many instances where the authorities concerned have been denying disability pension to military personnel who opted for pre-mature retirement owing to their low medical category.

Granting disability pension to a Brigadier who retired in 2004 along with arrears since the date he retired with 12 per cent interest, the Tribunal overruled the contention of the government that Regulation 50 of the Pension Rules did not entitle voluntary retirees to disability pension.

“After discussions, we have held that even if the incumbent may seek pre-mature retirement, he is still entitled to the disability element of pension,” the Bench said. The Bench observed that in the present case, the incumbent sought pre-mature retirement after completing 33 years and four-month service. A medical board had assessed his disability to be 30 per cent, which was attributed to and aggravated by military service.

He had earlier petitioned the Army headquarters and the Controller of Defence Accounts (Pensions), over the issue, but to no avail. Thereafter, he sought legal redressal to his grievance.
Voluntary retirees entitled to disability pension

Can the disabled expect immediate payment of arrears?
From past experience one wonders if court orders will be respected by MoD or GOI! ESM are made to run from pillar to pillar to seek justice.

ECHS: Health care given a go by- RTI exposes corruption

Treatment in Military Hospitals
Are Somnath, Pranab soldiers?
Eklavya Atray
Thursday, March 19, 2009
New Delhi: They swear by the Indian soldier in public. But in private, Union ministers, senior bureaucrats and many others do not hesitate to exploit health facilities meant exclusively for the Indian soldier.

With the Right to Information Act, DNA carried out a detailed inspection of records at the army's Research and Referral (R&R) Hospital in the capital. It found that hundreds of civilians were treating themselves at the prestigious hospital using their powerful connections.

Lok Sabha speaker Somnath Chatterjee, external affairs minister Pranab Mukherjee, former president R Venkatraman and several IAS officers, including secretaries, former defence secretaries and serving defence ministry bureaucrats were among hundreds of civilians treating themselves at the prestigious hospital.

There were also many unknown faces, who obviously came with strong recommendations. In fact, R&R hospital, the largest military hospital in India, has treated over 750 non-entitled patients in the last five years.

DNA found that these men and women were treated for diseases ranging from common dysentery to complicated surgeries, viral fever to life-threatening complications. In return the patients paid peanuts, the subsidised rate military personnel are entitled to.

The authorities covered up the staggering exploitation of military resource by saying that the hospital commandant was empowered to make exemptions for outsiders. But this comes at a time when the defence ministry is paying crores annually to private hospitals for treating retired military personnel and their kin under the ex-servicemen Contributory Health Scheme, due to shortage of facilities in military hospitals.
Are Somnath, Pranab soldiers

Army Hospital (Research & Referral)
R&R Hospital: Better Than The Best
The first human patient simulator
Beating heartz surgery
X-knife surgery
Robotic total hip replacement surgery
Biplane Digital Subtraction Angiograhpy
'dual head gamma camera SPECT system'
Molecular Lab
Digital fundus camera

Comment: The ECHS evolved to treat ESM and dependants is in a sordid state of decay sans funds. Military Hospitals refuse to treat ESM. Crores of Rupees spent in treating unauthorised civilians at Military Hospitals does not affect either the conscience of Military authorities or the Government as governance is by a bunch of corrupt bureaucrats. We thank DNA for exposing such a fraud perpetuated on the ESM fraternity.

One Crore Beneficiaries

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