ECHS BOON OR BANE
The Hon’ble Prime Minister Of India,
New Delhi -110 011
Mrs Sonia Gandhi,
Chair-Person, UPA,10 Janpat,
The Hon’ble Defence Minister of India,
New Delhi -110 011
The Chief of the Army Staff,
South Block, New Delhi – 110 011
The Chief of the Air Staff,
Air Headquarters, New Delhi – 110 011
The Chief of the Naval Staff,
Naval headquarters, New Delhi- 110 011
Headquarters Western Command,
Chandimandir, Dist Panchkula
The Director General Armed Forces Medical Services,
Ministry of Defence,
DHQ PO New Delhi 110 011
The Managing Director,ECHS,
Delhi Cantt 110 010
The Regional ECHS Cell,
Chandimandir, Dist Panchkula
ECHS BOON OR BANE
1. When ECHS was introduced Ex-Servicemen felt very happy that they would be able to get the best medical facility available in the country. Today when I look back I realize that ECHS has done the greatest damage to the Ex-Servicemen. This facility is looking after the officer cadre to some extent by virtue of their ranks and contacts , the JCO’s and Other Ranks are the worst sufferers as most of the officers reside in cities where ECHS Polyclinics exist and most of the JCO’s and other ranks reside in villages and as such are devoid of this facility. Those from the villages when are compelled by the ailment to visit the empanelled hospital, they have to depend on public transport, they also do not have proper facility for food and stay.
2. Earlier when one reported to the Military Hospital, after his reporting, the Hospital looked after the patient. Now the patient is made to run from pillar to post to receive the service of an empanelled hospital. The procedures are lengthy and time consuming. When I write this I am giving the living examples of the functioning of the ECHS.
3. My mother aged 87 years is the wife of an Army Officer and is a member of the ECHS. She is suffering from Dementia, Ischemic Heart Disease and Thyroid. She is dependent on ECHS Polyclinic Chandimandir. Because of Dementia she was referred to an empanelled hospital for admission and evaluation of her disease. We took a referral from the ECHS Polyclinic Chandimandir for the Fortis Super Specialty Hospital located at Phase 8 Mohali. She was not admitted by the hospital stating that no beds were available. On talking to doctors working with Fortis Hospital and known to us it was learnt that since ECHS patients are on contractual rates of payment as such the accommodation is generally denied till such time a serious ECHS patient who has to under-go an expensive procedure comes for admission like a heart patient who has to under-go a bypass. We were advised to get the tests done through the Out Patient Department (OPD). She was to be assessed by a Neurologist. It would be pertinent to mention that the Fortis Hospital is around 20 to 25 Kms from the ECHS Polyclinic Chandimandir.
4. The Neurologist did his tests and wanted her condition to be assessed by a Cardiologist. To see the Cardiologist another referral was required from the ECHS Polyclinic so we had to go back to the ECHS Polyclinic to get another referral for the Cardiologist. Since she is also a patient for Thyroid the Cardiologist wanted her to be evaluated by an Endocrinologist this entailed another referral from ECHS Polyclinic Chandimandir. So we went back to the Polyclinic to obtain another referral from the ECHS Polyclinic Chandimandir. The Endocrinologist wanted the patient to be admitted in the Hospital to administer certain drugs under hospital condition under the supervision of a doctor. We had to go back to ECHS Polyclinic Chandimandir to obtain a referral for admission into the hospital. She was again not admitted with an excuse that no beds were available and if she is registered now the bed would be available after 3 to 4 months. We were again advised by the doctors known to us to get the drug administered through the Day-Care unit of the hospital. We had no choice so this was done. All the three consulting specialists prescribed the medicines to be taken by her.
5. Now to obtain these medicines from the ECHS Polyclinic they had to be counter signed by the concerned specialists at the Western Command Hospital Chandimandir. The medicines which were prescribed some of them had the commercial names and the generic names were not known and one was advised by the OIC Medical Store to obtain these from the market at our own cost and show them the medicine so that they can assess which brand of the medicine with the same generic name was available with them.
6. The Endocrinologist at the Western Command Hospital wanted another test to be done through an empanelled hospital/Diagnostic Centre for this another referral was to be obtained through the ECHS Polyclinic Chandimandir. The referral was obtained the test was done and the results were shown to the Endocrinologist who wanted the test to be repeated after 3 months. The first test was done on 01 Jun 2012 and the repeat test was to be done again on 01 Sep 2012. This entailed another referral. The referrals which are given have the validity of 30 days. The OIC ECHS Polyclinic Chandimandir was approached on 21 Aug 2012 to obtain the referral. The referral was refused by the OIC ECHS Polyclinic who refused to give the referral and advised to come for the referral two days prior to the test.
7. It would be pertinent to mention that even after an operation; if the stitches are to be removed another referral is required from the ECHS Polyclinic.
8. If a patient takes a referral for a particular hospital and the patient is refused admission then the patient has to go back to the ECHS Polyclinic to obtain referral for another hospital. If that hospital also refuses admission how many times the patient will have to run up and down to get admitted in a hospital is a big question mark. It is also pertinent to mention that the ECHS Polyclinics function between fixed timings so the people concerned are not available at odd hours.
9. Here is a condition where the lady is a widow of an Army Officer and has a support system available to her through me. Imagine the condition of a retired JCO or an OR who comes from a village and has to run up and down to obtain the services of an empanelled hospital through the dependant ECHS Polyclinic . It is very difficult for them. The problem gets more compounded when it is the case of a widow with no support system.
10. ECHS organization in the last 5 years has spent nearly Rs2700 crores. The figures were obtained from the MD ECHS through an RTI. Photocopy of the same is attached for perusal.
11. The Armed Forces have an R&R Hospital at Delhi which can match any of the best hospitals in the country. We have highly qualified super specialists working with the armed forces. It is also seen that the Government had in the first year of its inception spent around Rs250 crores which has multiplied nearly 3 times to Rs750 crores in the financial year 2011-2012. This amount will further keep increasing. While the cost of treatment is going up the services provided by the empanelled hospitals are going down. Taking referrals for every specialist is time consuming besides wasting of money and man hour’s it is difficult for a patient (We must appreciate he/she is not a normal person)to travel all the way to obtain the referrals.
12. Also it is learnt that these ECHS Polyclinics indulge in corrupt practices as they try to convince you to go to a particular Empanelled Hospital/ Diagnostic Centre. The bills of the empanelled hospitals are not cleared on time till such time money exchanges hands. While talking to some of the doctors who are working in these empanelled hospitals they informed that they had instructions from their Principals to conduct maximum investigations on the patient to make up for the low contractual rates of the ECHS patients. It is also seen that in certain cases the empanelled hospitals keep the patient admitted for a longer duration tha n it is actually required. Where the admission is based on a package the patient is discharged earlier then the time stipulated in the package
13. From the above the following is suggested:-
(a) Open Own Veteran Hospitals. ( It would be seen that the main concentration of Ex-Servicemen is in around, Chandigarh, Delhi, Poona, Bangalore, Madras, Hyderabad , Lucknow , Calcutta, Jallandhar , Amritsar, Jaipur and Jodhpur). By doing this money which is being spent on the medical facilities being purchased will be saved and it would be like hither to fore as was when the patients reported to the Military Hospitals for treatment.
(b) Upgrade ECHS Polyclinics into hospitals as per requirement depending on patient strength.
(c) Beef up the bed strength of the existing military hospitals. With the higher strength a case should be taken up with the Government for enhanced promotions of the Commandants of the hospitals.
(d) Increase of the strength of doctors of these hospitals.
(e) Employ civilian super specialists with salaries comparable with their counter parts with the civil hospitals.
(f) The OIC ECHS Polyclinic should be a doctor and not an officer from other arm /service, as a doctor understands the gravity of an investigation as recommended by a medical specialist.
(g) Before empanelment of a hospital an under-taking should be taken that certain beds would be kept reserved for the ECHS patients and the daily bed state should be displayed at the ECHS polyclinic and also should be displayed on the ECHS web site for each station.
(h) In order to overcome the requirement of the patient running every-time to the ECHS Polyclinic, a representative, of the ECHS should be available with the empanelled hospitals to give the additional referrals to the patients in situ. However the initial referral may be given by the dependant ECHS Polyclinics as hither to fore.
(i) A list of the medicines which are available with the ECHS Polyclinics should be given to the empanelled hospitals and the hospitals advised to prescribe only those medicines which are available with the ECHS Polyclinics.
The above actions would mitigate the medical problems of the veterans to a great extant. It may kindly be appreciated that it is not a complaint but an effort to improve the system of functioning of the ECHS for the benefit of the Ex-Servicemen.
Dated :- 28 Aug 2012 (Major RS Gujral Retd)