Showing posts with label E C H S. Show all posts
Showing posts with label E C H S. Show all posts

Saturday, June 13, 2015

ECHS & MILITARY HOSPITALS : Great IAS Babus Who Shall Keep On Making Anti-Soldier's Laws










if the notification  BELOW is true, the officer who framed these rules should be hanged on the nearest tree or shot for endangering national security”.


MILITARY  HOSPITALS AT THE MERCY OF BABUs  :  BABU KI MAAR - Notice put up at the Command Hospital (Western Command)


 Great IAS Babus Who Shall Keep On Making Anti-Soldier's Laws

Notice put up at the Command Hospital (Western Command)


says it all. This is the latest bureaucratic salvo to pawn a soldier’s life in the name of exercising financial control, supposedly a measure to exercise political control over the military. Had one of those soldiers who participated in the operations landed in the hospital with severe wounds, he would have faced the music of the bureaucracy


not





                              NOW READ THE DETAILS










Soldiers are expendable without financial approvals and no outlays on used up soldiers – the govt policy?

June 12, 2015, 11:21 am IST in In Search of Propriety | India | TOI

There is an unwritten contract between the soldiering community and the people, represented by the government of the day. Under the deal, the soldiers are expected to walk into perilous and hazardous situations unhesitatingly and be prepared to risk their life even at the cost of his family losing his support for the rest of their lives. The government on the other hand is expected to take care of the veterans, families of the soldiers and the disabled unquestioningly.

Soldiers of the Indian Army and the helicopter pilots of the Indian Air Force carried out swift and precise surgical strikes at two locations on June, 09, 2015, to inflict heavy casualties to the North East militants, pre-empting a terror attack on the Indian soil. In a country where the bureaucrat is unwilling to take a decision for fear of being implicated in a scam, the soldiers went into the operations knowing fully well that at the end of the day, they may not return alive. They set aside all considerations about their family, parents or young children that might have crossed their mind when they were ordered to participate in the operations.  To them their commitment to the country was all that mattered. In a similar way, how does the government view their commitment to the soldiering community?

Notice put up at the Command Hospital (Western Command) says it all. This is the latest bureaucratic salvo to pawn a soldier’s life in the name of exercising financial control, supposedly a measure to exercise political control over the military. 
 
 
 
 Had one of those soldiers who participated in the operations landed in the hospital with severe wounds, he would have faced the music of the bureaucracy.
 
 
 
 
 
 
not

One more wheel inserted within the already existing ring to confuse, delay and deny legitimate medical treatment to a soldier when he lands in a hospital with pain and agony. 

The serving soldiers, their families, military veterans, the disabled including the war disabled and a soldier’s widow are the ones who come to the Military Hospitals or ECHS and then get referred to Command Hospitals for specialist opinion and treatment.

The ordeal gets started after a specialist examines the patient, goes through a few important test results and prescribes medicines. The Military’s medical supply chain does not stock a number of medicines primarily on considerations of infrequent usage and cost considerations. Shortages also occur in some limited supply and frequent usage medicines. Such medicines are locally purchased within the financial powers of the Commandant of the Hospital concerned on as required basis based on the recommendations of the Specialists. Such purchases are controlled and monitored by the head of the hospital.

With the introduction of the Integrated Financial Advisor (I FA), every time a patient including those admitted in the hospital is required to be  administered some medicine which is not available in the hospital’s pharmacy, the process for procurement of the medicine will have to be set in motion.

The purchase procedure envisaged will involve obtaining administrative approval of the competent authority, getting three quotations, preparation of comparative cost tables and forwarding a comprehensive case with full justification explaining the disease, the need and the urgency of the medicine’s requirement besides the quantum of medicines being sought to be purchased.  This will amount to the preparation of a statement of case for onward transmission to the I FA for approval. The procedure will require an officer to process and coordinate documentation relating to medicine purchases besides a computer, printer, photocopier, additional stationery and a clerk to handle correspondence and keep a tag of the letters and files being sent around. A courier with a two wheeler would be a requirement to move letters and files from one end to the other.

The I FA cannot be expected to be a one man army. He would need a clerk and a peon to convey files and letters from his office to the other. His location in relation to the hospital and the requirement of sending files from one place to the other would have its own implications in terms of a vehicle for movement and the inevitable time delay. If the I FA is required to be located within the hospital premises, an office will have to be found for housing him and his staff and that will be at the cost of patients’ requirements, the purpose for which the space would have been constructed. One is not clear if the I FA concerned would be exclusively designated to exercise control over the hospital or will be looking after the hospital in addition to his other assignments. That will have implications on his priorities and the time required for scrutiny and according financial approval.

One cannot also expect the IFA to be a signing machine. Being accountable to his own department the IFA would definitely want to satisfy himself of the need for the said medicines besides the possibilities of administering cheaper medicines. The dosage, the quantity proposed to be purchased and the cost factor will also be a matter of his concern before according approval. Being a general cadre bureaucrat, he would neither be wiser about the disease, the treatment, medicine nor the cost.

IFA would therefore have no option but to raise queries to understand the requirement. Being a specialized subject the officer processing the medicine purchase would have to refer the file to the specialist concerned for his clarification. The onus of educating the IFA and making him understand the requirement will then fall squarely on the specialist.  Thus the specialist doctor will start writing notes on the file to explain the case. Three to four cases in a day will keep the doctor sufficiently busy to subordinate and side track his primary job to the new found bureaucratic ordeal. In the process, one would have to be prepared for the file to keep moving back and forth.

Has the government taken into account the additional establishment, additional expenditure, space, time delays and its effect on the lives and comfort of patients, frustration and morale of the soldiering community, the rift that it will cause between the civil and military and the costs involved in instituting this spoke? How would all this save tax payer’s money? Would it be a mistake to call this a hare – brained initiative in the wrong direction? One thing is clear – the government trusts a junior generic bureaucrat much more than an experienced and a professional medical officer of the defence services with about 20 to 25 years of service!
 
 
As for patient, he is still in pain awaiting financial approval for the medicine. The doctors would only be distributing excuses and sympathy to keep him going. Since this procedure is also applicable to expendables, one can expect the hospitals to remain partially cleaned and dirty. Since halfhearted sanitation is not acceptable in operation theatres, essential and lifesaving operations may have to be delayed awaiting cleaning and other expendable material.
 
 
What happens if the patient dies because of the delay in the treatment or surgery? What about the pain and his physical discomfort? Who will be accountable? None need to fear because soldiers are expendable and one does not need financial sanction or approval for causing pain or expending a soldier’s life.
 
 
A soldier is tasked to assault across a minefield against an enemy entrenched in a well prepared position. He is commissioned to go on a patrol and walk into a position held by the enemy to ascertain his location, the layout of his defences, etc., as happened in the case of Captain Saurabh Kalia. No questions are asked or financial approvals obtained before launching a soldier on such risky and dangerous tasks. If unfortunately he happens to sacrifice his life in the mission or is captured as a Prisoner of War, the government shows no scruples by disowning the soldier.
 
 
 
Take the case of a PIL filed by Lt Gen JS Arora of 1971 fame in 1999 before the Gujarat High Court. The litigation sought that the 54 Prisoners of War believed to be in held in Pakistani jails be not treated as ‘presumed dead’ but treated as ‘on duty’ for all purposes till the notional date of their retirement so that the next of kin could receive financial benefits as applicable to a serving soldiers. The litigation also sought that the issue of release of prisoners from Pakistani jails be taken up with international institutions for justice.
 
 
 
Accepting his plea the High Court in 2011 directed the government to grant all service and retirement benefits to such Prisoners of War by treating them as being alive, and more importantly, directed the government to approach the International Court of Justice on the issue of non-release of our Prisoners of War. Guess what the government did?
 
 
 Instead of implementing the court order, the government filed an appeal on 02 May 2012 in the Supreme Court against the Gujarat High Court ruling and obtained a stay order. Is this not iniquitous and disgraceful?
 
 
 The government seems to have made up its mind to abandon the desolate families of soldiers who had died, gone missing, held as Prisoners of War or the survivors and spend no more money on them. Isn’t this the reason why though compelled to retire at an early age no ‘golden handshake’ kind of package or enhanced pensions are paid to soldiers unlike public sector or bank employees?
 
 
Will anyone in the world, excepting the suicide bomber, be prepared to risk their lives and make the supreme sacrifice knowing fully well that the government will make their families run around in circles over legitimate financial and other support after their demise?
 
 
Wouldn’t the government’s inaction to the atrocities committed on Captain Saurabh Kalia expose the reality that if something similar happens to him he too would be abandoned as in the case of Captain Kalia and his family consigned to a state of penury and misery? Can a country hope to build a motivated fighting force ready to make the supreme sacrifice with this approach of the government?
 
 
Make no mistake; we are moving the fighting forces of the country back to 1960s.

A respected bureaucrat and a nationalist MR Sivaraman, IAS, who when informed of the development states:
 
 
 “As a responsible former finance secretary of the largest state in India for 5 years and the longest serving revenue secretary to the government of India with around 30 years of experience in state government, national, international and private sector finance,
 
 if the notification is true, the officer who framed these rules should be hanged on the nearest tree or shot for endangering national security”.
 
He goes on to add “In my view the Chief should call for its immediate withdrawal and if they do not do so resign in protest”.

The Service Chiefs have an obligation to care for and safeguard the interests of the soldiering community. They have abdicated their responsibility by acting as a mere post office. Imagine the impression of the Chief that this inaction would have created in the minds of the rank and file. Is this good for the Army’s morale and the relationship between the commander and the commanded?

Did the Prime Minister or the defense minister order this bottleneck? I am sure they have not. Certainly this is not part of ‘Good Governance’. Who then is responsible for creating this hurdle? The political leadership needs to realize that such inappropriate actions will drown them in the discontent and anger thus generated among- st the people.

Will the Prime Minister and the defense minister initiate appropriate action to reverse the orders?
 
 Can they do it?
 
Many veterans feel that though the Prime Minister has a vision, he appears to lack the ability to reign in the bureaucracy which believes that politicians come and go but they are the face of continuity and hence the real government. It is a test for the country’s leadership (which is likely to fail again).































Monday, March 30, 2015

ECHS :IN CASE OF EMERGENCY MEDICAL AID




    ECHS :
IN CASE OF EMERGENCY MEDICAL AID



Dear Veterans
 
This is for those of you who are ECHS members.
 
None of us are getting any younger. As such, there could well be a day when we need to rush to the NEAREST or most convenient hospital which happens to be non-empanelled.
 
Please have a good look at the precise procedure you need to follow to ensure reimbursement of all medical expenses, in that case:
 
 
__________________
 
Nec temere nec timide!
 
Wg Cdr CK Sharma
Treasurer, IESM
22nd NDA :: 84th PC
 
The darkest places in hell are reserved for those who maintain their neutrality in times of moral crisis.     Danté

Saturday, September 1, 2012

ECHS BOON OR BANE










                                       ECHS BOON OR BANE




To,
The Hon’ble Prime Minister Of India,
                South Block,
 New Delhi -110 011
               
                Mrs Sonia Gandhi,
                Chair-Person, UPA,10 Janpat,
New Delhi

                The Hon’ble Defence Minister of India,
                South Block,
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

The GOC-in-C
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,
Maude Lines,
Delhi Cantt 110 010

The Regional ECHS Cell,
Station Headquarters,
Chandimandir, Dist Panchkula

     ECHS BOON OR BANE
Sir,
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.
Thanking you
                                                                                                                                                                Yours Faithfully
Dated :- 28 Aug 2012                                                                                                                       (Major RS Gujral Retd)