Health Watch CGHS: How government servants see it

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Health care is an ingredient of the most fundamental of all rights. The Indian Constitution has not conferred this right on its citizens but the Central Government employees both in Delhi and outside have an inbuilt structure in this regard. The Ministry of Health over the years has ensured ?adequate health care net work through the Central Government Health Scheme (CGHS) for its employees in major cities.

Started nearly 53 years ago in July 1954, when Nehru was Prime Minister the contributory CGHS with the twin objective of giving comprehensive medical care facilities and to avoid cumbersome medical reimbursement now covers over five million beneficiaries in Delhi and 25 important towns like Ahmedabad, Allahabad, Bangalore, Chennai, Guwahati, Hyderabad, Jabalpur, Jaipur, Kanpur, Kolkatta, Lucknow, Meerut, Mumbai, Nagpur, Patna, Pune, Thiruvanathapuram, Bhubaneswar and Ranchi.

Initially conceived for Government employees the CGHS now covers, Members of the Parliament, former MP?s, Judges of the Supreme Court and High Courts, (sitting and retired), Freedom Fighters, Central Government Pensioners and their families, former Presidents and former Vice-Presidents, former Governors and former Prime Ministers. The CGHS has a wide network of nearly 400 dispensaries which includes allopathic, ayurvedic, homeopathic, unani, sidhar, yoga centres and polyclinics. Laboratories and dental units are also functioning under the CGHS.

In addition, the CGHS beneficiaries were allowed to avail treatment in leading private hospitals in Delhi and outside from September 1996. This list has further been enlarged to 60-65 private hospitals/diagnostic centers from 2001.

The credit goes to the Federal Ministry of Health for having streamlined the procedure for obtaining treatment in some of the top private hospitals. In emergency, the private hospitals provide credit facility to all the CGHS beneficiaries on presentation of a valid CGHS card not only in Delhi, but the government has approved a large number of prestigious private hospitals and diagnostic centers outside also. In non emergency cases, the CGHS beneficiaries can obtain even 90 per cent medical advance of the estimated cost given by a recognised hospital. Further, retired Central Government Servants residing in a non-CGHS area but registered as a CGHS beneficiary with the nearest CGHS covered city can obtain reimbursement of medical expenditure incurred on heart operation and other treatment in a recognised private hospital after obtaining prior permission. The Central Government Pensioners can directly go to an approved hospital and obtain treatment on production of the CGHS card in emergency.

While some of the allopathic dispensaries more so in South Delhi are working smoothly, corruption, misbehavior and long lines of senior citizens, non supply of medicines in one go as also rude attitude of doctors/staff have been reported in a large number of CGHS dispensaries. In a number of West Delhi dispensaries the indented medicines are delivered after a lapse of few days. The Government pensioners have to purchase their requirements from the open market for which there is no provision for payment. They have to visit the CGHS dispensary again and again. It is a breakdown of system in many cases.

Although all doctors manning the CGHS dispensaries take an oath of service to the suffering humanity while taking medical degree and a number of doctors do follow it in letter and spirit but with the passage of time discontentment has crept in a part of the medical fraternity, who have forgotten this oath. Sometimes prescriptions get misplaced in dispensaries. Day in and day out, cases of maltreatment, delay in supply of medicines are increasing. The best treatment and medicines are available in the Parliament House Medical Centre meant for MP'sand VIP?s.

The Health Ministry is also playing a game of hide and seek with the accredited press correspondents. Till some time back accredited pressmen were extended the CGHS benefit, but recently they have been excluded.

Bringing major relief to Central Government employees, the Delhi High Court has ruled that they are entitled to full reimbursement of medical bills if they receive treatment at a private hospital that is on the government panel. Importantly, the court also said it is the duty of the government to ensure such hospital do not charge more than government could pay. The judges virtually struck down the provision wherein some government departments allow only a limited reimbursement citing Central Government Health Scheme as happened to a Telecom staff, the petitioner in the case. He was only reimbursed Rs 1.3 lakh of the total bill of Rs 2.3 lakh after a treatment at the Escorts Heart Institute following a heart attack.

Further, it takes undue long for reimbursement of claims from the Health Ministry, because the funds allocated disappear soon in the treatment of VIP?s. The medical bills for instance of former Prime Minister V.P. Singh for his dialysis etc, both in India and abroad are met from the CGHS allocation. According to reliable sources, none of the Indian hospitals provide facilities of running clean water for Dialysis purpose. All medical institutions including five star hospitals use stored tank water not suitable for dialysis. Despite RTI note sent over three months back, the Health Ministry has not given figures of the CGHS expenditure incurred on VIP'ssuch as V.P. Singh late Shri K.R. Narayanan and H.N. Bahuguna V.P. Sathe and others. Some people getting the CGHS facilities say that the whole set up is sinking.

(The author can be contacted at 6, Maitri Appts., A-3, Paschim Vihar, New Delhi-110 063)

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