Dear Members,
A news report from Indian Express is reproduced below.
There was never any doubt that the Committee will give a favorable verdict, it is rather unlikely that the GOI will even consider it at this juncture.
You will also recall that the President NFDC had made a presentation before this committee.
warm regards
Navy Foundation Delhi Charter
One Rank, One Pension
"SHOT IN THE ARM LIKELY FOR EX-SOLDIERS"
Ritu Sharma
Dec 15, 2011Express Buzz (Chennai) - [ Front Page ]
NEW DELHI : In a move that can bring joy to nearly 2.5 million retied soldiers, the Parliament Committee on Petitions is likely to favour their demand for 'One Rank, One Pension'.
The report, likely to be tabled in the Parliament next week, will be a vindication of the stand taken by the soldiers who have been running from pillar to post fighting for their rights.
Thousands of ex-servicemen and war veterans returned their gallantry medals protesting the decision of the Ministry of Defence not to grant 'One Rank, One Pension'. Soldiers have been demanding equal pension for personnel retiring from the same rank irrespective of their date of retirement. Persons reitiring before the pay commission cut-off date get less pension than those retiring after the date.
According to sources, the long pending demand has found support as the Committee on Petitions has been considering the petition submitted by Rajya Sabha M.P., Mr. Rajeev Chandrasekhar and 24 others in October 2010.
" The committee conducted a detailed hearing on the matter by inviting citizen groups, ex-servicemen and government representatives to depose and express their views on the issue. The committee completeed their hearing and the report will be presented during the winter session of Parliament ", sources added.
The petitioners in their argument had said that the demand of ex-servicemen may be considered on the lines of the pension for MPs, which is Rs. 20,000 for all first time members.
While the report of the Parliamentary panel is not legally binding on the government, it will definitely lend weight to their demands.
(P.S.: Regret no URL please. Express Buzz has not yet uploaded it on their web edition)
--
If you cant find happiness within, you'll
never find it outside, no matter where you look
or what you do - Swami Chimayananda
Wednesday, December 14, 2011
Lunch Postponed to 22 Jan 2012
Dear Members,
1. It is regretted that the Winter Lunch planned to be held on
Sunday, 18 Dec 2011 at Kota Kouse, is postponed in view of the Navy Nite
being held on 17 Dec in Delhi and the President's Review of the Fleet
being held on 19 Dec 2011 for which some retired officers
would be attending.
2. Our Lunch get together will now be held on Sunday, 22 Jan
2012 in the Gold and Silver Rooms of Kota House, commencing 1200 hrs.
All members and their spouse are cordially invited to join in and
make the get together a success. The standard nominal charge of Rs
400/- per couple and Rs 250/- for a single will be levied from members
towards the cost of Drinks and Lunch.
3. Kindly confirm your attendance for the Lunch to NFDC office
latest by 18 Jan 2012 to help us to make the arrangements.
Warm regards
(VK Thakur)
Commodore (Retd)
Secretary
1. It is regretted that the Winter Lunch planned to be held on
Sunday, 18 Dec 2011 at Kota Kouse, is postponed in view of the Navy Nite
being held on 17 Dec in Delhi and the President's Review of the Fleet
being held on 19 Dec 2011 for which some retired officers
would be attending.
2. Our Lunch get together will now be held on Sunday, 22 Jan
2012 in the Gold and Silver Rooms of Kota House, commencing 1200 hrs.
All members and their spouse are cordially invited to join in and
make the get together a success. The standard nominal charge of Rs
400/- per couple and Rs 250/- for a single will be levied from members
towards the cost of Drinks and Lunch.
3. Kindly confirm your attendance for the Lunch to NFDC office
latest by 18 Jan 2012 to help us to make the arrangements.
Warm regards
(VK Thakur)
Commodore (Retd)
Secretary
Winter Dinner Dec 2011
Dear Members,
You will recall that in the last newsletter we had intimated that we will be holding a winter lunch for a change. This is to reconfirm that the lunch is on and we expects a good turn out of members and their spouses , particularly those who cant venture out during the late evenings.
We will be having a multi-cuisine layout typical of Delhi at this time of the year and cocktails will also be served. Normal charges as hither to will apply.
Kindly forward your names at the earliest so that we can make adequate catering arrangements.
warm regards.
V Adm Harinder Singh (Retd)
--------------------------------------------------------------------------------------
Extract for Newsletter 3/ 2011
Winter Lunch for Members of NFDC. As a change, we propose to hold a winter Lunch get together on Sunday, 18 Dec 2011, to bid farewell to the year 2011 and also to welcome the New Year. This will be held on the rear lawns of Kota House Mess, commencing 1200 hrs. All members and their spouses are warmly invited to attend the lunch and make the afternoon a great success. Contributions from members towards the cost of drinks and lunch, etc will be the standard normal rates as hitherto fore. A further communication on this event will follow in due course.
You will recall that in the last newsletter we had intimated that we will be holding a winter lunch for a change. This is to reconfirm that the lunch is on and we expects a good turn out of members and their spouses , particularly those who cant venture out during the late evenings.
We will be having a multi-cuisine layout typical of Delhi at this time of the year and cocktails will also be served. Normal charges as hither to will apply.
Kindly forward your names at the earliest so that we can make adequate catering arrangements.
warm regards.
V Adm Harinder Singh (Retd)
--------------------------------------------------------------------------------------
Extract for Newsletter 3/ 2011
Winter Lunch for Members of NFDC. As a change, we propose to hold a winter Lunch get together on Sunday, 18 Dec 2011, to bid farewell to the year 2011 and also to welcome the New Year. This will be held on the rear lawns of Kota House Mess, commencing 1200 hrs. All members and their spouses are warmly invited to attend the lunch and make the afternoon a great success. Contributions from members towards the cost of drinks and lunch, etc will be the standard normal rates as hitherto fore. A further communication on this event will follow in due course.
Monday, January 17, 2011
MINUTES OF MEETING HELD ON 09 DEC 10 AT KOTA HOUSE
NFDC AGENDA FOR DISCUSSIONS WITH ECHS 09 DEC 2010
Issue of 3 Months Medicines and Longer
1. We were informed by CNS, COP, CPS and Capt, AL Narayan Director, ECHS (Navy) that “MDECHS has informed that AG/Army HQ had a meeting recently with DGMS (Army) & MDECHS regarding issue of medicines for three months to Veterans. AG has directed DGMS (Army) to resume issue of three months medicines to ECHS members on medical officer’s prescription. The policy letter on the subject is being promulgated to the environment shortly. But medicines are not being issued on the ground. It will avoid work load on Polyclinics, Doctors, Reception and Medicine issue counters. More than 60% members in ECHS are on CT.
2. Long Term Issue of Medicines. Veterans are being denied medicines when proceeding out of the country etc for longer periods despite showing air tickets and passports to the officer in charge (ECHS Polyclinic NOIDA).We feel we should be issued medicines for such long absences as there is no addl cost to the exchequer and medicines are the legitimate dues of the patient. shareefahmad.khan@gmail.com
In Cases of Emergency Base / R&R / Service Hospitals’ must Accept Veterans.
3. Officers staying in vicinity of Base hospital & R&R and needing medical attention be seen at these hospitals in cases of emergency, rather turning down without attending and life is lost/ condition deteriorates.
Case. On 17 Sep Mrs Chitra Pandey was not attended to by the Lt Col Anup the DMO at R&R at about 1630 hrs with her platelets at 18K and severe headache. Repeated requests and pleading with Base Hosp for reference to empaneled hospital were not accepted. She was treated at R&R on 12 Sep 10 for high fever,105.6 degrees. Later she was rushed to Fortis, Rockland and Max Hospital but no beds were available. Her condition worsened and family went through pain. OiC Lodhi Road Col Dhingra is well aware of this incident. His timely assistance helped getting Chitra, admitted to Sant Permanad Hospital, Civil lines PM 17 Sep 2010 only thru good personal networking. Armed Forces channel have become more bureaucratic.
Lodi Road Issues
4. A large number of retired officers are being served by Lodhi Road Polyclinic however the only and good medical specialist namely Manoj Aron was replaced. Available GPs are inexperienced and very slow. It takes a couple of hours for one's turn to come and the place is always over crowded. There is one old X-ray equipment without any radiologist. This results into R&R not accepting the X Ray report without radiologist's findings and the patient has to be X Rayed again with additional trips to R&R or Base Hospital This is taxing. You are requested to consider appointing at least two Medical specialists at the earliest.
5. The third MO has just come after months of a single MO and the second Med Specialist has not been there for many months and only up to 1300 hrs Cdr. (retd) Keshoram
6. Lodi Road Clinic is not authorized to refer cases to the empanelled Hospitals directly but has to refer all cases to the Base Hospital which in turn depending on the occupancy/facilities refer the case to the Empanelled hospitals. For the large number of ECHS members residing in East Delhi the Base Hospital is on the other extremity of the city and over 30-35 kilometers. Considering Delhi’s traffic and the age of the ECHS members, driving this distance is most trying to say the least. It is suggested that ECHS Lodi Road be authorized to refer cases directly to RR Hospital, the RR hospital in turn may further refer the case to the empanelled hospital in case the capacity/facility in RR does not exist.
7. Adequate and serviceable diagnostic equipment is not available. For example, the dental XRay machine took over a year to repair. We had to get XRays done privately.
NOIDA Specific Issues
8. Referral for Dental cases in Noida is made only to AFDC, which is overloaded with patients and difficult to get an appointment. Alternatively one has to go to some empanelled Dental Clinic in Janakpuri which is 40 Kms from Noida. Suggestion is to allow patients to be referred to some good empanelled hospitals’ in Noida. It takes 6m to 1 year to get dentures made. V.S.Vishnoi
9. Non availability of specialists e.g. ENT, Cardiologist etc.
10. Non availability of Medical Staff for X-ray, physiotherapy. There is also is an acute shortage of space for Medicine Store and medical staff. The equipment including instruments in Dental Centre Noida needs to be repaired/ replaced so that the doctors can do justice. At times even proper Lighting and filling material are not available. If we compare the facilities with R & R/ AFDC, ECHS Noida will be rated ‘sub-standard’
11. Funds for local purchase – need to be doubled.
12. The Doctors don’t have a stethoscope, thermometer, BP instrument, torch and instrument to check the throat etc. These must be provided to all doctors.
Mumbai’s Issues
13. There is no Civil hospital on the panel of ECHS in Mumbai and INHS Asvini is overcrowded. This a major problem and an issue for those living in the suburbs. chaman_chawla2000@yahoo.com
General Issues
14. ECHS Lodi Road Clinic is not authorized to refer cases to the empanelled Hospitals directly but has to refer all cases to the Base Hospital which in turn depending on the occupancy/facilities refer the case to the Empanelled hospitals. For the large number of ECHS members residing in East Delhi the Base Hospital is on the other extremity of the city and over 30-35 kilometers. Considering the Delhi traffic and the age of the ECHS member driving this distance is most trying to say the least. It is suggested that ECHS Lodi Road be authorized to refer cases directly to RR Hospital, the RR hospital in turn may further refer the case to the empanelled hospital in case the capacity/facility in RR does not exist.
15. A Veteran had an Ortho problem and visited ECHS on Saturday. He was referred to the Base Hospital Ortho Surgeon who sees outpatients only on Tuesdays and Fridays. He started his journey at 0700hrs and could manage to reach the Base hospital at 0845. On reporting to counter for registration he was informed that Ortho Surgeon is on leave. On further enquiry as to when the Ortho Surgeon will be on duty, he was informed " not this week". There are many who suffer similarly. We need a workable solution Avtar Singh
16. Issue of possibly fake / spurious medicines has been brought to the notice of OI/c the Clinic and the same was also given in writing for pursuing the matter further. The OI/c and MO i/c concurred that the medicine in question was spurious/fake. The matter needs to be pursued.
H Sahney,
17. At times very old and infirm Veterans, some over 90 years old have problems and they are not in a position to take the car ride to a hospital. We need to devise ways to provide support in such cases.
18. There is no Polyclinic support available on Sundays and holidays and this totals some 70 plus days in a year and this issue needs to be addressed. Similarly, since many Veterans’ take a second job after retirement, therefore Sundays may be made half working days and staff granted compensatory leave on a working day. Dr. Satish Kulhari
19. Military Hospitals shutting doors to the ESM and sufficient private super specialty hospitals not keen on getting to be empanelled to the ECHS.
20. Need to review the requirement of TAC (temp att cert) to be able to get medicines for than 7 days and of course, the concept of parent polyclinic. Col PK Garg
21. The official ECHS website needs to be redesigned to make it member friendly where information should be available conveniently. It should have provision for giving feed back / suggestions / complaints and date of up-dating of the site should be displayed. Complaints may also be received on the net. All members should be given the facility to get their email ID registered so that any future policy change or information can be communicated to those who have registered for the facility seamlessly by email.
22. CGHS have the following facilities, which could be considered for induction in ECHS besides bringing in, other improvements given below in the comparison between CGHS and ECHS :-
(a) CGHS Doctors are available on shift during off working hours to attend to patients after working hours. In the present ECHS system a patient can go to empanelled Hospitals only if they are critically ill as per list promulgated. If the illness does not fall within the promulgated list we have to go private doctor and pay the fees from our pocket.
(b) CGHS Doctors visit residence of patients if they are unable to go the clinics because of nature of sickness, very old age or other reasons.
23. ECHS doctors refuse to sign, Driving Licence renewal medical form, RTO insists that these should be signed by a Govt Doctor. Please request ECHS to help us in this.
24. Examination of the list of ECHS Empanelled Hospitals in NCR and other Regions shows that the MOA with a large number of Hospitals has expired in June 2010. It is possible that some of these may have been renewed but this information has not been updated on the Army ECHS website. It is suggested that the list of empanelled hospitals in the Army/Navy website be regularly updated so that the ECHS members can make an informed choices Further it is also suggested that the contact persons telephones- of the respective hospitals be also put on the website and updated at the time of renewal of the MOA. Vijay S Mathur VAdm (R)
25. ECHS does not keep catheters of various sizes despite application made. This may also be considered.
Common Issues – Vision Statement and Need For Setting Standards by ECHS
26. There is a very urgent need for the promulgation of a Vision statement and ‘Standards’ to be achieved in all spheres including standards of cleanliness and hygiene, waiting times, facilities at the Policlinics, distance of polyclinic from residence, reaching out to those in the hinterland etc.. Arrangement to see doctors with prior appointments rather than waiting in long queues also needs to be incorporated in this document.
27. There is considerable concern on the poor standard of cleanliness, especially the bathrooms-----they really stink and the unhygienic atmosphere in the waiting halls on a daily basis.
SALIENT DIFFERENCES BETWEEN CGHS AND ECHS
AND NEEDING TO BE BRIDGED
CGHS ECHS
1. Both serving as well as Only retired person are members
retired person are members
2. Open 24 hours Open only during working hours
3. Open on Sundays and holidays Closed on Sundays and Holidays
4 Situated extensively through the Only two in Delhi and only one at selected
length and breadth of the country, in towns
Cities and towns
5 Has a number of support Only one at each city and
Hospitals in Delhi and big cities
6 Referral to empanelled Referral to empanelled hospital
Hospital allowed for all ailments. restricted to some ailments.
7 NA drugs available through No such arrangement yet
selected chemist shops
8 Polyclinic situated within Polyclinic situated at much
5 kms distance in Delhi more than 15 kms
9. 24 hours service available for Patient has per force to go to Base/service
minor ailments such as fever and hospital after ECHS working hours and
not needing hospitalization Sundays/ holidays
10. No discrimination on priority Priority to serving over retired personnel.
between serving and retired persons
at support(civil) hospitals.
-----------------------------------------------------------------------------------------------------------------------------
NFDC Brief on Discussions Held with CPS and MD,ECHS
1. The meeting was held as scheduled, at Kota House on 9 Dec 10 with CPS, Vice Adm SPS Cheema in the Chair. MD ECHS with his staff and Officers in Charge of all Polyclinics in the NCR were present. From our side, VAdm SP Govil, Vice Adm AC Bhatia, Cmde H Sawhney, Cdr KC Bansal, Cdr. HK Nag, Cmde Ranjit Rai, Cmde RR Tandon, Cdr N Mahajan, Capt Pran Parashar, Cmde VK Thakur and VAdm Harinder Singh attended.
2. There has been some delay in promulgating these minutes as we were waiting for the official record of discussions. As some members of NFDC want a feed -back, a summary of the discussions is given in the succeeding paragraphs.
3. The meeting was very useful and productive in bringing out the problems being faced by the veterans. The veterans explained their basic requirements to help in creating a better understanding of their requirements and with the aim of closing the gap between the two sides. The Official team was very frank and extremely positive on the way ahead and assured us that the system would show all round improvement in the next few months.
4. Issue of Medicines for 3 Months and Longer. It was brought out that there was a contradiction between the orders issued by the Service Hqrs and those issued by the erstwhile DGAFMS. The latter was unwilling to see the point of view of the veterans. The officers-in charge confirmed that they were willing to issue medicines for longer periods provided their demands are met in full; the former DGAFMS had opposed this also. ECHS and service Hqrs will try and improve the supply of medicines. Members proceeding abroad will also be able to draw medicines for longer periods once adequate supplies were available. The issue of some fake medicines finding their way to the Veterans was also noted for action. Local purchase powers, though revised recently were still inadequate. Problems are also compounded as each service is following its own procedures leading to variations between the Polyclinics. These procedure are also being standardized.
5. Third Party Administrators. The proposal for Third Party Administrators (TPAs) has already been approved for the CGHS and will be introduced in to ECHS very shortly. These administrators will attend to reimbursements and clearances of bills to hospitals and individuals. The TPAs will cut out the Civil/Military interface. Similarly the empanelment of Pharmacies to issue medicines on the lines of CGHS will ensure a continuous supply of medicines directly to the patients, though this system may take some time. In the meantime the Military supply channels are being improved.
6. Lodi Road Issues. MD,ECHS acknowledged that there were many shortcomings and agreed to make up some of the shortages of personnel, maintenance and equipment. Making up the shortage of the junior staff may not happen in a hurry as there were not many volunteers due to the poor pay structure. There was general agreement that the Lodi Rd clinic had shown distinct improvement recently, though much still needed to be done. The MD also pointed out that the rush should even out, once the three additional polyclinics in Delhi get operational. However, he added that there were difficulties as far as accommodation for these clinics was concerned. One of the Clinics is expected to be located in Chankyapuri.
7. Referrals. Veterans from Delhi are unlikely to get the facility of being referred directly to empanelled hospitals, due to Govt regulations and also the likelihood of setting up a Veterans' Hospital in the NCR, for which a case is being progressed.
8. NOIDA Specific Issues. There was a broad consensus that Noida Polyclinic was generally running well, though much more still needed to be done. MD agreed to make up shortages of equipment, medicines and funds at the earliest. Also,\more space would be available for the clinic once the adjacent building was made available and both buildings renovated and modernized. He was unable to provide a referral facility for Dental care as none of the local clinics were volunteering and he requested NFDC Members to try and cajole local dentistry clinics to join up. Members' help is solicited towards this end.
9. ECHS Facilities at Jalvayu Vihar. It was urged that some ECHS facilities be located at the MI Room in Jal Vayu Vihar MI Room (Sectors 21 and 25) for the benefit of the veterans residing there. MD ECHS stated that as per their plans, once the renovation of the Sector 37 polyclinic is taken in hand, part of ECHS would be relocated to the Sector 25 MI Room.
10. Polyclinic Support. There is no polyclinic support outside working hours, on Sundays and holidays, for the aged and infirm who cannot make it to the Polyclinic and the need for TACs. MD informed that there is no bar whatsoever to Veterans going to empanelled hospitals for illnesses that they may consider essential and urgent for treatment and we should use this facility that already exists. A suitable system to provide OPD support is also being discussed by ECHS and will be promulgated after approval. ECHS will work towards the goal of providing support outside working hours and also publish its vision statement, as requested by us. TACs are not essential and the need will cease once the new ECHS Cards are issued, possibly within a month. The fact that they are given medicines for a shorter period is because of shortage of medicines with the Polyclinics whose priority is to satisfy the needs of their dependents first. However, this situation should improve once the supply of medicines improves.
-----------------------------------------------------------------------------------------------------------------------
ECHS BRIEF GIVEN BY ECHS AT THE MEETING
ECHS was started on 01 Apr 2003 based on felt need of a large population of ex-servicemen across the country. This scheme modeled on the lines of CGHS provided comprehensive medical cover to the members for all known diseases. Prior to 1963 there was no provision for Medicare to ex-servicemen. In 1963, the govt. permitted limited medical facilities to the ex-servicemen. Limitation was based on local availability of facility and medicines. Local purchase of medicines for treating ex-servicemen was not allowed since the concession was based on local spare capacity utilisation within existing budgetary allocations for serving soldiers. Only ex-servicemen and their spouse / widows were permitted this 'gratis' Medicare with exclusions of diseases like cardiac ailments, renal failures, cancer, TB, leprosy, psy illness and paraplegia. Military Hospitals covered places where only 20% of ex-servicemen had settled. Therefore only very limited number of patients could actually get medical attention by the AFMS.
ECHS was therefore the most notable welfare scheme ever launched in India for ex-servicemen. The members of ECHS became entitled to comprehensive Medicare covering all known diseases. ECHS marked Govt's commitment to providing full budgetary support to the healthcare of ex-servicemen and their families. Not only ex-servicemen and their spouse / widows, ECHS covered entitled parents and children. ECHS beneficiaries became entitled to treatment not only in service hospitals, they could also be referred to select private hospitals for best possible Medicare and to ensure that service hospitals are not overloaded. Apart from 106 ECHS Polyclinics in military stations, 121 Polyclinics were established in non-military stations where a large majority of retired soldiers had settled down. These Polyclinics were provided with doctors, physicians, paramedics and at some places even gynecologists to provide full fledged OPD facility to the members. Diagnostic aides like X-Ray and path lab has also been provided at the polyclinics.
ECHS membership has now crossed 11 Lakh with a total of over 34 Lakh beneficiaries. Smart cards have been issued to the members to establish irrefutable proof of the identity through biometrics.
As the scheme progressed and advanced towards stabilisation, the large and expanding beneficiary base necessitated review and reforms. Main challenge of the scheme was how to handle increasing OPD load at the Polyclinics with skeletal contractual staff authorisation, how to decongest the high-pressure Polyclinics and service
hospitals, how to prevent infirm patients running from pillar to post for getting entitled Medicare and reimbursements and how to extend the reach of ECHS to remote areas with considerable ex-servicemen population.
The free and frank no holds barred discussions during the Chandimandir ECHS Seminar of Jul 2009 based on theme-'The Way Ahead', marked a turning point for ECHS and facilitated much needed reforms. Reformed referral policy liberalized procedure for treatment in private hospitals and paved way for decongesting service hospitals (Army, Command and Zonal), removed local restrictions on referrals and opened non-empanelled dialysis centres for beneficiaries. Direct referrals by remote Polyclinics were permitted to empanelled super-speciality hospitals of nearby cities. This enabled the outstation patients to directly access outstation multi-speciality hospitals without being referred through high-pressure Polyclinics of larger cities like Delhi, Chandigarh, Bangalore, Kolkata, and Pune etc. This provision also helped in preventing congestion at the Polyclinics of these cities.
Another issue facilitated during the Chandimandir Seminar was mutual decision by the Services and the ex-servicemen's bodies to work in partnership for resolving problems of members and for improving the services under the Scheme. Voluntary service by the members has been notable at Secunderabad Polyclinic where right from registration of sick report to assistance in construction of additional accommodation, member volunteers are doing wonderful works. The 'Secunderabad Model' is there for others to emulate and take a notch higher.
After persistent efforts of the Armed Forces, the Govt has approved the expansion of ECHS to open 199 additional ECHS Polyclinics. This will enable benefits to ex-servicemen in districts where their population is up to 1500. Remote areas where the ECHS population is up to 800 would also be covered. Anomaly of denial of ECHS membership to Nepal Domiciled Gorkha ex-servicemen was removed when the Govt. approved their membership for treatment in India. It is now intended to seek establishment of Polyclinics in Nepal. This would bring the NDGs ex-servicemen settled in Nepal at par with their counterparts in India.
Certain other improvements in the scheme being actively pursued with the Govt. are:-
-Enhancement of powers of competent financial authorities to enable early consideration of Medicare bills.
-Improving supply of medicines and consumables through two means. The first, through the proposal of outsourcing the pharmacy services to reputed manufacturers and suppliers and the second through enhancing the financial limit of local purchase of medicines by Officer-in-charge of the Polyclinics. Provision is also being sought for reimbursement of purchase of non-available medicine to the members.
-Improving quality of OPD services at the Polyclinics by seeking authorisation of deficient category of essential staff like radiologists, radiographers, physiotherapists, pharmacists, dental assistants / hygienists and clerks. Presently the Armed Forces are spending approx Rs 5 Crore annually for this purpose.
-There are about 6.5 Lakh ECHS hospitalizations each year. Hospital bill clearance takes much longer than the stipulated period of 60 days in absence of dedicated staff / organisation for this purpose. Therefore bill processing by Third Party Administrators is intended to replace the present adhoc processing system.. This would not only reduce load from the Station HQs but also enable the hospitals to receive reimbursements within three weeks of bill submission.
-Empanelment of private hospitals for providing cashless treatment to ECHS beneficiaries is an ongoing process. However, this process takes unduly long due to delayed submission of completed proceedings of Board of Officers convened for this purpose. In some cases, this process takes nearly two years. Govt. is now considering utilizing the services of National Board of Accredition for Hospitals and Healthcare providers (NABH). This step is expected to reduce the empanelment period to approx a month.
While the formal Govt. nod for much needed improvements in ECHS is awaited, certain other steps have been taken by the Armed Forces for meeting the enhanced aspirations of the beneficiaries. Providing telephonic appointments with the Polyclinic doctors in afternoons is a small step, which has added to clientele satisfaction. ECHS staff at various high-pressure stations has also been advised to set up extension counters in localities with high member density so that ECHS benefits, especially medicines are available in their neighborhood. This step would also help in decongesting the Polyclinics.
It has been realized that such a large health scheme cannot be effectively managed without using technology. Therefore, automation of Polyclinic processes and networking of all Polyclinics is underway on Public Private Partnership model.
Recently a study on ECHS and CGHS was conducted by the Indian Council for Research on International Economic Relations. The survey undertaken under this study revealed the members preference for ECHS as against offered health insurance scheme. 93% beneficiaries preferred ECHS to health insurance.
ECHS is a flagship welfare scheme of the Govt. for the welfare of ex-servicemen. Approximately Rs 1000 Crore is being spent by the Govt. for meeting the health care needs of the veteran soldiers and their families of the three services and the Indian Coast Guard. The Armed Forces are continuously endeavouring to improve the quality and reach of this scheme, which is now on the threshold of a major expansion.
Ten ECHS hospitals are planned at Delhi Cantt, Chandigarh/Panchkula, Jalandhar Cantt, Lucknow, Kolkata, Jaipur/Jodhpur, Secundrabad, Pune, Kochi and Bangalore. ECHS hospital at Delhi Cantt will be established first followed by other cities. These hospitals will be of are 500 beds facility in 25 acre area with a capital and revenue budget of 250 Crore and 135 Crore respectively.
-----------------------------------------------------------------------------------------------------------------------
INTEGRATED HEADQUARTERS MINISTRY OF THE DEFENCE (NAVY)
ECHS OFFICE
MINUTES OF MEETING HELD ON 09 DEC 10 AT KOTA HOUSE
MDECHS INTERACTION WITH PRESIDENT NFDC
1. The following were present :-
Vice Admiral SPS Cheema, CPS - Chairman
Maj Gen A Srivastava, MDECHS
Cmde MVS Kumar PDESA
Captain AL Narayan Director ECHS(Navy)
Vice Admiral Harinder Singh (Retd) President NFDC
Cmde VK Thakur (Retd) Secy NFDC
Oi/Cs of ECHS Polyclinics Lodhi Road, Gurgaon, Noida, Faridabad and Ghaziabad (Hindon)
Approx 20 retired Naval Officers of NCR/ Delhi
2. CPS has welcomed the members for the meeting especially president Navy Foundation Delhi Charter and MDECHS.
AGENDA POINTS
ITEM I & II - ISSUE OF THREE MONTHS MEDICINES AND
LONG TERM ISSUE OF MEDICINES
3. Status. We were informed by CNS, COP, CPS and Capt, AL Narayan Director, ECHS (Navy) that “MDECHS has informed that AG/Army HQ had a meeting recently with DGMS (Army) & MDECHS regarding issue of medicines for three months to Veterans. AG has directed DGMS (Army) to resume issue of three months medicines to ECHS members on medical officer’s prescription. The policy letter on the subject is being promulgated to the environment shortly. But medicines are not being issued on the ground. It will avoid work load on Polyclinics, Doctors, Reception and Medicine issue counters. More than 60% members in ECHS are on CT. Veterans are being denied medicines when proceeding out of the country etc for longer periods despite showing air tickets and passports to the officer in charge (ECHS Polyclinic NOIDA).We feel we should be issued medicines for such long absences as there is no additional cost to the exchequer and medicines are the legitimate dues of the patient.
4. Discussion. The issues of medicines is the total responsibility of DGAFMS. Necessary funds from ECHS for example for this financial year an amount of Rs. 360 Crore have been placed with DGAFMS. However, AFMSDs functioning under DGAFMS are supplying only 10% of the required medicines. The remaining 90% are being supplied through the existing Local Purchase procedure as is being done for serving personnel in Military Hospitals. A case has also been taken up for review of financial powers of Oi/C polyclinics for local purchase by Oi/C polyclinic including military polyclinics Rs. two lac for ‘A’ and ‘B’ type polyclinics and Rs. one lac for ‘C’ and ‘D’ type polyclinics. Not withstanding the above, MDECHS has intimated that policy letter on the subject for issue of three months medicines exists in ECHS but DGAFMS has issued a overriding directive that medicines will be issued for only one month and more importantly the Oi/C of polyclinics have informed that the stock being held does not permit them to issue three months medicines and that is the reason why polyclinics are unable to issue three months medicines to ECHS members. However, MDECHS has intimated that Navy could make necessary arrangements at Commands / Naval Hospitals levels so that medicines could be issued for three months. As far as Delhi / NCR is concerned MDECHS would again take up the issue with DGAFMS for resolving this issue of medicines.
5. Decision. MDECHS has been requested to take up the issue of three months medicines with DGAFMS and thereafter promulgate the policy letter.
Action By : MDECHS
ITEM III - IN CASES OF EMERGENCY BASE / R&R / SERVICE HOSPITAL
MUST ACCEPT VETERANS
6. Status. Officers staying in vicinity of Base hospital & R&R and needing medical attention be seen at these hospitals in cases of emergency, rather turning down without attending and life is lost/ condition deteriorates.
7. Discussion. The military hospitals will accept cases of emergency for providing medicare subject to availability of facility / beds. Refusal to attend to medical emergencies is against medical ethics. Any case of this nature would be brought to the notice of concerned DGMS / DGAFMS.
8. Decision. MDECHS has been requested to take up the issue of medicare in Base / R&R with DGAFMS and thereafter promulgate the policy letter.
Action By : MDECHS
LODHI ROAD ISSUES
ITEM IV & V - APPOINTMENT OF SUITABLE MEDICAL OFFICERS / RADIOLOGIST
9. Status. A large number of retired officers are being served by Lodhi road Polyclinic however the only and good medical specialist namely Manoj Aron was replaced. Available GPs are inexperienced and very slow. It takes a couple of hours for one's turn to come and the place is always over crowded. There is one old X-ray equipment without any radiologist. This results into R&R not accepting the X Ray report without radiologist's findings and the patient has to be X Rayed again with additional trips to R&R or Base Hospital This is taxing. You are requested to consider appointing at least two Medical specialists at the earliest. The third MO has just come after months of a single MO and the second Med Specialist has not been there for many months and only up to 1300 hrs.
10. Discussion. MDECHS has intimated that necessary steps will be taken to ensure good medical specialists are appointed at the polyclinic. He also further intimated that he would consider posting of two medical specialists by re appropriating. The issue of Radiologist will be resolved once the additional manpower sanction is obtained from MOD.
11. Decision. MDECHS has been requested to authorise two medical specialists to Lodi Road Polyclinic and expedite obtaining additional manpower sanction from MoD for authorising Radiologist.
Action By : MDECHS
ITEM VI - REFERRAL TO PRIVATE EMPANELMENT HOSP DIRECTLY BY
LODHI ROAD POLYCLINIC
12. Status. Lodi Road Clinic is not authorized to refer cases to the empanelled Hospitals directly but has to refer all cases to the Base Hospital which in turn depending on the occupancy/facilities refer the case to the Empanelled hospitals. For the large number of ECHS members residing in East Delhi the Base Hospital is on the other extremity of the city and over 30-35 kilometers. Considering Delhi’s traffic and the age of the ECHS members, driving this distance is most trying to say the least. It is suggested that ECHS Lodi Road be authorized to refer cases directly to RR Hospital, the RR hospital in turn may further refer the case to the empanelled hospital in case the capacity/facility in RR does not exist.
13. Discussion. MDECHS has agreed to this point to consider favorably and that the suitable policy letter will be promulgated at the earliest subject to confirming non availability of facilities / beds.
14. Decision. Executive orders in this regard have since been issued by the Central Organisation ECHS.
Action By : MDECHS
ITEM – VII - AVAILABILITY OF EQUIPMENTS IN OPERATIONAL STATUS
15. Status. Adequate and serviceable diagnostic equipment is not available. For example, the dental XRay machine took over a year to repair. We had to get XRays done privately.
16. Discussion. This issue will be addressed expeditiously as required. The issue of stocking personal catheters at polyclinics will be taken up with DGAFMS / concerned SEMO.
17. Decision. MDECHS has been requested to take up the issue with DGAFMS for necessary action.
Action By : MDECHS
NOIDA SPECIFIC ISSUES
ITEM VIII - REFERRAL FOR DENTAL IN NOIDA TO JANAKPURI
18. Status. Referral for Dental cases in Noida is made only to AFDC, which is overloaded with patients and difficult to get an appointments. Alternatively one has to go to some empanelled Dental Clinic in Janakpuri which is 40 Kms from Noida. Suggestion is to allow patients to be referred to some good empanelled hospitals’ in Noida.
19. Discussion. Since the Janakpuri dental clinic is 40 Km away and the local dental clinics are not coming forward for empanelment due to low rates or for other reasons, the Chairmen requested the retired fraternity to use their good social network and ensure the local dental clinics come up for empanelment as the new 2010 ECHS rates are on the higher side. ECHS is also planning to create own dental laboratory adjunct to the polyclinics for meeting the denture requirement. ECHS has been authorized 58 procedures like CGHS.
20. Decision. Retired fraternity has been requested to use their influence for getting suitable dental centres in Noida for empanelment under ECHS.
Action By : MDECHS
ITEM IX - NON AVAILABILITY OF SPECIALISTS – ENT, CARDIOLOGIST
21. Status. Non availability of specialists - ENT, Cardiologist.
22. Discussion. MDECHS explained that Polyclinics are meant to provide general OPD cover including physician and gynae. For Specialist / super specialist cover, patients are referred to service / empanelled facilities.
23. Decision. MDECHS has intimated that Polyclinics are meant to provide general OPD cover including physician and gynae. For Specialist / super specialist cover, patients are referred to service / empanelled facilities.
Action By : Oi/C Polyclinics (Delhi / NCR)
ITEM X - STATUS OF DENTAL POLYCLINIC
24. Status. Non availability of Medical Staff for X-ray, physiotherapy/. There is also is an acute shortage of space for Medicine Store and medical staff. The equipment including instruments in Dental Centre Noida needs to be repaired/ replaced so that the doctors good do Justice. At times even proper Lighting and filling material is not available. If we compare the facilities with R & R/ AFDC, ECHS Noida will be rated ‘sub-standard’
25. Discussion. Oi/C Noida Polyclinic was requested to ensure that the complaints of dental centre are addressed aggressively at the earliest.
26. Decision. MDECHS has been requested to ask Oi/C Noida Polyclinic to ensure that the complaints of dental centre are addressed aggressively at the earliest.
Action By : Oi/C Polyclinic Noida
ITEM XI - FUNDS FOR LOCAL PURCHASE NEED TO BE INCREASED
27. Status. Funds for local purchase – need to be increased.
28. Discussion. This issue is pending with Mod and once the approval is received the Oi/C Polyclinic both at the military and non military will have power of 2 lakh in ‘A’ and ‘B’ Type of polyclinic and 1 lakh in ‘C’ and ‘D’ type of polyclinic.
29. Decision. MDECHS has been requested to promulgate the policy letter after approval from MoD.
Action By : MDECHS
ITEM XII - DOCTORS MEDICAL EQUIPMENTS
30. Status. The Doctors don’t have a stethoscope, thermometer, BP instrument, torch and instrument to check the throat etc. These must be provided to all doctors.
31. Discussion. Oi/C Noida Polyclinic has been requested to ensure at the earliest that the doctors are provided medical equipment like Stethoscope, Thermometer, BP instrument, torch and instrument to check the throat etc at the earliest. Oi/C polyclinic has intimated that this was a lapse because doctors posted to the polyclinic are more than the authorised strength but he said that he would ensure that these instruments are made available to all the doctors at earliest.
32. Decision Oi/C Noida Polyclinic has been requested to provide medical equipment to all the doctors of Noida Polyclinic.
Action By : Oi/C Polyclinic Noida
MUMBAI ISSUES
ITEM XIII - NO PVT. EMPANELMENT HOSPITAL AND INHS ASVINI IS OVERLOAD
33. Status. There is no Civil hospital on the panel of ECHS in Mumbai and INHS Asvini is overcrowded.
34. Discussion. More private hospitals are not coming up for empanelment under ECHS because they have enough loads on direct cash payment basis and ECHS is on credit basis. One more polyclinic is being set up in Navi Mumbai which should reduce the load of OPD at Asvini.
35. Decision One more polyclinic is being set up in Navi Mumbai which should reduce the load of OPD at Asvini.
Action By : Dir ECHS(N)
GENERAL ISSUES
ITEM XIV - REPEAT POINT OF POINT 6
ITEM XV - AVAILABILITY OF ORTHO FACILITY IN BASE HOSP
36. Status. A Veteran had an Ortho problem and visited ECHS on Saturday. He was referred to the Base Hospital Ortho Surgeon who sees outpatients only on Tuesdays and Fridays. He started his journey at 0700hrs and could manage to reach the Base hospital at 0845. On reporting to counter for registration he was informed that Ortho Surgeon is on leave. On further enquiry as to when the Ortho Surgeon will be on duty, he was informed " not this week". There are many who suffer similarly.
37. Discussion. Ortho facility in Base hosp can be availed only subject to availability of facility / beds. The ECHS members are entitled to visit any empanelled hospital for treatment in case of non availability of facility in Base Hospital and intimate the polyclinic the next day alternately if the emergency is such he could visit any of hosp including non empanelled and seek reimbursement.
38. Decision. MDECHS has intimated that ECHS members are entitled to visit any empanelled hospital for treatment in case of non availability of facility in Base Hospital.
Action By : ECHS Members
ITEM XVI - ISSUE OF FAKE / SPURIOUS MEDICINES
39. Status. Issue of possibly fake / spurious medicines has been brought to the notice of OI/c the Clinic and the same was also given in writing for pursuing the matter further. The OI/c and MO i/c concurred that the medicine in question was spurious/fake. The matter needs to be pursued.
40. Discussion. MDECHS has intimated that he would bring this to the notice of DGAFMS and remedial action initiated to avoid recurrence.
41. Decision. MDECHS has been requested to take up the issue with DGAFMS for necessary action to avoid recurrence.
Action By : MDECHS
ITEM XVII - REPEAT POINT OF POINT 7
.
ITEM XVIII - TRANSPORT FOR AGED VETERANS
42. Status. At times very old and infirm Veterans, some over 90 years old have problems and they are not in a position to take the car ride to a hospital. We need to devise ways to provide support in such cases.
43. Discussion. MDECHS has intimated that it is not possible to provide car to the ECHS Member to the hospital with the existing infra structure of transport. However should there be medical requirement due to the status of the patient the ambulance at the polyclinic will be provided to transfer the patient to the referred hospital.
44. Decision. MDECHS has intimated that it is not possible to provide car to the ECHS Member to the hospital with the existing infra structure of transport. However should there be medical requirement due to the status of the patient the ambulance at the polyclinic will be provided to transfer the patient to the referred hospital.
Action By : Oi/C Polyclinics(Delhi / NCR)
ITEM XIX - POLYCLINICS ROUND THE CLOCK
45. Status. There is no Polyclinic support available on Sundays and holidays and this totals some 70 plus days in a year and this issue needs to be addressed. Similarly, since many Veterans’ take a second job after retirement, therefore Sundays may be made half working days and staff granted compensatory leave on a working day.
46. Discussion. During non consultation period / holidays, patients are free to get treatment from empanelled hospitals in emergency. Suitable policy instructions are intended to be issued enabling essential treatment at empanelled hospitals on holidays / non-working hours.
47. Decision. MDECHS has been requested to issue the policy letter regarding enabling essential treatment at empanelled hospitals on holidays / non-working hours.
Action By : MDECHS
ITEM XX - MILITARY HOSPITALS SHUTTING DOORS TO ESM AND PRIVATE SUPER SPECIALTY HOSPITAL NOT EMPANELLING
48. Status. Military Hospitals shutting doors to the ESM and sufficient private super specialty hospitals not keen on getting to be empanelled to the ECHS.
49. Discussion. MDECHS has intimated that he would take up this issue with DGAFMS to provide medicare subject to availability to facility / beds. With the implementation of 2010 CGHS rates which are higher, the private super specialty hospitals would be keen to come under ECHS.
50. Decision. MDECHS has been requested to take up this issue with DGAFMS and thereafter promulgate the policy letter.
Action By : MDECHS
ITEM XXI - TAC CERTIFICATE
51. Status. Need to review the requirement of TAC (temp att cert) to be able to get medicines for than 7 days and of course, the concept of parent polyclinic.
52. Discussion. The TAC certificate requirement is relevant because of the status of the data base of members expected to the polyclinics however with the online of computerization / automation this issue will be addressed favourably for the purpose of issue of medicines of more than seven days if not for obtaining costly individual equipment like hearing aids / medical equipment etc.
53. Decision. The TAC certificate requirement is relevant because of the status of the data base of members expected to the polyclinics however with the online of computerization / automation this issue will be addressed favourably for the purpose of issue of medicines of more than seven days if not for obtaining costly individual equipment like hearing aids / medical equipment etc.
Action By : MDECHS
ITEM XXII - WEBSITE USER FRIENDLY / E-MAIL ID REGISTRATION
54. Status. The official ECHS website needs to be redesigned to make it member friendly where information should be available conveniently. It should have provision for giving feed back / suggestions / complaints and date of up-dating of the site should be displayed. Complaints may also be received on the net. All members should be given the facility to get their email ID registered so that any future policy change or information can be communicated to those who have registered for the facility seamlessly by email.
55. Discussion. MDECHS has intimated that this will be implemented.
56. Decision. MDECHS has been requested to implement this at the earliest and promulgate to all concerned.
Action By : MDECHS
ITEM XXIII - CGHS DOCTORS WORKING HOURS / VISITING RESIDENCE OF PATIENT
57. Status. CGHS have the following facilities, which could be considered for induction in ECHS besides bringing in, other improvements given below in the comparison between CGHS and ECHS :-
(a) CGHS Doctors are available on shift during off working hours to attend to patients after working hours. In the present ECHS system a patient can go to empanelled Hospitals only if they are critically ill as per list promulgated. If the illness does not fall within the promulgated list we have to go private doctor and pay the fees from our pocket.
(b) CGHS Doctors visit residence of patients if they are unable to go the clinics because of nature of sickness, very old age or other reasons.
58. Discussion. MDECHS has intimated that CGHS does not open all dispensaries during off working hours. They only provide some high pressure dispensaries with minimal medical facilities. This issue can be considered once we have sanction for additional staff from MoD.
59. Decision. MDECHS has been requested to consider the issue after the sanction for additional staff from MoD is obtained and promulgate to all concerned thereafter.
Action By : MDECHS
ITEM XXIV - DOCTORS TO SIGN DRIVING LICENCE RENEWAL FORMS
60. Status. ECHS doctors refuse to sign, Driving Licence renewal medical form, RTO insists that these should be signed by a Govt Doctor. Please request ECHS to help us in this.
61. Discussion. MDECHS has intimated that he would promulgate the policy letter on the subject directing doctors to sign the Driving Licence renewal form and if required the necessary approval from RTO will be obtained, so that their signatures are acceptable.
62. Decision. MDECHS has been requested to promulgate the policy letter on the subject so that ECHS doctor's signature are acceptable for driving licence renewal medical form.
Action By : MDECHS
ITEM XXV - VALIDITY OF MOA WITH PRIVATE EMPANELMENT HOSPITALS
63. Status. Examination of the list of ECHS Empanelled Hospitals in NCR and other Regions shows that the MOA with a large number of Hospitals has expired in June 2010. It is possible that some of these may have been renewed but this information has not been updated on the Army ECHS website. It is suggested that the list of empanelled hospitals in the Army/Navy website be regularly updated so that the ECHS members can make an informed choices Further it is also suggested that the contact persons telephones- of the respective hospitals be also put on the website and updated at the time of renewal of the MOA.
64. Discussion. MDECHS has intimated that this request will be complied and ensure that the list of private empanelment hospitals with valid MOA will be hosted on website to enable ECHS members to make their choice of treatment.
65. Decision. MDECHS has been requested to update the list of private empanelment hospitals to enable ECHS members to make their choice of treatment.
Action By : MDECHS
COMMON ISSUES
ITEM XXVI - VISION STATEMENT AND NEED FOR SETTING STANDARDS BY ECHS / APPOINTMENT BY TELEPHONE
66. Status. There is a very urgent need for the promulgation of a Vision statement and ‘Standards’ to be achieved in all spheres including standards of cleanliness and hygiene, waiting times, facilities at the Policlinics, distance of polyclinic from residence, reaching out to those in the hinterland etc etc. Arrangement to see doctors with prior appointments rather than waiting in long queues.
67. Discussion. MDECHS has intimated that vision statement and standard for ECHS has already been promulgated and a copy of the same could be obtained from ECHS Central Organisation. Arrangements to meet doctors on appointment on telephone in the afternoons has already been implemented.
68. Decision. Director ECHS (N) is requested to obtain the vision statement from MDECHS and forward to NFDC.
Action By : Director ECHS (N)
ITEM XXVII - CLEANLINESS OF TOILETS AT POLYCLINIC
69. Status. There is considerable concern on the poor standard of cleanliness, especially the bathrooms, they really stink and the unhygienic atmosphere in the waiting halls on a daily basis.
70. Discussion. This is a cause of concern and that Oi/C polyclinic must ensure that standard of cleanliness in the toilets at polyclinic is of highest standard in spite of constraints of water / cleaning labourers problems.
71. Decision. Oi/C Polyclinics have been requested to take necessary action regarding cleanliness of toilets of polyclinics if required by obtaining the necessary assistance from station commanders with respect to constraints of availability of water / safaiwalas.
Action By : Oi/C Polyclinics – Delhi / NCR
CONCLUDING REMARKS
72. There being no other points, the meeting was over.
73. In conclusion, CPS requested MDECHS to resolve the issues raised during the meeting for clientele satisfaction as medicare is most important need for the veterans.
74. These minutes issue with the approval of the Chairman.
(AL Narayan)
Capt (IN)
Director ECHS(N)
SO/CNS SO/COP SO/CPS
SO/DGMS(NAVY) SO/MDECHS PDESA
SECY NFDC
OI/C POLYCLINICS.
BASE HOSPITAL (DELHI CANTT), LODHI ROAD,
GURGAON, NOIDA, FARIDABAD, GHAZIABAD (HINDON)
Issue of 3 Months Medicines and Longer
1. We were informed by CNS, COP, CPS and Capt, AL Narayan Director, ECHS (Navy) that “MDECHS has informed that AG/Army HQ had a meeting recently with DGMS (Army) & MDECHS regarding issue of medicines for three months to Veterans. AG has directed DGMS (Army) to resume issue of three months medicines to ECHS members on medical officer’s prescription. The policy letter on the subject is being promulgated to the environment shortly. But medicines are not being issued on the ground. It will avoid work load on Polyclinics, Doctors, Reception and Medicine issue counters. More than 60% members in ECHS are on CT.
2. Long Term Issue of Medicines. Veterans are being denied medicines when proceeding out of the country etc for longer periods despite showing air tickets and passports to the officer in charge (ECHS Polyclinic NOIDA).We feel we should be issued medicines for such long absences as there is no addl cost to the exchequer and medicines are the legitimate dues of the patient. shareefahmad.khan@gmail.com
In Cases of Emergency Base / R&R / Service Hospitals’ must Accept Veterans.
3. Officers staying in vicinity of Base hospital & R&R and needing medical attention be seen at these hospitals in cases of emergency, rather turning down without attending and life is lost/ condition deteriorates.
Case. On 17 Sep Mrs Chitra Pandey was not attended to by the Lt Col Anup the DMO at R&R at about 1630 hrs with her platelets at 18K and severe headache. Repeated requests and pleading with Base Hosp for reference to empaneled hospital were not accepted. She was treated at R&R on 12 Sep 10 for high fever,105.6 degrees. Later she was rushed to Fortis, Rockland and Max Hospital but no beds were available. Her condition worsened and family went through pain. OiC Lodhi Road Col Dhingra is well aware of this incident. His timely assistance helped getting Chitra, admitted to Sant Permanad Hospital, Civil lines PM 17 Sep 2010 only thru good personal networking. Armed Forces channel have become more bureaucratic.
Lodi Road Issues
4. A large number of retired officers are being served by Lodhi Road Polyclinic however the only and good medical specialist namely Manoj Aron was replaced. Available GPs are inexperienced and very slow. It takes a couple of hours for one's turn to come and the place is always over crowded. There is one old X-ray equipment without any radiologist. This results into R&R not accepting the X Ray report without radiologist's findings and the patient has to be X Rayed again with additional trips to R&R or Base Hospital This is taxing. You are requested to consider appointing at least two Medical specialists at the earliest.
5. The third MO has just come after months of a single MO and the second Med Specialist has not been there for many months and only up to 1300 hrs Cdr. (retd) Keshoram
6. Lodi Road Clinic is not authorized to refer cases to the empanelled Hospitals directly but has to refer all cases to the Base Hospital which in turn depending on the occupancy/facilities refer the case to the Empanelled hospitals. For the large number of ECHS members residing in East Delhi the Base Hospital is on the other extremity of the city and over 30-35 kilometers. Considering Delhi’s traffic and the age of the ECHS members, driving this distance is most trying to say the least. It is suggested that ECHS Lodi Road be authorized to refer cases directly to RR Hospital, the RR hospital in turn may further refer the case to the empanelled hospital in case the capacity/facility in RR does not exist.
7. Adequate and serviceable diagnostic equipment is not available. For example, the dental XRay machine took over a year to repair. We had to get XRays done privately.
NOIDA Specific Issues
8. Referral for Dental cases in Noida is made only to AFDC, which is overloaded with patients and difficult to get an appointment. Alternatively one has to go to some empanelled Dental Clinic in Janakpuri which is 40 Kms from Noida. Suggestion is to allow patients to be referred to some good empanelled hospitals’ in Noida. It takes 6m to 1 year to get dentures made. V.S.Vishnoi
9. Non availability of specialists e.g. ENT, Cardiologist etc.
10. Non availability of Medical Staff for X-ray, physiotherapy. There is also is an acute shortage of space for Medicine Store and medical staff. The equipment including instruments in Dental Centre Noida needs to be repaired/ replaced so that the doctors can do justice. At times even proper Lighting and filling material are not available. If we compare the facilities with R & R/ AFDC, ECHS Noida will be rated ‘sub-standard’
11. Funds for local purchase – need to be doubled.
12. The Doctors don’t have a stethoscope, thermometer, BP instrument, torch and instrument to check the throat etc. These must be provided to all doctors.
Mumbai’s Issues
13. There is no Civil hospital on the panel of ECHS in Mumbai and INHS Asvini is overcrowded. This a major problem and an issue for those living in the suburbs. chaman_chawla2000@yahoo.com
General Issues
14. ECHS Lodi Road Clinic is not authorized to refer cases to the empanelled Hospitals directly but has to refer all cases to the Base Hospital which in turn depending on the occupancy/facilities refer the case to the Empanelled hospitals. For the large number of ECHS members residing in East Delhi the Base Hospital is on the other extremity of the city and over 30-35 kilometers. Considering the Delhi traffic and the age of the ECHS member driving this distance is most trying to say the least. It is suggested that ECHS Lodi Road be authorized to refer cases directly to RR Hospital, the RR hospital in turn may further refer the case to the empanelled hospital in case the capacity/facility in RR does not exist.
15. A Veteran had an Ortho problem and visited ECHS on Saturday. He was referred to the Base Hospital Ortho Surgeon who sees outpatients only on Tuesdays and Fridays. He started his journey at 0700hrs and could manage to reach the Base hospital at 0845. On reporting to counter for registration he was informed that Ortho Surgeon is on leave. On further enquiry as to when the Ortho Surgeon will be on duty, he was informed " not this week". There are many who suffer similarly. We need a workable solution Avtar Singh
16. Issue of possibly fake / spurious medicines has been brought to the notice of OI/c the Clinic and the same was also given in writing for pursuing the matter further. The OI/c and MO i/c concurred that the medicine in question was spurious/fake. The matter needs to be pursued.
H Sahney,
17. At times very old and infirm Veterans, some over 90 years old have problems and they are not in a position to take the car ride to a hospital. We need to devise ways to provide support in such cases.
18. There is no Polyclinic support available on Sundays and holidays and this totals some 70 plus days in a year and this issue needs to be addressed. Similarly, since many Veterans’ take a second job after retirement, therefore Sundays may be made half working days and staff granted compensatory leave on a working day. Dr. Satish Kulhari
19. Military Hospitals shutting doors to the ESM and sufficient private super specialty hospitals not keen on getting to be empanelled to the ECHS.
20. Need to review the requirement of TAC (temp att cert) to be able to get medicines for than 7 days and of course, the concept of parent polyclinic. Col PK Garg
21. The official ECHS website needs to be redesigned to make it member friendly where information should be available conveniently. It should have provision for giving feed back / suggestions / complaints and date of up-dating of the site should be displayed. Complaints may also be received on the net. All members should be given the facility to get their email ID registered so that any future policy change or information can be communicated to those who have registered for the facility seamlessly by email.
22. CGHS have the following facilities, which could be considered for induction in ECHS besides bringing in, other improvements given below in the comparison between CGHS and ECHS :-
(a) CGHS Doctors are available on shift during off working hours to attend to patients after working hours. In the present ECHS system a patient can go to empanelled Hospitals only if they are critically ill as per list promulgated. If the illness does not fall within the promulgated list we have to go private doctor and pay the fees from our pocket.
(b) CGHS Doctors visit residence of patients if they are unable to go the clinics because of nature of sickness, very old age or other reasons.
23. ECHS doctors refuse to sign, Driving Licence renewal medical form, RTO insists that these should be signed by a Govt Doctor. Please request ECHS to help us in this.
24. Examination of the list of ECHS Empanelled Hospitals in NCR and other Regions shows that the MOA with a large number of Hospitals has expired in June 2010. It is possible that some of these may have been renewed but this information has not been updated on the Army ECHS website. It is suggested that the list of empanelled hospitals in the Army/Navy website be regularly updated so that the ECHS members can make an informed choices Further it is also suggested that the contact persons telephones- of the respective hospitals be also put on the website and updated at the time of renewal of the MOA. Vijay S Mathur VAdm (R)
25. ECHS does not keep catheters of various sizes despite application made. This may also be considered.
Common Issues – Vision Statement and Need For Setting Standards by ECHS
26. There is a very urgent need for the promulgation of a Vision statement and ‘Standards’ to be achieved in all spheres including standards of cleanliness and hygiene, waiting times, facilities at the Policlinics, distance of polyclinic from residence, reaching out to those in the hinterland etc.. Arrangement to see doctors with prior appointments rather than waiting in long queues also needs to be incorporated in this document.
27. There is considerable concern on the poor standard of cleanliness, especially the bathrooms-----they really stink and the unhygienic atmosphere in the waiting halls on a daily basis.
SALIENT DIFFERENCES BETWEEN CGHS AND ECHS
AND NEEDING TO BE BRIDGED
CGHS ECHS
1. Both serving as well as Only retired person are members
retired person are members
2. Open 24 hours Open only during working hours
3. Open on Sundays and holidays Closed on Sundays and Holidays
4 Situated extensively through the Only two in Delhi and only one at selected
length and breadth of the country, in towns
Cities and towns
5 Has a number of support Only one at each city and
Hospitals in Delhi and big cities
6 Referral to empanelled Referral to empanelled hospital
Hospital allowed for all ailments. restricted to some ailments.
7 NA drugs available through No such arrangement yet
selected chemist shops
8 Polyclinic situated within Polyclinic situated at much
5 kms distance in Delhi more than 15 kms
9. 24 hours service available for Patient has per force to go to Base/service
minor ailments such as fever and hospital after ECHS working hours and
not needing hospitalization Sundays/ holidays
10. No discrimination on priority Priority to serving over retired personnel.
between serving and retired persons
at support(civil) hospitals.
-----------------------------------------------------------------------------------------------------------------------------
NFDC Brief on Discussions Held with CPS and MD,ECHS
1. The meeting was held as scheduled, at Kota House on 9 Dec 10 with CPS, Vice Adm SPS Cheema in the Chair. MD ECHS with his staff and Officers in Charge of all Polyclinics in the NCR were present. From our side, VAdm SP Govil, Vice Adm AC Bhatia, Cmde H Sawhney, Cdr KC Bansal, Cdr. HK Nag, Cmde Ranjit Rai, Cmde RR Tandon, Cdr N Mahajan, Capt Pran Parashar, Cmde VK Thakur and VAdm Harinder Singh attended.
2. There has been some delay in promulgating these minutes as we were waiting for the official record of discussions. As some members of NFDC want a feed -back, a summary of the discussions is given in the succeeding paragraphs.
3. The meeting was very useful and productive in bringing out the problems being faced by the veterans. The veterans explained their basic requirements to help in creating a better understanding of their requirements and with the aim of closing the gap between the two sides. The Official team was very frank and extremely positive on the way ahead and assured us that the system would show all round improvement in the next few months.
4. Issue of Medicines for 3 Months and Longer. It was brought out that there was a contradiction between the orders issued by the Service Hqrs and those issued by the erstwhile DGAFMS. The latter was unwilling to see the point of view of the veterans. The officers-in charge confirmed that they were willing to issue medicines for longer periods provided their demands are met in full; the former DGAFMS had opposed this also. ECHS and service Hqrs will try and improve the supply of medicines. Members proceeding abroad will also be able to draw medicines for longer periods once adequate supplies were available. The issue of some fake medicines finding their way to the Veterans was also noted for action. Local purchase powers, though revised recently were still inadequate. Problems are also compounded as each service is following its own procedures leading to variations between the Polyclinics. These procedure are also being standardized.
5. Third Party Administrators. The proposal for Third Party Administrators (TPAs) has already been approved for the CGHS and will be introduced in to ECHS very shortly. These administrators will attend to reimbursements and clearances of bills to hospitals and individuals. The TPAs will cut out the Civil/Military interface. Similarly the empanelment of Pharmacies to issue medicines on the lines of CGHS will ensure a continuous supply of medicines directly to the patients, though this system may take some time. In the meantime the Military supply channels are being improved.
6. Lodi Road Issues. MD,ECHS acknowledged that there were many shortcomings and agreed to make up some of the shortages of personnel, maintenance and equipment. Making up the shortage of the junior staff may not happen in a hurry as there were not many volunteers due to the poor pay structure. There was general agreement that the Lodi Rd clinic had shown distinct improvement recently, though much still needed to be done. The MD also pointed out that the rush should even out, once the three additional polyclinics in Delhi get operational. However, he added that there were difficulties as far as accommodation for these clinics was concerned. One of the Clinics is expected to be located in Chankyapuri.
7. Referrals. Veterans from Delhi are unlikely to get the facility of being referred directly to empanelled hospitals, due to Govt regulations and also the likelihood of setting up a Veterans' Hospital in the NCR, for which a case is being progressed.
8. NOIDA Specific Issues. There was a broad consensus that Noida Polyclinic was generally running well, though much more still needed to be done. MD agreed to make up shortages of equipment, medicines and funds at the earliest. Also,\more space would be available for the clinic once the adjacent building was made available and both buildings renovated and modernized. He was unable to provide a referral facility for Dental care as none of the local clinics were volunteering and he requested NFDC Members to try and cajole local dentistry clinics to join up. Members' help is solicited towards this end.
9. ECHS Facilities at Jalvayu Vihar. It was urged that some ECHS facilities be located at the MI Room in Jal Vayu Vihar MI Room (Sectors 21 and 25) for the benefit of the veterans residing there. MD ECHS stated that as per their plans, once the renovation of the Sector 37 polyclinic is taken in hand, part of ECHS would be relocated to the Sector 25 MI Room.
10. Polyclinic Support. There is no polyclinic support outside working hours, on Sundays and holidays, for the aged and infirm who cannot make it to the Polyclinic and the need for TACs. MD informed that there is no bar whatsoever to Veterans going to empanelled hospitals for illnesses that they may consider essential and urgent for treatment and we should use this facility that already exists. A suitable system to provide OPD support is also being discussed by ECHS and will be promulgated after approval. ECHS will work towards the goal of providing support outside working hours and also publish its vision statement, as requested by us. TACs are not essential and the need will cease once the new ECHS Cards are issued, possibly within a month. The fact that they are given medicines for a shorter period is because of shortage of medicines with the Polyclinics whose priority is to satisfy the needs of their dependents first. However, this situation should improve once the supply of medicines improves.
-----------------------------------------------------------------------------------------------------------------------
ECHS BRIEF GIVEN BY ECHS AT THE MEETING
ECHS was started on 01 Apr 2003 based on felt need of a large population of ex-servicemen across the country. This scheme modeled on the lines of CGHS provided comprehensive medical cover to the members for all known diseases. Prior to 1963 there was no provision for Medicare to ex-servicemen. In 1963, the govt. permitted limited medical facilities to the ex-servicemen. Limitation was based on local availability of facility and medicines. Local purchase of medicines for treating ex-servicemen was not allowed since the concession was based on local spare capacity utilisation within existing budgetary allocations for serving soldiers. Only ex-servicemen and their spouse / widows were permitted this 'gratis' Medicare with exclusions of diseases like cardiac ailments, renal failures, cancer, TB, leprosy, psy illness and paraplegia. Military Hospitals covered places where only 20% of ex-servicemen had settled. Therefore only very limited number of patients could actually get medical attention by the AFMS.
ECHS was therefore the most notable welfare scheme ever launched in India for ex-servicemen. The members of ECHS became entitled to comprehensive Medicare covering all known diseases. ECHS marked Govt's commitment to providing full budgetary support to the healthcare of ex-servicemen and their families. Not only ex-servicemen and their spouse / widows, ECHS covered entitled parents and children. ECHS beneficiaries became entitled to treatment not only in service hospitals, they could also be referred to select private hospitals for best possible Medicare and to ensure that service hospitals are not overloaded. Apart from 106 ECHS Polyclinics in military stations, 121 Polyclinics were established in non-military stations where a large majority of retired soldiers had settled down. These Polyclinics were provided with doctors, physicians, paramedics and at some places even gynecologists to provide full fledged OPD facility to the members. Diagnostic aides like X-Ray and path lab has also been provided at the polyclinics.
ECHS membership has now crossed 11 Lakh with a total of over 34 Lakh beneficiaries. Smart cards have been issued to the members to establish irrefutable proof of the identity through biometrics.
As the scheme progressed and advanced towards stabilisation, the large and expanding beneficiary base necessitated review and reforms. Main challenge of the scheme was how to handle increasing OPD load at the Polyclinics with skeletal contractual staff authorisation, how to decongest the high-pressure Polyclinics and service
hospitals, how to prevent infirm patients running from pillar to post for getting entitled Medicare and reimbursements and how to extend the reach of ECHS to remote areas with considerable ex-servicemen population.
The free and frank no holds barred discussions during the Chandimandir ECHS Seminar of Jul 2009 based on theme-'The Way Ahead', marked a turning point for ECHS and facilitated much needed reforms. Reformed referral policy liberalized procedure for treatment in private hospitals and paved way for decongesting service hospitals (Army, Command and Zonal), removed local restrictions on referrals and opened non-empanelled dialysis centres for beneficiaries. Direct referrals by remote Polyclinics were permitted to empanelled super-speciality hospitals of nearby cities. This enabled the outstation patients to directly access outstation multi-speciality hospitals without being referred through high-pressure Polyclinics of larger cities like Delhi, Chandigarh, Bangalore, Kolkata, and Pune etc. This provision also helped in preventing congestion at the Polyclinics of these cities.
Another issue facilitated during the Chandimandir Seminar was mutual decision by the Services and the ex-servicemen's bodies to work in partnership for resolving problems of members and for improving the services under the Scheme. Voluntary service by the members has been notable at Secunderabad Polyclinic where right from registration of sick report to assistance in construction of additional accommodation, member volunteers are doing wonderful works. The 'Secunderabad Model' is there for others to emulate and take a notch higher.
After persistent efforts of the Armed Forces, the Govt has approved the expansion of ECHS to open 199 additional ECHS Polyclinics. This will enable benefits to ex-servicemen in districts where their population is up to 1500. Remote areas where the ECHS population is up to 800 would also be covered. Anomaly of denial of ECHS membership to Nepal Domiciled Gorkha ex-servicemen was removed when the Govt. approved their membership for treatment in India. It is now intended to seek establishment of Polyclinics in Nepal. This would bring the NDGs ex-servicemen settled in Nepal at par with their counterparts in India.
Certain other improvements in the scheme being actively pursued with the Govt. are:-
-Enhancement of powers of competent financial authorities to enable early consideration of Medicare bills.
-Improving supply of medicines and consumables through two means. The first, through the proposal of outsourcing the pharmacy services to reputed manufacturers and suppliers and the second through enhancing the financial limit of local purchase of medicines by Officer-in-charge of the Polyclinics. Provision is also being sought for reimbursement of purchase of non-available medicine to the members.
-Improving quality of OPD services at the Polyclinics by seeking authorisation of deficient category of essential staff like radiologists, radiographers, physiotherapists, pharmacists, dental assistants / hygienists and clerks. Presently the Armed Forces are spending approx Rs 5 Crore annually for this purpose.
-There are about 6.5 Lakh ECHS hospitalizations each year. Hospital bill clearance takes much longer than the stipulated period of 60 days in absence of dedicated staff / organisation for this purpose. Therefore bill processing by Third Party Administrators is intended to replace the present adhoc processing system.. This would not only reduce load from the Station HQs but also enable the hospitals to receive reimbursements within three weeks of bill submission.
-Empanelment of private hospitals for providing cashless treatment to ECHS beneficiaries is an ongoing process. However, this process takes unduly long due to delayed submission of completed proceedings of Board of Officers convened for this purpose. In some cases, this process takes nearly two years. Govt. is now considering utilizing the services of National Board of Accredition for Hospitals and Healthcare providers (NABH). This step is expected to reduce the empanelment period to approx a month.
While the formal Govt. nod for much needed improvements in ECHS is awaited, certain other steps have been taken by the Armed Forces for meeting the enhanced aspirations of the beneficiaries. Providing telephonic appointments with the Polyclinic doctors in afternoons is a small step, which has added to clientele satisfaction. ECHS staff at various high-pressure stations has also been advised to set up extension counters in localities with high member density so that ECHS benefits, especially medicines are available in their neighborhood. This step would also help in decongesting the Polyclinics.
It has been realized that such a large health scheme cannot be effectively managed without using technology. Therefore, automation of Polyclinic processes and networking of all Polyclinics is underway on Public Private Partnership model.
Recently a study on ECHS and CGHS was conducted by the Indian Council for Research on International Economic Relations. The survey undertaken under this study revealed the members preference for ECHS as against offered health insurance scheme. 93% beneficiaries preferred ECHS to health insurance.
ECHS is a flagship welfare scheme of the Govt. for the welfare of ex-servicemen. Approximately Rs 1000 Crore is being spent by the Govt. for meeting the health care needs of the veteran soldiers and their families of the three services and the Indian Coast Guard. The Armed Forces are continuously endeavouring to improve the quality and reach of this scheme, which is now on the threshold of a major expansion.
Ten ECHS hospitals are planned at Delhi Cantt, Chandigarh/Panchkula, Jalandhar Cantt, Lucknow, Kolkata, Jaipur/Jodhpur, Secundrabad, Pune, Kochi and Bangalore. ECHS hospital at Delhi Cantt will be established first followed by other cities. These hospitals will be of are 500 beds facility in 25 acre area with a capital and revenue budget of 250 Crore and 135 Crore respectively.
-----------------------------------------------------------------------------------------------------------------------
INTEGRATED HEADQUARTERS MINISTRY OF THE DEFENCE (NAVY)
ECHS OFFICE
MINUTES OF MEETING HELD ON 09 DEC 10 AT KOTA HOUSE
MDECHS INTERACTION WITH PRESIDENT NFDC
1. The following were present :-
Vice Admiral SPS Cheema, CPS - Chairman
Maj Gen A Srivastava, MDECHS
Cmde MVS Kumar PDESA
Captain AL Narayan Director ECHS(Navy)
Vice Admiral Harinder Singh (Retd) President NFDC
Cmde VK Thakur (Retd) Secy NFDC
Oi/Cs of ECHS Polyclinics Lodhi Road, Gurgaon, Noida, Faridabad and Ghaziabad (Hindon)
Approx 20 retired Naval Officers of NCR/ Delhi
2. CPS has welcomed the members for the meeting especially president Navy Foundation Delhi Charter and MDECHS.
AGENDA POINTS
ITEM I & II - ISSUE OF THREE MONTHS MEDICINES AND
LONG TERM ISSUE OF MEDICINES
3. Status. We were informed by CNS, COP, CPS and Capt, AL Narayan Director, ECHS (Navy) that “MDECHS has informed that AG/Army HQ had a meeting recently with DGMS (Army) & MDECHS regarding issue of medicines for three months to Veterans. AG has directed DGMS (Army) to resume issue of three months medicines to ECHS members on medical officer’s prescription. The policy letter on the subject is being promulgated to the environment shortly. But medicines are not being issued on the ground. It will avoid work load on Polyclinics, Doctors, Reception and Medicine issue counters. More than 60% members in ECHS are on CT. Veterans are being denied medicines when proceeding out of the country etc for longer periods despite showing air tickets and passports to the officer in charge (ECHS Polyclinic NOIDA).We feel we should be issued medicines for such long absences as there is no additional cost to the exchequer and medicines are the legitimate dues of the patient.
4. Discussion. The issues of medicines is the total responsibility of DGAFMS. Necessary funds from ECHS for example for this financial year an amount of Rs. 360 Crore have been placed with DGAFMS. However, AFMSDs functioning under DGAFMS are supplying only 10% of the required medicines. The remaining 90% are being supplied through the existing Local Purchase procedure as is being done for serving personnel in Military Hospitals. A case has also been taken up for review of financial powers of Oi/C polyclinics for local purchase by Oi/C polyclinic including military polyclinics Rs. two lac for ‘A’ and ‘B’ type polyclinics and Rs. one lac for ‘C’ and ‘D’ type polyclinics. Not withstanding the above, MDECHS has intimated that policy letter on the subject for issue of three months medicines exists in ECHS but DGAFMS has issued a overriding directive that medicines will be issued for only one month and more importantly the Oi/C of polyclinics have informed that the stock being held does not permit them to issue three months medicines and that is the reason why polyclinics are unable to issue three months medicines to ECHS members. However, MDECHS has intimated that Navy could make necessary arrangements at Commands / Naval Hospitals levels so that medicines could be issued for three months. As far as Delhi / NCR is concerned MDECHS would again take up the issue with DGAFMS for resolving this issue of medicines.
5. Decision. MDECHS has been requested to take up the issue of three months medicines with DGAFMS and thereafter promulgate the policy letter.
Action By : MDECHS
ITEM III - IN CASES OF EMERGENCY BASE / R&R / SERVICE HOSPITAL
MUST ACCEPT VETERANS
6. Status. Officers staying in vicinity of Base hospital & R&R and needing medical attention be seen at these hospitals in cases of emergency, rather turning down without attending and life is lost/ condition deteriorates.
7. Discussion. The military hospitals will accept cases of emergency for providing medicare subject to availability of facility / beds. Refusal to attend to medical emergencies is against medical ethics. Any case of this nature would be brought to the notice of concerned DGMS / DGAFMS.
8. Decision. MDECHS has been requested to take up the issue of medicare in Base / R&R with DGAFMS and thereafter promulgate the policy letter.
Action By : MDECHS
LODHI ROAD ISSUES
ITEM IV & V - APPOINTMENT OF SUITABLE MEDICAL OFFICERS / RADIOLOGIST
9. Status. A large number of retired officers are being served by Lodhi road Polyclinic however the only and good medical specialist namely Manoj Aron was replaced. Available GPs are inexperienced and very slow. It takes a couple of hours for one's turn to come and the place is always over crowded. There is one old X-ray equipment without any radiologist. This results into R&R not accepting the X Ray report without radiologist's findings and the patient has to be X Rayed again with additional trips to R&R or Base Hospital This is taxing. You are requested to consider appointing at least two Medical specialists at the earliest. The third MO has just come after months of a single MO and the second Med Specialist has not been there for many months and only up to 1300 hrs.
10. Discussion. MDECHS has intimated that necessary steps will be taken to ensure good medical specialists are appointed at the polyclinic. He also further intimated that he would consider posting of two medical specialists by re appropriating. The issue of Radiologist will be resolved once the additional manpower sanction is obtained from MOD.
11. Decision. MDECHS has been requested to authorise two medical specialists to Lodi Road Polyclinic and expedite obtaining additional manpower sanction from MoD for authorising Radiologist.
Action By : MDECHS
ITEM VI - REFERRAL TO PRIVATE EMPANELMENT HOSP DIRECTLY BY
LODHI ROAD POLYCLINIC
12. Status. Lodi Road Clinic is not authorized to refer cases to the empanelled Hospitals directly but has to refer all cases to the Base Hospital which in turn depending on the occupancy/facilities refer the case to the Empanelled hospitals. For the large number of ECHS members residing in East Delhi the Base Hospital is on the other extremity of the city and over 30-35 kilometers. Considering Delhi’s traffic and the age of the ECHS members, driving this distance is most trying to say the least. It is suggested that ECHS Lodi Road be authorized to refer cases directly to RR Hospital, the RR hospital in turn may further refer the case to the empanelled hospital in case the capacity/facility in RR does not exist.
13. Discussion. MDECHS has agreed to this point to consider favorably and that the suitable policy letter will be promulgated at the earliest subject to confirming non availability of facilities / beds.
14. Decision. Executive orders in this regard have since been issued by the Central Organisation ECHS.
Action By : MDECHS
ITEM – VII - AVAILABILITY OF EQUIPMENTS IN OPERATIONAL STATUS
15. Status. Adequate and serviceable diagnostic equipment is not available. For example, the dental XRay machine took over a year to repair. We had to get XRays done privately.
16. Discussion. This issue will be addressed expeditiously as required. The issue of stocking personal catheters at polyclinics will be taken up with DGAFMS / concerned SEMO.
17. Decision. MDECHS has been requested to take up the issue with DGAFMS for necessary action.
Action By : MDECHS
NOIDA SPECIFIC ISSUES
ITEM VIII - REFERRAL FOR DENTAL IN NOIDA TO JANAKPURI
18. Status. Referral for Dental cases in Noida is made only to AFDC, which is overloaded with patients and difficult to get an appointments. Alternatively one has to go to some empanelled Dental Clinic in Janakpuri which is 40 Kms from Noida. Suggestion is to allow patients to be referred to some good empanelled hospitals’ in Noida.
19. Discussion. Since the Janakpuri dental clinic is 40 Km away and the local dental clinics are not coming forward for empanelment due to low rates or for other reasons, the Chairmen requested the retired fraternity to use their good social network and ensure the local dental clinics come up for empanelment as the new 2010 ECHS rates are on the higher side. ECHS is also planning to create own dental laboratory adjunct to the polyclinics for meeting the denture requirement. ECHS has been authorized 58 procedures like CGHS.
20. Decision. Retired fraternity has been requested to use their influence for getting suitable dental centres in Noida for empanelment under ECHS.
Action By : MDECHS
ITEM IX - NON AVAILABILITY OF SPECIALISTS – ENT, CARDIOLOGIST
21. Status. Non availability of specialists - ENT, Cardiologist.
22. Discussion. MDECHS explained that Polyclinics are meant to provide general OPD cover including physician and gynae. For Specialist / super specialist cover, patients are referred to service / empanelled facilities.
23. Decision. MDECHS has intimated that Polyclinics are meant to provide general OPD cover including physician and gynae. For Specialist / super specialist cover, patients are referred to service / empanelled facilities.
Action By : Oi/C Polyclinics (Delhi / NCR)
ITEM X - STATUS OF DENTAL POLYCLINIC
24. Status. Non availability of Medical Staff for X-ray, physiotherapy/. There is also is an acute shortage of space for Medicine Store and medical staff. The equipment including instruments in Dental Centre Noida needs to be repaired/ replaced so that the doctors good do Justice. At times even proper Lighting and filling material is not available. If we compare the facilities with R & R/ AFDC, ECHS Noida will be rated ‘sub-standard’
25. Discussion. Oi/C Noida Polyclinic was requested to ensure that the complaints of dental centre are addressed aggressively at the earliest.
26. Decision. MDECHS has been requested to ask Oi/C Noida Polyclinic to ensure that the complaints of dental centre are addressed aggressively at the earliest.
Action By : Oi/C Polyclinic Noida
ITEM XI - FUNDS FOR LOCAL PURCHASE NEED TO BE INCREASED
27. Status. Funds for local purchase – need to be increased.
28. Discussion. This issue is pending with Mod and once the approval is received the Oi/C Polyclinic both at the military and non military will have power of 2 lakh in ‘A’ and ‘B’ Type of polyclinic and 1 lakh in ‘C’ and ‘D’ type of polyclinic.
29. Decision. MDECHS has been requested to promulgate the policy letter after approval from MoD.
Action By : MDECHS
ITEM XII - DOCTORS MEDICAL EQUIPMENTS
30. Status. The Doctors don’t have a stethoscope, thermometer, BP instrument, torch and instrument to check the throat etc. These must be provided to all doctors.
31. Discussion. Oi/C Noida Polyclinic has been requested to ensure at the earliest that the doctors are provided medical equipment like Stethoscope, Thermometer, BP instrument, torch and instrument to check the throat etc at the earliest. Oi/C polyclinic has intimated that this was a lapse because doctors posted to the polyclinic are more than the authorised strength but he said that he would ensure that these instruments are made available to all the doctors at earliest.
32. Decision Oi/C Noida Polyclinic has been requested to provide medical equipment to all the doctors of Noida Polyclinic.
Action By : Oi/C Polyclinic Noida
MUMBAI ISSUES
ITEM XIII - NO PVT. EMPANELMENT HOSPITAL AND INHS ASVINI IS OVERLOAD
33. Status. There is no Civil hospital on the panel of ECHS in Mumbai and INHS Asvini is overcrowded.
34. Discussion. More private hospitals are not coming up for empanelment under ECHS because they have enough loads on direct cash payment basis and ECHS is on credit basis. One more polyclinic is being set up in Navi Mumbai which should reduce the load of OPD at Asvini.
35. Decision One more polyclinic is being set up in Navi Mumbai which should reduce the load of OPD at Asvini.
Action By : Dir ECHS(N)
GENERAL ISSUES
ITEM XIV - REPEAT POINT OF POINT 6
ITEM XV - AVAILABILITY OF ORTHO FACILITY IN BASE HOSP
36. Status. A Veteran had an Ortho problem and visited ECHS on Saturday. He was referred to the Base Hospital Ortho Surgeon who sees outpatients only on Tuesdays and Fridays. He started his journey at 0700hrs and could manage to reach the Base hospital at 0845. On reporting to counter for registration he was informed that Ortho Surgeon is on leave. On further enquiry as to when the Ortho Surgeon will be on duty, he was informed " not this week". There are many who suffer similarly.
37. Discussion. Ortho facility in Base hosp can be availed only subject to availability of facility / beds. The ECHS members are entitled to visit any empanelled hospital for treatment in case of non availability of facility in Base Hospital and intimate the polyclinic the next day alternately if the emergency is such he could visit any of hosp including non empanelled and seek reimbursement.
38. Decision. MDECHS has intimated that ECHS members are entitled to visit any empanelled hospital for treatment in case of non availability of facility in Base Hospital.
Action By : ECHS Members
ITEM XVI - ISSUE OF FAKE / SPURIOUS MEDICINES
39. Status. Issue of possibly fake / spurious medicines has been brought to the notice of OI/c the Clinic and the same was also given in writing for pursuing the matter further. The OI/c and MO i/c concurred that the medicine in question was spurious/fake. The matter needs to be pursued.
40. Discussion. MDECHS has intimated that he would bring this to the notice of DGAFMS and remedial action initiated to avoid recurrence.
41. Decision. MDECHS has been requested to take up the issue with DGAFMS for necessary action to avoid recurrence.
Action By : MDECHS
ITEM XVII - REPEAT POINT OF POINT 7
.
ITEM XVIII - TRANSPORT FOR AGED VETERANS
42. Status. At times very old and infirm Veterans, some over 90 years old have problems and they are not in a position to take the car ride to a hospital. We need to devise ways to provide support in such cases.
43. Discussion. MDECHS has intimated that it is not possible to provide car to the ECHS Member to the hospital with the existing infra structure of transport. However should there be medical requirement due to the status of the patient the ambulance at the polyclinic will be provided to transfer the patient to the referred hospital.
44. Decision. MDECHS has intimated that it is not possible to provide car to the ECHS Member to the hospital with the existing infra structure of transport. However should there be medical requirement due to the status of the patient the ambulance at the polyclinic will be provided to transfer the patient to the referred hospital.
Action By : Oi/C Polyclinics(Delhi / NCR)
ITEM XIX - POLYCLINICS ROUND THE CLOCK
45. Status. There is no Polyclinic support available on Sundays and holidays and this totals some 70 plus days in a year and this issue needs to be addressed. Similarly, since many Veterans’ take a second job after retirement, therefore Sundays may be made half working days and staff granted compensatory leave on a working day.
46. Discussion. During non consultation period / holidays, patients are free to get treatment from empanelled hospitals in emergency. Suitable policy instructions are intended to be issued enabling essential treatment at empanelled hospitals on holidays / non-working hours.
47. Decision. MDECHS has been requested to issue the policy letter regarding enabling essential treatment at empanelled hospitals on holidays / non-working hours.
Action By : MDECHS
ITEM XX - MILITARY HOSPITALS SHUTTING DOORS TO ESM AND PRIVATE SUPER SPECIALTY HOSPITAL NOT EMPANELLING
48. Status. Military Hospitals shutting doors to the ESM and sufficient private super specialty hospitals not keen on getting to be empanelled to the ECHS.
49. Discussion. MDECHS has intimated that he would take up this issue with DGAFMS to provide medicare subject to availability to facility / beds. With the implementation of 2010 CGHS rates which are higher, the private super specialty hospitals would be keen to come under ECHS.
50. Decision. MDECHS has been requested to take up this issue with DGAFMS and thereafter promulgate the policy letter.
Action By : MDECHS
ITEM XXI - TAC CERTIFICATE
51. Status. Need to review the requirement of TAC (temp att cert) to be able to get medicines for than 7 days and of course, the concept of parent polyclinic.
52. Discussion. The TAC certificate requirement is relevant because of the status of the data base of members expected to the polyclinics however with the online of computerization / automation this issue will be addressed favourably for the purpose of issue of medicines of more than seven days if not for obtaining costly individual equipment like hearing aids / medical equipment etc.
53. Decision. The TAC certificate requirement is relevant because of the status of the data base of members expected to the polyclinics however with the online of computerization / automation this issue will be addressed favourably for the purpose of issue of medicines of more than seven days if not for obtaining costly individual equipment like hearing aids / medical equipment etc.
Action By : MDECHS
ITEM XXII - WEBSITE USER FRIENDLY / E-MAIL ID REGISTRATION
54. Status. The official ECHS website needs to be redesigned to make it member friendly where information should be available conveniently. It should have provision for giving feed back / suggestions / complaints and date of up-dating of the site should be displayed. Complaints may also be received on the net. All members should be given the facility to get their email ID registered so that any future policy change or information can be communicated to those who have registered for the facility seamlessly by email.
55. Discussion. MDECHS has intimated that this will be implemented.
56. Decision. MDECHS has been requested to implement this at the earliest and promulgate to all concerned.
Action By : MDECHS
ITEM XXIII - CGHS DOCTORS WORKING HOURS / VISITING RESIDENCE OF PATIENT
57. Status. CGHS have the following facilities, which could be considered for induction in ECHS besides bringing in, other improvements given below in the comparison between CGHS and ECHS :-
(a) CGHS Doctors are available on shift during off working hours to attend to patients after working hours. In the present ECHS system a patient can go to empanelled Hospitals only if they are critically ill as per list promulgated. If the illness does not fall within the promulgated list we have to go private doctor and pay the fees from our pocket.
(b) CGHS Doctors visit residence of patients if they are unable to go the clinics because of nature of sickness, very old age or other reasons.
58. Discussion. MDECHS has intimated that CGHS does not open all dispensaries during off working hours. They only provide some high pressure dispensaries with minimal medical facilities. This issue can be considered once we have sanction for additional staff from MoD.
59. Decision. MDECHS has been requested to consider the issue after the sanction for additional staff from MoD is obtained and promulgate to all concerned thereafter.
Action By : MDECHS
ITEM XXIV - DOCTORS TO SIGN DRIVING LICENCE RENEWAL FORMS
60. Status. ECHS doctors refuse to sign, Driving Licence renewal medical form, RTO insists that these should be signed by a Govt Doctor. Please request ECHS to help us in this.
61. Discussion. MDECHS has intimated that he would promulgate the policy letter on the subject directing doctors to sign the Driving Licence renewal form and if required the necessary approval from RTO will be obtained, so that their signatures are acceptable.
62. Decision. MDECHS has been requested to promulgate the policy letter on the subject so that ECHS doctor's signature are acceptable for driving licence renewal medical form.
Action By : MDECHS
ITEM XXV - VALIDITY OF MOA WITH PRIVATE EMPANELMENT HOSPITALS
63. Status. Examination of the list of ECHS Empanelled Hospitals in NCR and other Regions shows that the MOA with a large number of Hospitals has expired in June 2010. It is possible that some of these may have been renewed but this information has not been updated on the Army ECHS website. It is suggested that the list of empanelled hospitals in the Army/Navy website be regularly updated so that the ECHS members can make an informed choices Further it is also suggested that the contact persons telephones- of the respective hospitals be also put on the website and updated at the time of renewal of the MOA.
64. Discussion. MDECHS has intimated that this request will be complied and ensure that the list of private empanelment hospitals with valid MOA will be hosted on website to enable ECHS members to make their choice of treatment.
65. Decision. MDECHS has been requested to update the list of private empanelment hospitals to enable ECHS members to make their choice of treatment.
Action By : MDECHS
COMMON ISSUES
ITEM XXVI - VISION STATEMENT AND NEED FOR SETTING STANDARDS BY ECHS / APPOINTMENT BY TELEPHONE
66. Status. There is a very urgent need for the promulgation of a Vision statement and ‘Standards’ to be achieved in all spheres including standards of cleanliness and hygiene, waiting times, facilities at the Policlinics, distance of polyclinic from residence, reaching out to those in the hinterland etc etc. Arrangement to see doctors with prior appointments rather than waiting in long queues.
67. Discussion. MDECHS has intimated that vision statement and standard for ECHS has already been promulgated and a copy of the same could be obtained from ECHS Central Organisation. Arrangements to meet doctors on appointment on telephone in the afternoons has already been implemented.
68. Decision. Director ECHS (N) is requested to obtain the vision statement from MDECHS and forward to NFDC.
Action By : Director ECHS (N)
ITEM XXVII - CLEANLINESS OF TOILETS AT POLYCLINIC
69. Status. There is considerable concern on the poor standard of cleanliness, especially the bathrooms, they really stink and the unhygienic atmosphere in the waiting halls on a daily basis.
70. Discussion. This is a cause of concern and that Oi/C polyclinic must ensure that standard of cleanliness in the toilets at polyclinic is of highest standard in spite of constraints of water / cleaning labourers problems.
71. Decision. Oi/C Polyclinics have been requested to take necessary action regarding cleanliness of toilets of polyclinics if required by obtaining the necessary assistance from station commanders with respect to constraints of availability of water / safaiwalas.
Action By : Oi/C Polyclinics – Delhi / NCR
CONCLUDING REMARKS
72. There being no other points, the meeting was over.
73. In conclusion, CPS requested MDECHS to resolve the issues raised during the meeting for clientele satisfaction as medicare is most important need for the veterans.
74. These minutes issue with the approval of the Chairman.
(AL Narayan)
Capt (IN)
Director ECHS(N)
SO/CNS SO/COP SO/CPS
SO/DGMS(NAVY) SO/MDECHS PDESA
SECY NFDC
OI/C POLYCLINICS.
BASE HOSPITAL (DELHI CANTT), LODHI ROAD,
GURGAON, NOIDA, FARIDABAD, GHAZIABAD (HINDON)
Sunday, June 13, 2010
ECHS News
IESM ECHS Division
Feedback for improvement of ECHS Services
Quarter Ending Mar 10
Part I- Mission and Terms of Reference(No change from earlier Feedbacks)
Introduction
With the increasing cost of healthcare, and depleting income post retirement, issues concerning Health are obvious areas of concern to veterans.
The ECHS, designed on lines of CGHS providing healthcare to Civil Services Government employees are a big help in this regard. However, given the spread of ESM habitations, and the sheer numbers of ESM, certain innovative/ out of box thinking is essential to ensure that this fundamental right of ESM is guarded.
It is assumed that ‘numbers’ should give US a bargaining leverage with reference to private hospitals / establishments, provided we are able to become a ‘commercial possibility’, and are therefore able to drive a bargain to our advantage. Implicit in this statement is the possibility of better rates, at point of usage delivery for health products/ medicines and modernizing of our polyclinics and processes.
Responding to this requirement, the Indian Ex Servicemen Movement (IESM) constituted an ECHS division, as ESM user interface with ECHS. Accordingly Region Liaison Cells (RLC) and Polyclinic Liaison Cells (PLC) have been created, to provide this user interface at all levels. With ‘eyes and ears’ at the grass root level, and with an ESM apex at NCR, it is believed that a reasonable feedback would be available on a continual basis, to the MD ECHS and accordingly to the AG and the DGAFMS, to be able to create the finest healthcare system for the ESM; perhaps surpassing the CGHS
Essentials of ‘The Finest Healthcare System’. (No change from Earlier Feedbacks)
a) Clean, comfortable polyclinics with hygienic facilities for drinking water, toilets and spacious, ventilated waiting areas with adequate seating.
b) Speedy Registration.
c) Empathetic staff and Doctors. ECHS is basically a ‘Service Industry’. The ‘Comfort and Feel Good of the client (patient) comes FIRST – Always and Every time.
d) A Prioritization system for patients in distress/ Senior Veterans and those needing urgent attention.
e) Quick consultation with Doctor and issue of medicine.
f) Expeditious procurement of NA medicines. Intimation to patient about availability.
g) Issued medicines to have sufficient residual shelf life.
h) Simplification of processes to ensure patient is not harassed / made to run around for referrals, approvals etc.
i) Simple processes to ensure empanelled hospitals and not the patient , run around to get approvals/ intimations etc. Polyclinic to be the Single window for all the patient’s requirements.
j) Speedy processing and clearing of hospital bills.
k) Speedy processing and clearance of patient reimbursements.
l) Monitoring and Performance Audit of Empanelled Hospitals.
m) A support system to render advice including legal, to ‘wronged’ veterans to file consumer complaints in case of default/ deficiency in services at any level of the medical chain.
n) In case of any dispute/doubt on what is to be done, the Patients’ convenience and comfort must be the supreme, overriding, deciding factor ALWAYS AND EVERYTIME.
Part II- Review of Previous Feedback Points
Feedback from RLC/ PLC So Far
Major Areas of concern .
(a) TAC. On being issued the Smart Card the ESM were assured that the card would be usable Pan India. In actual practice however, a Temporary Attachment Certificate (TAC) is required when a user wishes to use polyclinic facilities other than his/ her own. It has been opined, both formally and in informal discussions, that the Smart Card MUST be honoured Pan India. Software experts confirm that the present card HAS the potential to be so used. Irrespective of this, a NEW ECHS card is being introduced that as per ECHS authorities, would overcome this problem.THIS POINT IS A CARRY OVER FROM FEEDBACK OF OCT 09.
(b) Emergency Treatment.THE Procedural aspects HAVE BEEN CLARIFIED IN ECHS LETTER NO B/49774/AG/ECHS/Referral DATED 01 Dec 2009. THERE HAVE BEEN IMPLEMENTATION PROBLEMS AT SOME POLYCLINICS, WHICH HAS BEEN BROUGHT TO NOTICE OF ECHS HQ.
(c) Financial Reimbursement in Emergency Admissions. A case has been reported wherein Lt Col Joglekar-a veteran got admitted to an empanelled hospital in Pune in a cardiac emergency. An emergency referral was obtained two days later, but he died in hospital. The officer’s wife was asked to pay which she did. Later, when the ECHS paid the hospital, the latter refunded PART of the payment made by the lady. Question arises
i) If the hospital knew that the officer was an ECHS member, WHY did they ask the widow to pay?
ii) When they got the payment from the ECHS, why was the ENTIRE amount charged from the lady NOT refunded to her? In all fairness, it should have been. AND if the bill was cleared BY THE Polyclinic in parts, why was she not advised how much and why the deductions were being made? Regrettably the local authorities have not responded to her queries in this regard.
BASED ON A FORMAL COMPLAINT LODGED BY MRS JOGLEKAR, ECHS HQ HAS BEEN APPRISED OF THE CASE. DETAILS OF ACTION TAKE BY THEM ARE NOT KNOWN.
(d) Issue of Three Months Medicine. With chronic ailments, medicines are prescribed for long durations and patient asked to report for review in say six months, one year. As medicines continue for the same duration, it would be greatly helpful for the patient to be given (at the doctor’s discretion), medicine for three months. This requirement is pertinent also to patients proceeding abroad for long durations. But more importantly, is relevant to patients in outlying, rural areas, who often need to travel 150-200 km to the polyclinic. Two illustrative cases are attached as Annexure 1. It is strongly recommended that in interests of effective patient care, up to 90 days medicine MUST be permitted to be issued at the doctors’ discretion. THE CASE HAS BEEN FOLLOWED UP AT THE APEX LEVEL. THE PROBLEM IS PERCEPTIONAL, WITH DGAFMS PRINCIPALLY DISAGREEING WITH THE PROPOSAL ON ‘ETHICAL GROUNDS’. THIS HOWEVER RUNS CONTRARY TO GOI LETTER NO MH & FW, O.M. No. S-11011/8/99-CGHS(P), dt 13.10.1999, ISSUED TO CLARIFY A SIMILAR SITUATION IN CONTEXT OF CGHS. THE CASE IS BEING FOLLOWED UP. IN A MEETING WITH AG, IT WAS BROUGHT UP BY US, AND SOME OTHER ESM ORGANIZATIONS WHOSE REPS ALSO ATTENDED THE MEETING.
(e) Dis-empanellment of Quality Hospitals. While initial perspectives envisaged good and reputed hospitals for in house treatment of ESM, the delays in clearing their bills by ECHS has resulted in their gradual weaning away. To correct this - IT IS HEARTENING THAT ECHS HAS SUCCESSFULLY CARRIED OUT TRIALS FOR INTRODUCTION OF TPA METHODOLOGY IN THEIR OPS. IT IS HOPED THAT THIS WOULD OVERCOME THE PROBLEM OF DELAYED PAYMENTS. THIS WAS CONFIRMED DURING OUR MEETING WITH AG (mentioned above).
(f) NA Medicine. While it is appreciated that ‘exact’ brand prescribed by an empanelled hospital OPD may not be immediately available, those prescribed after a hospital admission must be immediately disbursed to the patient. It has been suggested that on discharge, a patient may be issued medicine from the hospital itself for up to one week, and billed for in the hospital bill. As for others, procedures for NA procurements may be refined to expedite its issue. The ECHS division of IESM, is encouraging a system of veteran volunteers to assist ESM patients at polyclinics, and one of their contributions is proposed to be to inform veterans through sms, phone etc that their NA medicine have arrived. ECHS supply chain on its part must plan on ‘Point of Usage’ delivery of medicine, as against stocking and transporting medicine which adds to cost and delays. With an All India network of pharmaceutical companies, this should be negotiated. This would reduce requirements of storage, and guard against medicine going overage. It may even be a good measure to have pharmaceutical companies establish pharmacies on contractual basis/ outsourced in close proximity of polyclinics. IT IS HEARTENING TO LEARN THAT ECHS IS CONTEMPLATING CHANGED LOGISTIC SUPPLY CHAIN MANAGEMENT INCLUDING OUTSOURCING TO OVECOME STOCKING/ SUPPLY PROBLEMS. THIS POINT IS A CARRY OVER SINCE OCT 09.
(g) Pharmacists. Currently pharmacists are not on the establishment of polyclinics, and where posted, are on a lower scale of pay than their counterparts in nursing services. It is felt that their emoluments and aspects of desired retention need careful attention. THIS POINT IS CARRIED FORWARD FROM THE FEEDBACK OF OCT 09.
(h) Dental Care. O P D Dental care is being provided by the ECHS. However, referral facilities for dentures & other specialised requirements are outsourced but are practically non-existent in the E C H S system (there is ONE dental care facility empanelled in NCR- ONE! At Delhi), the rates are fixed in a manner to deter any worthwhile establishment from seeking empanelment. It is recommended that this be reviewed upward. We have volumes and should be able to strike a bargain in rates. THIS POINT IS CARRIED FORWARD FROM THE FEEDBACK OF OCT 09.
(i) Manning/ Organizing for Effectiveness. Present ad-hoc /improvised manning of the Rs 720 crore ECHS, based on offsets is clearly undesirable. Its effect on the Operational effectiveness aside, it deprives the scheme of continuity and growth. It is recommended that GOI approval for a dedicated authorization for the ECHS be taken up. THIS POINT IS CARRIED FORWARD FROM THE FEEDBACK OF OCT 09. IT IS HOWEVER INFORMALLY LEARNT THAT SUCH A COMMITTTEE IS BEING SET UP TO ATTEND TO THIS SERIOUS CONGENITAL ANOMALY.
(j) The Polyclinics. Polyclinics are the ‘delivery points of service’ from the ECHS. It is essential they be well laid out, suitably equipped and efficiently and empathetically manned. Some suggestions in this regard are
i) The layout/ design of Polyclinics should be standardized in consultation with an architect specializing in hospital layouts. Should be adopted Pan India.
ii) It should cater for enough space for comfortable, ventilated, protected from vagaries of weather, waiting areas. Enough rooms for the facilities and provision clean drinking water, sufficient conveniences and storage.
iii) It should lend itself for expansion.
iv) Criteria for selection of OC Polyclinic must include being net savvy, and possessing an understanding of service industry - preferably that of healthcare services.
v) Must have LAN connectivity to ensure optimal smart cards usage, pharmaceutical inventory control and correct demand procedures. This WILL ensure cost effectiveness.
THIS POINT IS CARRIED FORWARD FROM THE FEEDBACK OF OCT 09.
(k) Compensating Military Hospitals for In-house Treatment.
i) Service hospitals (MHs) are authorised & scaled as per the Garrison strength (authorised soldiers only) of the station. ESM are entitled for indoor treatment under specified provisions, as an exception. ECHS was conceived & sanctioned in view of large number of restrictions for treatment of ESM as per the GOI rules vide the RMSAF (Regulations for Medical Services of the Armed Forces).
ii) With gradually increasing number of ECHS patients being admitted to MHs, since inception of the scheme, the load on these units has increased. The staff strength at MHs, particularly the Group D staff is consequently inadequate. All patients invariably complain of poor cleanliness, poor service by safaiwallas, ward boys & ayahs. On the other hand, ECHS has been advised to use the spare capacities of the MHs & rightly so. However in view of the aforesaid problems of staffing/ resourcing, patients do not get the best care which they deserve.
iii) To compensate the MHs ECHS should authorise payment of a nominal amount, say Rs 500/- for each ordinary bed occupied per day to the MH & Rs 1000/- per day for ICU beds. All expensive consumables for eg catheters, stents etc should be paid for by the ECHS. The money paid from ECHS at these nominal rates will bring huge savings to the ECHS in comparison to the Empanelled Civil Hospitals which charge Rs 2000/- to Rs 4000/- per day. At the same time, these funds could be used towards qualitative improvements in patient care and cleanliness.
iv) To improve the facilities of the MH concerned this money should be retained by the MH Commandant, properly accounted for, and utilised only for improvement of facilities for ECHS patients. It could be used for additional hiring of safaiwallas, ward boys and ayahs etc.
THIS POINT IS CARRIED FORWARD FROM THE FEEDBACK OF OCT 09. HOWEVER IT IS UNDERSTOOD THAT THE COMMITTEE REFERRED ABOVE WILL LOOK INTO THIS AND SUCH SOLUTIONS TO MAKE HEALTHCARE AT MIILITARY FACILITIES BETTER.
l) Staffing Pattern at Polyclinics. The present pattern of having type A,B, C and D polyclinics requires a relook. After 5 years the load on polyclinics should be well known. High pressure polyclinics need to have additional staff based on their dependency. Noida , Gurgaon and Chandigarh are in excess of other type A polyclinics. THIS POINT IS CARRIED FORWARD FROM THE FEEDBACK OF OCT 09.
m) OPD Treatment in Off Hours. There is a definite need for permitting empanelled hospitals to undertake OPD treatment after Polyclinic closing hours. An acceptable system (of either having Polyclinic Doctor on Call/ permitting OPD outsourced needs to be put in place. THIS POINT IS CARRIED FORWARD FROM THE FEEDBACK OF OCT 09.
n) Locating Polyclinics. The intricate logistics and difficulty of ‘getting to’ the polyclinics in some stations, eg Mumbai, have been reported by veterans. Apparently the need to utilize existing infrastructure for polyclinics overlooked the ‘convenience’ of users. As the latter becomes more important with age, it is felt that this needs higher priority. In Mumbai for instance, both, the ‘time and space’ aspect of travel, and the road/ rail alignments needed to be borne in mind while firstly, locating polyclinics AND secondly, working out Area dependencies. It is recommended that as a start, this be studied, coopting inputs / assistance from local IESM ECHS Division representatives. THIS POINT IS A CARRY OVER SINCE JAN 10.
o) Tenure and QR of OC Polyclinics. It has been suggested by veterans that a contract of one year is inadequate for OC Polyclinics. By the time he learns the job, its time to move on. It has been recommended that it should be five years. It has also been suggested that OC Polyclinic must be one who is computer savvy, and has had at least two years in the civvies street, before assuming this appointment. This exposure would give him/her, an empathetic understanding of the handling of staff/ clients (ESM). THIS POINT IS A CARRY OVER SINCE JAN 10.
PART III- FRESH FEEDBACK POINTS FOR CURRENT QUARTER
Relocation of Polyclinic Needed. Gahmar in Gazipur distt, UP, is one of the largest villages in Asia. Referred to as the SOLDIERS’ VILLAGE, it has the unique distinction of having 2-3 members of each family in the defence forces of India. There are fair number of World War II veterans..........some as old as 104 years. The nearest polyclinic is at Gazipur, the district Hq, approx 50Km away. It is felt that this needs relocation to Gahmar, considering the village’s substantial contribution to the Defence forces, and the ESM population there.
Loss of ECHS Membership Card. There is a need to evolve a procedure that enables continuous ECHS support even without the card. There is also a requirement to review the current ECHS rules that dictate a ‘cancellation’ of membership when a card is lost the second time. With a photo attached to the card and Biometric checks built in, it is reiterated that such restrictions are not needed.
Integration of Existing Healthcare Services . Neither serving personnel, nor their dependents are eligible for ECHS benefits. In the circumstances, a separated family member has queried as to what does a separated family/dependent family do when the nearest service hospital facilities are over 125 kms from the selected place of residence? There may be an NCC unit located close by and so...even in their case neither servicemen nor their families can avail of the services of the ECHS. That stated, however, they are treated on 'humanitarian grounds.
This anomaly needs to be addressed. Carrying this further, there is a need to explore a nationwide integration with CGHS empanelled facilities if not their clinics.
Upgrade of Hospital Accomodation. A point often projected is regarding upgrades of hospital accommodation beyond the ‘entitled class’. It is understood that this stays a personal adjustment between the ESM patient and the hospital. Currently, hospitals are charging difference between the Full rates between the two rents (ie Full Rental of Room to which upgrading MINUS the rent of accommodation entitled). It is suggested that such contingencies be built into the contract with hospitals and they be required to charge the differential at the contracted rates.
Hospitalization while Abroad. There have been instances of veterans being admitted to hospitals while abroad. Present rules do not permit reimbursement/ coverage for them. It is suggested that a modality be worked out on lines of Non Empanelled hospitalizations, wherein, in such cases at least ECHS rates of local hospitals be reimbursed to them.
Empanelling Hospitals. Very many hospitals are currently empanelled for specific referrals.eg for Cardio only OR Iconology only. It is felt that such contractual agreements of part empanelment deprive ESM of majority of services available with the hospital. At the same time, the hospital benefits in cashing in on the more commercially viable services. It is suggested that a ‘package contract’ specifying rates etc be projected to the hospitals, and a ’package’ be offered to ECHS users. While the hospital would lose out in some services, profit in some and cut even in others, such standardized contracts across the country would immensely benefit ECHS users. We have numbers, which is a marketing cantilever.
PART IV- CASE STUDIES
Case of Cpl Bhandari’s Reimbursement. It will be recalled that following an accident, an AF veteran (Cpl Bhandari) at Jabalpur was admitted to a hospital (empanelled/ Non empanelled stayed a confusion for sometime even for us – the ECHS website does not mention it) by his son’s friends, as the latter is at Dubai. Hospital bill was cleared by the patient on discharge. When his son mailed to the IESM ECHS Division narrating the case, we advised him to submit the bill to the Polyclinic, which was done, wherein we were advised by Polyclinic to submit it to the Hospital who would follow up with them. It was then that we learnt that it is an empanelled hospital which in order to overcome delays in bill clearing has resorted to having patients pay and then claim and reimburse to the patient. Despite constant follow up, the Hospital did not budge from their stand that they would refund ONLY the amount received from the ECHS. Such malpractices by hospitals seem commonplace countrywide, as was earlier witnessed in Mrs Joglekar’s case (see Feedback Oct 09). After being constantly harassed by the Jabalpur hospital , Cpl Bhandari’s family has taken a decision to take the hospital to a consumer court, purely on principles. As per them, though the road would be tough, and even though ‘money’ is not the issue, they would like to do it in larger interest of the ESM community. Our salute to them, and we hope their effort will be backed suitably by the ECHS.
Mrs Joglekar’s Reimbursement. It will be recalled that Mrs Joglekar was made to clear the hospital bill after her husband expired in hospital. After prolonged follow up, while she got the ECHS rates refunded, the full amount paid by her was not refunded to her. At our behest, she took up the case with Station Hq and ECHS. The case is presently stuck up with Region Hq who needs to revert to the ECHS Hq with their comments. (ECHS Hq letter No B/49717-C/AG/ECHS/2767 dated 27 Apr 2010 refers).
Dependency Certificate for absence away from Parent Polyclinic. A veteran pointed out that his mother (herself a military veteran’s wife) faces problems of ECHS support while travelling in NCR, being asked to revert to her dependent polyclinic (BH) even when staying variedly with her sons settled in Noida, Gurgaon and Delhi. It has been clarified by ECHS Hq that such matters can be addressed on Regional basis and the Regional Centre is empowered to issue dependency instructions on a case by case basis.
Conclusion
Excellence is a constant pursuit. While enough ground has been covered in improving ECHS services since inception, creating the “FINEST HEALTHCARE SYSTEM” in the country would still involve constant refinement and respecting client feed back as a challenging opportunity to improve. Question that needs to be asked, to the Armed Forces Health Services hierarchy, to quote
Posted by Indian ExServicemen Movement at 10:56 PM 0 comments
Monday, March 15, 2010
Cpl Bhandari case at Jabalpur
Kuthiala Sir,
This case continues to get deeper into needless issues. WE have been in picture from Day one.
An accident, at the very least with a fracture "would constitute 'emergency'.
On Reporting, there was some confusion about the empanellment. You would recall that till the Polyclinic asked for the documents to be submitted through the hospital, we were thinking we were dealing with a non empanelled hospital. This stage was the first indicator (and we spoke about it in detail) that it was an empanelled hospital with an identical 'pay first, claim and then be reimbursed the ECHS cleared amount' philosophy followed in Mrs Jogelkar's case. While on the issue, you will recall we checked on web and did not find the hospital in the annexure of empanelled hospitals. This deepened the mystery.
Be that as it may, the Hospital had NO business to charge and then reimburse ECHS rates to the veteran. They are ONLY ENTITLED to ECHS rates, including audit deductions if any, and must therefore reimburse the TOTAL amount.
We need to convey to the hospital that there is no getting away from this, and it would be a no holds barred action by us, jointly, to ensure they honor what they are committed to, in being an empanelled hospital.
Feedback for improvement of ECHS Services
Quarter Ending Mar 10
Part I- Mission and Terms of Reference(No change from earlier Feedbacks)
Introduction
With the increasing cost of healthcare, and depleting income post retirement, issues concerning Health are obvious areas of concern to veterans.
The ECHS, designed on lines of CGHS providing healthcare to Civil Services Government employees are a big help in this regard. However, given the spread of ESM habitations, and the sheer numbers of ESM, certain innovative/ out of box thinking is essential to ensure that this fundamental right of ESM is guarded.
It is assumed that ‘numbers’ should give US a bargaining leverage with reference to private hospitals / establishments, provided we are able to become a ‘commercial possibility’, and are therefore able to drive a bargain to our advantage. Implicit in this statement is the possibility of better rates, at point of usage delivery for health products/ medicines and modernizing of our polyclinics and processes.
Responding to this requirement, the Indian Ex Servicemen Movement (IESM) constituted an ECHS division, as ESM user interface with ECHS. Accordingly Region Liaison Cells (RLC) and Polyclinic Liaison Cells (PLC) have been created, to provide this user interface at all levels. With ‘eyes and ears’ at the grass root level, and with an ESM apex at NCR, it is believed that a reasonable feedback would be available on a continual basis, to the MD ECHS and accordingly to the AG and the DGAFMS, to be able to create the finest healthcare system for the ESM; perhaps surpassing the CGHS
Essentials of ‘The Finest Healthcare System’. (No change from Earlier Feedbacks)
a) Clean, comfortable polyclinics with hygienic facilities for drinking water, toilets and spacious, ventilated waiting areas with adequate seating.
b) Speedy Registration.
c) Empathetic staff and Doctors. ECHS is basically a ‘Service Industry’. The ‘Comfort and Feel Good of the client (patient) comes FIRST – Always and Every time.
d) A Prioritization system for patients in distress/ Senior Veterans and those needing urgent attention.
e) Quick consultation with Doctor and issue of medicine.
f) Expeditious procurement of NA medicines. Intimation to patient about availability.
g) Issued medicines to have sufficient residual shelf life.
h) Simplification of processes to ensure patient is not harassed / made to run around for referrals, approvals etc.
i) Simple processes to ensure empanelled hospitals and not the patient , run around to get approvals/ intimations etc. Polyclinic to be the Single window for all the patient’s requirements.
j) Speedy processing and clearing of hospital bills.
k) Speedy processing and clearance of patient reimbursements.
l) Monitoring and Performance Audit of Empanelled Hospitals.
m) A support system to render advice including legal, to ‘wronged’ veterans to file consumer complaints in case of default/ deficiency in services at any level of the medical chain.
n) In case of any dispute/doubt on what is to be done, the Patients’ convenience and comfort must be the supreme, overriding, deciding factor ALWAYS AND EVERYTIME.
Part II- Review of Previous Feedback Points
Feedback from RLC/ PLC So Far
Major Areas of concern .
(a) TAC. On being issued the Smart Card the ESM were assured that the card would be usable Pan India. In actual practice however, a Temporary Attachment Certificate (TAC) is required when a user wishes to use polyclinic facilities other than his/ her own. It has been opined, both formally and in informal discussions, that the Smart Card MUST be honoured Pan India. Software experts confirm that the present card HAS the potential to be so used. Irrespective of this, a NEW ECHS card is being introduced that as per ECHS authorities, would overcome this problem.THIS POINT IS A CARRY OVER FROM FEEDBACK OF OCT 09.
(b) Emergency Treatment.THE Procedural aspects HAVE BEEN CLARIFIED IN ECHS LETTER NO B/49774/AG/ECHS/Referral DATED 01 Dec 2009. THERE HAVE BEEN IMPLEMENTATION PROBLEMS AT SOME POLYCLINICS, WHICH HAS BEEN BROUGHT TO NOTICE OF ECHS HQ.
(c) Financial Reimbursement in Emergency Admissions. A case has been reported wherein Lt Col Joglekar-a veteran got admitted to an empanelled hospital in Pune in a cardiac emergency. An emergency referral was obtained two days later, but he died in hospital. The officer’s wife was asked to pay which she did. Later, when the ECHS paid the hospital, the latter refunded PART of the payment made by the lady. Question arises
i) If the hospital knew that the officer was an ECHS member, WHY did they ask the widow to pay?
ii) When they got the payment from the ECHS, why was the ENTIRE amount charged from the lady NOT refunded to her? In all fairness, it should have been. AND if the bill was cleared BY THE Polyclinic in parts, why was she not advised how much and why the deductions were being made? Regrettably the local authorities have not responded to her queries in this regard.
BASED ON A FORMAL COMPLAINT LODGED BY MRS JOGLEKAR, ECHS HQ HAS BEEN APPRISED OF THE CASE. DETAILS OF ACTION TAKE BY THEM ARE NOT KNOWN.
(d) Issue of Three Months Medicine. With chronic ailments, medicines are prescribed for long durations and patient asked to report for review in say six months, one year. As medicines continue for the same duration, it would be greatly helpful for the patient to be given (at the doctor’s discretion), medicine for three months. This requirement is pertinent also to patients proceeding abroad for long durations. But more importantly, is relevant to patients in outlying, rural areas, who often need to travel 150-200 km to the polyclinic. Two illustrative cases are attached as Annexure 1. It is strongly recommended that in interests of effective patient care, up to 90 days medicine MUST be permitted to be issued at the doctors’ discretion. THE CASE HAS BEEN FOLLOWED UP AT THE APEX LEVEL. THE PROBLEM IS PERCEPTIONAL, WITH DGAFMS PRINCIPALLY DISAGREEING WITH THE PROPOSAL ON ‘ETHICAL GROUNDS’. THIS HOWEVER RUNS CONTRARY TO GOI LETTER NO MH & FW, O.M. No. S-11011/8/99-CGHS(P), dt 13.10.1999, ISSUED TO CLARIFY A SIMILAR SITUATION IN CONTEXT OF CGHS. THE CASE IS BEING FOLLOWED UP. IN A MEETING WITH AG, IT WAS BROUGHT UP BY US, AND SOME OTHER ESM ORGANIZATIONS WHOSE REPS ALSO ATTENDED THE MEETING.
(e) Dis-empanellment of Quality Hospitals. While initial perspectives envisaged good and reputed hospitals for in house treatment of ESM, the delays in clearing their bills by ECHS has resulted in their gradual weaning away. To correct this - IT IS HEARTENING THAT ECHS HAS SUCCESSFULLY CARRIED OUT TRIALS FOR INTRODUCTION OF TPA METHODOLOGY IN THEIR OPS. IT IS HOPED THAT THIS WOULD OVERCOME THE PROBLEM OF DELAYED PAYMENTS. THIS WAS CONFIRMED DURING OUR MEETING WITH AG (mentioned above).
(f) NA Medicine. While it is appreciated that ‘exact’ brand prescribed by an empanelled hospital OPD may not be immediately available, those prescribed after a hospital admission must be immediately disbursed to the patient. It has been suggested that on discharge, a patient may be issued medicine from the hospital itself for up to one week, and billed for in the hospital bill. As for others, procedures for NA procurements may be refined to expedite its issue. The ECHS division of IESM, is encouraging a system of veteran volunteers to assist ESM patients at polyclinics, and one of their contributions is proposed to be to inform veterans through sms, phone etc that their NA medicine have arrived. ECHS supply chain on its part must plan on ‘Point of Usage’ delivery of medicine, as against stocking and transporting medicine which adds to cost and delays. With an All India network of pharmaceutical companies, this should be negotiated. This would reduce requirements of storage, and guard against medicine going overage. It may even be a good measure to have pharmaceutical companies establish pharmacies on contractual basis/ outsourced in close proximity of polyclinics. IT IS HEARTENING TO LEARN THAT ECHS IS CONTEMPLATING CHANGED LOGISTIC SUPPLY CHAIN MANAGEMENT INCLUDING OUTSOURCING TO OVECOME STOCKING/ SUPPLY PROBLEMS. THIS POINT IS A CARRY OVER SINCE OCT 09.
(g) Pharmacists. Currently pharmacists are not on the establishment of polyclinics, and where posted, are on a lower scale of pay than their counterparts in nursing services. It is felt that their emoluments and aspects of desired retention need careful attention. THIS POINT IS CARRIED FORWARD FROM THE FEEDBACK OF OCT 09.
(h) Dental Care. O P D Dental care is being provided by the ECHS. However, referral facilities for dentures & other specialised requirements are outsourced but are practically non-existent in the E C H S system (there is ONE dental care facility empanelled in NCR- ONE! At Delhi), the rates are fixed in a manner to deter any worthwhile establishment from seeking empanelment. It is recommended that this be reviewed upward. We have volumes and should be able to strike a bargain in rates. THIS POINT IS CARRIED FORWARD FROM THE FEEDBACK OF OCT 09.
(i) Manning/ Organizing for Effectiveness. Present ad-hoc /improvised manning of the Rs 720 crore ECHS, based on offsets is clearly undesirable. Its effect on the Operational effectiveness aside, it deprives the scheme of continuity and growth. It is recommended that GOI approval for a dedicated authorization for the ECHS be taken up. THIS POINT IS CARRIED FORWARD FROM THE FEEDBACK OF OCT 09. IT IS HOWEVER INFORMALLY LEARNT THAT SUCH A COMMITTTEE IS BEING SET UP TO ATTEND TO THIS SERIOUS CONGENITAL ANOMALY.
(j) The Polyclinics. Polyclinics are the ‘delivery points of service’ from the ECHS. It is essential they be well laid out, suitably equipped and efficiently and empathetically manned. Some suggestions in this regard are
i) The layout/ design of Polyclinics should be standardized in consultation with an architect specializing in hospital layouts. Should be adopted Pan India.
ii) It should cater for enough space for comfortable, ventilated, protected from vagaries of weather, waiting areas. Enough rooms for the facilities and provision clean drinking water, sufficient conveniences and storage.
iii) It should lend itself for expansion.
iv) Criteria for selection of OC Polyclinic must include being net savvy, and possessing an understanding of service industry - preferably that of healthcare services.
v) Must have LAN connectivity to ensure optimal smart cards usage, pharmaceutical inventory control and correct demand procedures. This WILL ensure cost effectiveness.
THIS POINT IS CARRIED FORWARD FROM THE FEEDBACK OF OCT 09.
(k) Compensating Military Hospitals for In-house Treatment.
i) Service hospitals (MHs) are authorised & scaled as per the Garrison strength (authorised soldiers only) of the station. ESM are entitled for indoor treatment under specified provisions, as an exception. ECHS was conceived & sanctioned in view of large number of restrictions for treatment of ESM as per the GOI rules vide the RMSAF (Regulations for Medical Services of the Armed Forces).
ii) With gradually increasing number of ECHS patients being admitted to MHs, since inception of the scheme, the load on these units has increased. The staff strength at MHs, particularly the Group D staff is consequently inadequate. All patients invariably complain of poor cleanliness, poor service by safaiwallas, ward boys & ayahs. On the other hand, ECHS has been advised to use the spare capacities of the MHs & rightly so. However in view of the aforesaid problems of staffing/ resourcing, patients do not get the best care which they deserve.
iii) To compensate the MHs ECHS should authorise payment of a nominal amount, say Rs 500/- for each ordinary bed occupied per day to the MH & Rs 1000/- per day for ICU beds. All expensive consumables for eg catheters, stents etc should be paid for by the ECHS. The money paid from ECHS at these nominal rates will bring huge savings to the ECHS in comparison to the Empanelled Civil Hospitals which charge Rs 2000/- to Rs 4000/- per day. At the same time, these funds could be used towards qualitative improvements in patient care and cleanliness.
iv) To improve the facilities of the MH concerned this money should be retained by the MH Commandant, properly accounted for, and utilised only for improvement of facilities for ECHS patients. It could be used for additional hiring of safaiwallas, ward boys and ayahs etc.
THIS POINT IS CARRIED FORWARD FROM THE FEEDBACK OF OCT 09. HOWEVER IT IS UNDERSTOOD THAT THE COMMITTEE REFERRED ABOVE WILL LOOK INTO THIS AND SUCH SOLUTIONS TO MAKE HEALTHCARE AT MIILITARY FACILITIES BETTER.
l) Staffing Pattern at Polyclinics. The present pattern of having type A,B, C and D polyclinics requires a relook. After 5 years the load on polyclinics should be well known. High pressure polyclinics need to have additional staff based on their dependency. Noida , Gurgaon and Chandigarh are in excess of other type A polyclinics. THIS POINT IS CARRIED FORWARD FROM THE FEEDBACK OF OCT 09.
m) OPD Treatment in Off Hours. There is a definite need for permitting empanelled hospitals to undertake OPD treatment after Polyclinic closing hours. An acceptable system (of either having Polyclinic Doctor on Call/ permitting OPD outsourced needs to be put in place. THIS POINT IS CARRIED FORWARD FROM THE FEEDBACK OF OCT 09.
n) Locating Polyclinics. The intricate logistics and difficulty of ‘getting to’ the polyclinics in some stations, eg Mumbai, have been reported by veterans. Apparently the need to utilize existing infrastructure for polyclinics overlooked the ‘convenience’ of users. As the latter becomes more important with age, it is felt that this needs higher priority. In Mumbai for instance, both, the ‘time and space’ aspect of travel, and the road/ rail alignments needed to be borne in mind while firstly, locating polyclinics AND secondly, working out Area dependencies. It is recommended that as a start, this be studied, coopting inputs / assistance from local IESM ECHS Division representatives. THIS POINT IS A CARRY OVER SINCE JAN 10.
o) Tenure and QR of OC Polyclinics. It has been suggested by veterans that a contract of one year is inadequate for OC Polyclinics. By the time he learns the job, its time to move on. It has been recommended that it should be five years. It has also been suggested that OC Polyclinic must be one who is computer savvy, and has had at least two years in the civvies street, before assuming this appointment. This exposure would give him/her, an empathetic understanding of the handling of staff/ clients (ESM). THIS POINT IS A CARRY OVER SINCE JAN 10.
PART III- FRESH FEEDBACK POINTS FOR CURRENT QUARTER
Relocation of Polyclinic Needed. Gahmar in Gazipur distt, UP, is one of the largest villages in Asia. Referred to as the SOLDIERS’ VILLAGE, it has the unique distinction of having 2-3 members of each family in the defence forces of India. There are fair number of World War II veterans..........some as old as 104 years. The nearest polyclinic is at Gazipur, the district Hq, approx 50Km away. It is felt that this needs relocation to Gahmar, considering the village’s substantial contribution to the Defence forces, and the ESM population there.
Loss of ECHS Membership Card. There is a need to evolve a procedure that enables continuous ECHS support even without the card. There is also a requirement to review the current ECHS rules that dictate a ‘cancellation’ of membership when a card is lost the second time. With a photo attached to the card and Biometric checks built in, it is reiterated that such restrictions are not needed.
Integration of Existing Healthcare Services . Neither serving personnel, nor their dependents are eligible for ECHS benefits. In the circumstances, a separated family member has queried as to what does a separated family/dependent family do when the nearest service hospital facilities are over 125 kms from the selected place of residence? There may be an NCC unit located close by and so...even in their case neither servicemen nor their families can avail of the services of the ECHS. That stated, however, they are treated on 'humanitarian grounds.
This anomaly needs to be addressed. Carrying this further, there is a need to explore a nationwide integration with CGHS empanelled facilities if not their clinics.
Upgrade of Hospital Accomodation. A point often projected is regarding upgrades of hospital accommodation beyond the ‘entitled class’. It is understood that this stays a personal adjustment between the ESM patient and the hospital. Currently, hospitals are charging difference between the Full rates between the two rents (ie Full Rental of Room to which upgrading MINUS the rent of accommodation entitled). It is suggested that such contingencies be built into the contract with hospitals and they be required to charge the differential at the contracted rates.
Hospitalization while Abroad. There have been instances of veterans being admitted to hospitals while abroad. Present rules do not permit reimbursement/ coverage for them. It is suggested that a modality be worked out on lines of Non Empanelled hospitalizations, wherein, in such cases at least ECHS rates of local hospitals be reimbursed to them.
Empanelling Hospitals. Very many hospitals are currently empanelled for specific referrals.eg for Cardio only OR Iconology only. It is felt that such contractual agreements of part empanelment deprive ESM of majority of services available with the hospital. At the same time, the hospital benefits in cashing in on the more commercially viable services. It is suggested that a ‘package contract’ specifying rates etc be projected to the hospitals, and a ’package’ be offered to ECHS users. While the hospital would lose out in some services, profit in some and cut even in others, such standardized contracts across the country would immensely benefit ECHS users. We have numbers, which is a marketing cantilever.
PART IV- CASE STUDIES
Case of Cpl Bhandari’s Reimbursement. It will be recalled that following an accident, an AF veteran (Cpl Bhandari) at Jabalpur was admitted to a hospital (empanelled/ Non empanelled stayed a confusion for sometime even for us – the ECHS website does not mention it) by his son’s friends, as the latter is at Dubai. Hospital bill was cleared by the patient on discharge. When his son mailed to the IESM ECHS Division narrating the case, we advised him to submit the bill to the Polyclinic, which was done, wherein we were advised by Polyclinic to submit it to the Hospital who would follow up with them. It was then that we learnt that it is an empanelled hospital which in order to overcome delays in bill clearing has resorted to having patients pay and then claim and reimburse to the patient. Despite constant follow up, the Hospital did not budge from their stand that they would refund ONLY the amount received from the ECHS. Such malpractices by hospitals seem commonplace countrywide, as was earlier witnessed in Mrs Joglekar’s case (see Feedback Oct 09). After being constantly harassed by the Jabalpur hospital , Cpl Bhandari’s family has taken a decision to take the hospital to a consumer court, purely on principles. As per them, though the road would be tough, and even though ‘money’ is not the issue, they would like to do it in larger interest of the ESM community. Our salute to them, and we hope their effort will be backed suitably by the ECHS.
Mrs Joglekar’s Reimbursement. It will be recalled that Mrs Joglekar was made to clear the hospital bill after her husband expired in hospital. After prolonged follow up, while she got the ECHS rates refunded, the full amount paid by her was not refunded to her. At our behest, she took up the case with Station Hq and ECHS. The case is presently stuck up with Region Hq who needs to revert to the ECHS Hq with their comments. (ECHS Hq letter No B/49717-C/AG/ECHS/2767 dated 27 Apr 2010 refers).
Dependency Certificate for absence away from Parent Polyclinic. A veteran pointed out that his mother (herself a military veteran’s wife) faces problems of ECHS support while travelling in NCR, being asked to revert to her dependent polyclinic (BH) even when staying variedly with her sons settled in Noida, Gurgaon and Delhi. It has been clarified by ECHS Hq that such matters can be addressed on Regional basis and the Regional Centre is empowered to issue dependency instructions on a case by case basis.
Conclusion
Excellence is a constant pursuit. While enough ground has been covered in improving ECHS services since inception, creating the “FINEST HEALTHCARE SYSTEM” in the country would still involve constant refinement and respecting client feed back as a challenging opportunity to improve. Question that needs to be asked, to the Armed Forces Health Services hierarchy, to quote
Posted by Indian ExServicemen Movement at 10:56 PM 0 comments
Monday, March 15, 2010
Cpl Bhandari case at Jabalpur
Kuthiala Sir,
This case continues to get deeper into needless issues. WE have been in picture from Day one.
An accident, at the very least with a fracture "would constitute 'emergency'.
On Reporting, there was some confusion about the empanellment. You would recall that till the Polyclinic asked for the documents to be submitted through the hospital, we were thinking we were dealing with a non empanelled hospital. This stage was the first indicator (and we spoke about it in detail) that it was an empanelled hospital with an identical 'pay first, claim and then be reimbursed the ECHS cleared amount' philosophy followed in Mrs Jogelkar's case. While on the issue, you will recall we checked on web and did not find the hospital in the annexure of empanelled hospitals. This deepened the mystery.
Be that as it may, the Hospital had NO business to charge and then reimburse ECHS rates to the veteran. They are ONLY ENTITLED to ECHS rates, including audit deductions if any, and must therefore reimburse the TOTAL amount.
We need to convey to the hospital that there is no getting away from this, and it would be a no holds barred action by us, jointly, to ensure they honor what they are committed to, in being an empanelled hospital.
Circular 430 of PCDA
Tuesday, March 16, 2010
New Pension Scales: JCOs, NCOs and Sepoys and equivalents Circular No 430: Improvement in the pension to bridge the gap in pension of Pre 01.01.2006 and Post 01.01.2006 discharged Personnel of Armed Forces.
Gist of the 156 orders vide circular 430 of PCDA is given below courtesy Cdr Balaji of Pension Cell.
Dear Sir
Gist of the 156 orders vide circular 430 of PCDA is given below courtesy Cdr Balaji of Pension Cell.
The orders are too complicated for a layman to comprehend.
Individuals having any questions may write to pension@iesm.org
Brgds
R W Pathak
PCDA CIRCULAR 430
Para 4.1 – Not applicable to Families of PBOR
Para 3 - GOI letter to take effect from 1.7.09 and Fixation / arrears paid in a Time Bound manner say 2-3 months.
Para 4.2 Does not apply to Hony Commissioned Officers
Para 6.1 – PDAs to revise the Pension with out calling for applications and taking down the details from the Original PPO (to ascertain which Group, etc)
Para 6.1 (i) on wards is very important – PDAs to refix Pension of all PBORs w.e.f. 1.1.996 as was fixed in 1997.
Para 6.2 – Existing Pension as on 1.1.96, pre- 10.10.2007 and post 10.10.2007 will be the same (This is as a sequel to the Supreme Court Order given recently as it is an anomaly corrected and has to be from ORIGINAL DATE and some artificial date………as per Judgement) and hence the PDAs have really work on it In my view the addl Pensionery benefits given w.e.f. 10.10.97) – all have to be re-fixed with DRs etc and that is a huge job)
Para 6.4 – Pension can be corrected if there is any discrepancy vis a vis the Tables provided.
Para 7.1 – Qualifying Service – It is shown in PPO from 1988 but for Personnel prior to that they have to produce their discharge certificate (IAFA-369)
Para 7.3 – From 9.10.1997 all those in different Trade were regrouped in X, Y & Z and this has to followed and is effective form 1.1.1996.
Para 8 – Pensioners in receipt of 2 Pensions – Both would be revised as per the Tables below.
Para 8.2 DSC Personnel – Those in receipt of Army Pension and DSC Pension – only Army Pension would be revised and for the DSC Pension to be referred to PCDA.
However, if they are receiving only DSC Pension then their Pension can be revised as per the Tables.
Para 9.1 – Where the Pensioner was alive on 1.7.2009 and died subsequent to this date then the legal heir is entitled to Life Time arrears
Para 10 – No arrears will be applicable prior to 1.7.2009
Para 11.1 Banks to render a Monthly Progress report to PCDA as per Annexure ‘C’
Para 11.3 (Verbatim) A copy of the said Annexure “C” will invariably be provided by the PDA to the Pensioners concerned for their information
NOTE: A copy of PCDA Circular and GOI, MOD letter PC10(1) 2009(D)/(Pen/Pol) dated 8.3.2010 is available on the Web Site www.pcdapension.nic.in
GOI MOD LETTER DATED 8.3.2010
Para 1.1 – All pre-1997 retirees to be brought on par with post 10.10.1997 retirees
Para 1.2 To be fixed notionally at the highest scale of Pay in which retired
Para 1.2.2 – Enhanced weightages to be continued with as per GOM decision(2006)
Para 3.1 Pension Fixation –
Highest scale of Pay in the rank retired applicable from 10.10.1997 corresponding to the fitment tables given in SAI 1/S/2008 +
Minimum of the Pay in Pay Band + 50% of MSP and GP+50% of Highest of Classification Allowance (revised rates effective from 1.9.2008)
Note; Havildars granted Hony rank of Naik Subedar to get additional Pension of Rs.226/-
Para 5.1 – Hony SLT / LT – 50% of the Minimum of Pay Band + 50% of MSP and GP RANKPAY BANDGPMSPPENSION MINIMUM OF PAY BAND + 50% OF GP+MSP
HONY SLT15600-391005400600013500
HONY LT15600-391006100600013850
Para 8 – No arrears will be paid prior to 1.7.2009.
Para 9 – No additional commutation permissible on enhganced Pension.
Para 10 – Will not affect the DCRG already paid. In other words no Additional DCRG in view of enhanced Pension Admissible.
Para 13 – PDAs to fix Pension and Pay arrears with out calling for Applications from the Pensioners.
Para 13.2 – The Pension determined in the Tables is inclusive of Weight age Factor
New Pension Scales: JCOs, NCOs and Sepoys and equivalents Circular No 430: Improvement in the pension to bridge the gap in pension of Pre 01.01.2006 and Post 01.01.2006 discharged Personnel of Armed Forces.
Gist of the 156 orders vide circular 430 of PCDA is given below courtesy Cdr Balaji of Pension Cell.
Dear Sir
Gist of the 156 orders vide circular 430 of PCDA is given below courtesy Cdr Balaji of Pension Cell.
The orders are too complicated for a layman to comprehend.
Individuals having any questions may write to pension@iesm.org
Brgds
R W Pathak
PCDA CIRCULAR 430
Para 4.1 – Not applicable to Families of PBOR
Para 3 - GOI letter to take effect from 1.7.09 and Fixation / arrears paid in a Time Bound manner say 2-3 months.
Para 4.2 Does not apply to Hony Commissioned Officers
Para 6.1 – PDAs to revise the Pension with out calling for applications and taking down the details from the Original PPO (to ascertain which Group, etc)
Para 6.1 (i) on wards is very important – PDAs to refix Pension of all PBORs w.e.f. 1.1.996 as was fixed in 1997.
Para 6.2 – Existing Pension as on 1.1.96, pre- 10.10.2007 and post 10.10.2007 will be the same (This is as a sequel to the Supreme Court Order given recently as it is an anomaly corrected and has to be from ORIGINAL DATE and some artificial date………as per Judgement) and hence the PDAs have really work on it In my view the addl Pensionery benefits given w.e.f. 10.10.97) – all have to be re-fixed with DRs etc and that is a huge job)
Para 6.4 – Pension can be corrected if there is any discrepancy vis a vis the Tables provided.
Para 7.1 – Qualifying Service – It is shown in PPO from 1988 but for Personnel prior to that they have to produce their discharge certificate (IAFA-369)
Para 7.3 – From 9.10.1997 all those in different Trade were regrouped in X, Y & Z and this has to followed and is effective form 1.1.1996.
Para 8 – Pensioners in receipt of 2 Pensions – Both would be revised as per the Tables below.
Para 8.2 DSC Personnel – Those in receipt of Army Pension and DSC Pension – only Army Pension would be revised and for the DSC Pension to be referred to PCDA.
However, if they are receiving only DSC Pension then their Pension can be revised as per the Tables.
Para 9.1 – Where the Pensioner was alive on 1.7.2009 and died subsequent to this date then the legal heir is entitled to Life Time arrears
Para 10 – No arrears will be applicable prior to 1.7.2009
Para 11.1 Banks to render a Monthly Progress report to PCDA as per Annexure ‘C’
Para 11.3 (Verbatim) A copy of the said Annexure “C” will invariably be provided by the PDA to the Pensioners concerned for their information
NOTE: A copy of PCDA Circular and GOI, MOD letter PC10(1) 2009(D)/(Pen/Pol) dated 8.3.2010 is available on the Web Site www.pcdapension.nic.in
GOI MOD LETTER DATED 8.3.2010
Para 1.1 – All pre-1997 retirees to be brought on par with post 10.10.1997 retirees
Para 1.2 To be fixed notionally at the highest scale of Pay in which retired
Para 1.2.2 – Enhanced weightages to be continued with as per GOM decision(2006)
Para 3.1 Pension Fixation –
Highest scale of Pay in the rank retired applicable from 10.10.1997 corresponding to the fitment tables given in SAI 1/S/2008 +
Minimum of the Pay in Pay Band + 50% of MSP and GP+50% of Highest of Classification Allowance (revised rates effective from 1.9.2008)
Note; Havildars granted Hony rank of Naik Subedar to get additional Pension of Rs.226/-
Para 5.1 – Hony SLT / LT – 50% of the Minimum of Pay Band + 50% of MSP and GP RANKPAY BANDGPMSPPENSION MINIMUM OF PAY BAND + 50% OF GP+MSP
HONY SLT15600-391005400600013500
HONY LT15600-391006100600013850
Para 8 – No arrears will be paid prior to 1.7.2009.
Para 9 – No additional commutation permissible on enhganced Pension.
Para 10 – Will not affect the DCRG already paid. In other words no Additional DCRG in view of enhanced Pension Admissible.
Para 13 – PDAs to fix Pension and Pay arrears with out calling for Applications from the Pensioners.
Para 13.2 – The Pension determined in the Tables is inclusive of Weight age Factor
Wednesday, July 8, 2009
PDCA Pensions...Circulars
Pension Website Must for Pensioners..Click me
REGISTERED
MOST IMPORTANT CIRCULAR
OFFICE OF THE PCDA (PENSIONS), DRAUPADI GHAT ALLAHABAD
The Chief Accountant, RBI, Deptt. of Govt. Bank Account Central
C-7 IInd Floor Bandre Kurla Complex, P.B. No. 8143 Bandre East,
All CMDs of Public Sector Banks
CMD of ICICI Bank
CMD of HDFC Bank
Military and Air Attache, Indian Embassy Kathmandu Nepal.
The Defence Pension Disbursing Officers.
The Treasury officers.
The Pay and Accounts Office.
Pay and Accounts Office, Government of Maharashtra, Mumbai.
The Post Master Kathua (J & K), Camp Bell Bay (Andaman &
Implementation of Government’s decision on the recommendations
of the Sixth Central Pay Commission – Revision of Pension of Pre
2006 Armed Forces Pensioners / Family Pensioners.
Reference:-GOI, MOD letter No. No. 17(4)/2008(1)/D(Pen/Policy) dated 11.11.2008 and this Office Circulars No. 397 dated 18.11.2008, 398 dated 18.11.2008 and No. 401 dated 18.12.2008
-----*-----*-----
Annexure – II of the Ministry of Defence letter No. 17(4)/2008(1)/D
(Pen/Policy) dated 11.11.2008 which was modified/substituted vide Ministry of Defence letter No. 17(4)/2008(1)/D (Pen/Policy) dated 11.12.2008 is further substituted by enclosed Annexure II vide MOD letter No. 17(4)/2008(1)/D
(Pen/Policy) dated 20.01.2009(copy enclosed), which is self explanatory.
In Annexure-III, Table - 2 of MOD letter dated 11.11.2008, the rate of
family pension in respect of Nb Subedar Group ’A’/’X’ and Subedar Group ’A’/’X’
Nb Sub Group “A”/”X”
Subedar Group “A”/”X’”
The words and figures “under Para 5.1” as appearing below the Table but
above the Notes of Annexure –I
(Pen/Services) dated 11.11.2008 may be deleted as it has no relevance to Para
5.(Para 5.1.not in existence)
4.
It has come to the notice that some of the PDAs while consolidating the Pension/family pension under Annexure –I to MOD letter dated 11.11.2008 are
not stepping up the pension/family pension vide Annexure –II and Annexure-III
to MOD letter where it is beneficial than the pension under Annexure -I in
respect of the commissioned officers / PBOR. They are resorting only to the
consolidation of pension as per the Annexure –I. Such action on the part of the
PDAs, in particular to Banks, is not in accordance to the Government Orders,
leads to complaints from the Pensioners/ Family Pensioners and has been viewed
seriously by the Government as it is affecting the morale of the Ex Service men.
Detailed instructions in this regard already exist in Para 6 of this office circular
No. 397 dated 18.11.2008.
However, it is once again reiterated that the PDAs may invariably adhere
to the following steps while revising the pension/family pension with effect from
1.1.2006.
(i)
First, determine the basic pension from the records held and consolidate
as per Annexure –I to MOD letter No.17 (4)/2008(1)/D (Pen/services) dated
11.11.2008.
(ii)
Thereafter check the pension so consolidated against the minimum
pension authorised under the protection clause as in Annexure – II in respect of
the commissioned officers and Annexure –III in respect of Personnel Below
Officers Rank with reference to rank last held and qualifying service. The
pension/family pension as per Annexure –II or Annexure-III as the case may be,
if beneficial, is to be paid with effect from 1.1.2006.
5.
Lt General holding appointment of Army Commander and Vice Chief of the
Army Staff in Army and equivalent rank in Navy and Air Force were granted
higher rate of pension on their retirement after 1.3.1978.Pension Payment Order
(PPO) in their respect do/do not indicate the specific appointment they held on
the date of retirement. However, while revising their pension on implementation
of Fifth CPC, the Corrigendum PPO in each case indicate the appointment held by
the Lt General as Army Commander or Vice Chief of Army Staff (VCOAS).PDAs
are therefore, requested to look into their records and revise the pension of
Army Commanders/VCOAS accordingly vide Annexure –I read with Annexure –II
to MOD letter 11.11.2008 as now substituted. Where the PDAs are not able to
locate the Corr PPO revising pension for Army Commander/VCOAS with effect
from 1.1.1996, in their record, the officer may be requested to provide his copy
of PPO(Photocopy may be retained by the Officer) and pension may be revised
and simultaneously the case may be referred to the Pension Sanctioning
authority concerned for confirmation of the revised rate of pension with effect
from 1.1.2006.
6.
In Annexure-I of MOD letter dated 11.11.2008, consolidated rate of
pension for basic pension of above Rs. 13000/- but less than Rs. 15000/- have
not been indicated due to the fixed scale of pension. In cases where existing
pension is more than Rs. 13000/- the same shall be consolidated as per
provision of Para 4 of MOD letter dated 11.11.2008.
2
7.
Further, in some cases the quantum of pension indicated in Annexure –III
to MOD’s letter No.17 (4)/2008(1)/ D (Pen/Policy) dated 11.11.2008 as
circulated vide this office Circular No. 397 dated 18.11.2008 quoted under
reference, in respect of Naik and Havildar having less qualifying service than
their full terms of engagements plus admissible weightage works out to be less
as compared to the one shown for the rank of a Sepoy. This is due to higher
weightage of 10 years admissible to a Sepoy as compared to the rank of Naik
and Havildar, the admissible weightage for whom is comparatively less viz. 8
years and 6 years respectively. Therefore, where even if each of them have
rendered equal number of years of actual qualifying service, the qualifying
service for pension with weightage in the case of Sepoy will be more by 4 years
as compared to Havildar and by 2 years as compared to Naik. The prorata
reduction in the quantum of admissible pension will thus be more in the case of
Havildar by 4 years and 2 years for Naik as compared to the Sepoy even if they
render equal number of actual qualifying service.
It is further clarified that the said Annexure-III is not the ultimate
determinator for the entitlement of pension and in case the revised pension as
per Annexure –I to the MOD’s letter dated 11.11.2008 happens to be more
beneficial than the one indicted in the Annexure -III ibid, more beneficial
pension will be payable. However, in case the pension consolidated as per
Annexure –I read with para 4 of MOD letter dated 11.11.2008 is less than the
amount indicated in Annexure –III, the pension protection as indicated in these
tables will be given. The rate of pension in Annexure –III is protective and not
the entitlement.
8.
Appendix ‘A’ of Circular No. 397 dated 18.11.2008 has been slightly
modified. Now the Pay Bands in respect of PBOR and Commissioned Officers
introduced in 6th CPC with effect from 1.1.2006 are also included in this
Appendix ‘A’ for information. The modified Appendix “A” is enclosed for
information of all concerned.
9.
It is observed that during implementation of Ministry of Defence letter
dated 11.11.2008 (Circular NO 397 dated 18.11.2008), several queries are being
received from various corners.
Therefore,the following further clarifications/instructions are issued for the smooth implementation of Ministry of Defence letter on the subject:-
(i)
As per existing rule, pension of TS Naik/Hony NK and Hony Havildar is
Re 1/- less than pension admissible for NK and Havildar for the same length of
qualifying Service and group of pay in which he was last paid respectively. It is
therefore, clarified that the rate of pension shown in Annexure III (modified
parity of pension) may be reduced by Re 1/- while comparing revised pension for
TS Naik, Hony Naik and Hony Havildar between Annexure –I and Annexure-III –
Table 1.
(ii)
Havildar granted Hony rank of Nb Subedar and retired prior to 1.1.96 are
drawing consolidated pension taking into account the additional pension of
Rs 100/- pm with effect from 1.1.1996 as per MOD letter dated 14.07.1998.The
scheme of improvement in pension of PBOR introduced with effect from 1.1.2006
vide MOD letter No.14 (3)/2004-D(Pen/Sers) –Vol –III dated 1.2.2006 and No.
14(3)/2004-D(Pen/Sers) –Vol V dated 2.5.2006 was not beneficial to Havildar
3
granted honorary rank of Naib Subedar. However, Havildar retired on or after
1.1.96 and granted Hony rank of Naib Subedar and who are in receipt of
additional pension of Rs 100/-pm with pension for Havildar, during revision of
their pension as per orders of Improvement of Pension of PBOR this additional
pension of Rs 100/- is included in RCP shown in table No.6, 18 and 24 of Circular
No.350 dated 19.5.2006. Thus the pension of Havildar granted Hony Nb Sub
whether retired prior to 1.1.96 or on or after 1.1.96, their revised pension as per
orders of Improvement in Pension of PBOR i.e. Circular No.350 may be
consolidated under Annexure –I of MOD letter dated 11.11.2008. Neither further
additional pension of Rs 100/- will be taken for consolidation in such cases nor
will it be paid further in addition to the consolidated as per Annexure I or
stepped up pension where rate of pension is beneficial in Annexure – III.
(iii)
PBOR discharged prior to 1.6.1953 may be equated to PBOR of “Y” group
as there were no groups prior to 01.06.53. Therefore revised pension as in
Annexure –III in respect of those PBOR who retired prior to 01.06.53 may be
treated equivalent to Gp ‘Y’.
(iv)
An Artificer rank of the Navy will be treated in Gp ‘X’ of that rank.
(v)
For the purpose of modified parity as per Annexure – III, Gp ‘V’ in Air
Force and Naval Aviation and Sub Marine Sailors other than those on Gp ‘A’ rate
of pay in Navy, will be treated as Gp ‘Y’ of that rank and service.
(vi) Certain ranks and their abbreviated form as indicated in the PPOs are
given in this office Circular No. 362 dated 01.02.2007.The alternative names as
well as connected abbreviation are given below:-
Rank Also Known As
Sepoy Craftsman(Cfn),Rifleman(Rfn),Sapper(Spr),Guardsman
(Gdsm),Signalman, Para Trooper (PTR), Recruit
(Rect),Gunner(GNR),Pioneer (PNR), Sowar (SWR),
Grenadier(GDR) etc Lance Naiks are also Sepoy.
Naik Lance Dafadar or NK or L/Dafadar
Havildar Dafadar, Hav, Dfr
Nb Subedar Jamadar
Subedar Risaldar
Subedar Major Risaldar Major
(vii) In cases where Armed Forces Officers/Personnel Below Officer Rank died
in service or retired and died later after 1.1.1999, in their case Ordinary Family
Pension at enhanced rate is payable to the family member. In such cases
enhanced rate of Ordinary Family Pension is to be consolidated under Annexure
–I only and be payable upto the period notified in the PPO.
4
10.
All the Pension Disbursing Authorities are requested to intimate the
progress of consolidation/Revision of Pension/Family Pension as on 31.01.2009
in the enclosed proforma as Appendix “B”. In the case of Banks, the Paying
Branches of Bank shall render the progress report through their Link Branch /
Zonal Office (LHO in case of SBI). The Link Branches will consolidate the report
for the Paying Branches under their jurisdiction and Zonal Offices will consolidate
the progress report for the Link Branches under their control and submit the
report to the Shri D C Hansda, IDAS, Dy. CDA (P), Group Officer Audit
Section, Office of the PCDA (P), Draupadi Ghat, Allahabad by
28.02.2009.Thereafter, progressive monthly report may please be
rendered by the end of the month to the nominated officer indicated
above.
11. This circular has been uploaded on PCDA (P) website
www.pcdapension.nic.in for disseminated across the defence pensioners
and PDAs.
No. Grants/Tech/0165-VIII
(S R MEENA)
Dated: 02.02.2009
Jt. C.D.A. (P)
Copy to :-
1.
Director General Re- Settlement
2.
All Record Offices/Regiment. Corp.
3.
Bureau of Sailors, Cheetah Camp, Mumbai.
4.
Air Force Record, Dhaula Kunwa, Delhi Cantt.
5.
Rajya Sainik Welfare and Re settlement Boards
6.
Ex Servicemen league.
7.
All Defence Pensioners Associations.
As the pensioners/family pensioners might not be aware about the precise reasons
leading to the stated variation in the quantum of pension as shown in Annexure –III in the case of Naik and Havildar vis a vis Sepoy. It is requested that the position as brought out in Para 7 above may be suitably explained to the Naik/Havildar pensioners. It may be clarified to them that the said Annexure – III is not the ultimate determinator for the entitlement of pension and in case the revised pension as per Annexure –I to MOD letter dated 11.11.2008
happens to be more beneficial than the one indicated in Annexure –III ibid, more beneficial pension will be payable.
2.
Consequent upon the implementation of recommendations of Sixth CPC, the
enhanced rate of ordinary family pension shall now be payable for a period of ten years, without any upper age limit from the date following the date of death of the personnel, to the family of a personnel who dies in service. These provisions will, however, not apply in cases where the period of seven years for payment of enhanced family pension has already been completed as on 01.01.2006 and the family was in receipt of normal rate of ordinary family pension on that date. There will be no change in the period for payment of enhanced family pension to the family in the case of death of a pensioner i.e. 7 years from the date of
5
death or till attaining the age 67 years whichever is earlier. Where, however family pensioner
was in receipt of Enhanced rate of Ordinary Family pension on or after 01.01.2006
consequent upon death of Armed Forces Personnel in service he/ she may be advised to
contact his/ her Record Office in the case of a PBOR and CDA (O) in the case of officers to
refer his/her case for enhancement of period of payment by 3 years through a Corrigendum
PPO to his/her Pension Disbursing Authority.
8
The Dy. Secretary, Govt. of India, Ministry of PPG & P (Deptt. of P & PW), Lok Nayak
Bhawan, New Delhi.
9 Director (Pensions), Govt. of India, Ministry of Defence D(Pen/Sers), Sena Bhawan,
Wing ‘A’ New Delhi.
10. Army HQrs AG’s Branch, PS-4(b) DHQ, PO New Delhi – 110011.
11. AHQ GS Branch, TA Directorate, DHQ PO New Delhi – 110011.
12. Naval HQrs, PP & A, DHQ PO New Delhi.
13. DPA, Vayu Bhawan, New Delhi – 11.
14. Air HQrs Ad PP & P – 3, West Block-VI, R. K. Puram, New Delhi – 110066.
15. Shri A. K. JENA, IDAS, Dy. CGDA(AT-II), O/O the CGDA, West Block-V, R. K.
Puram, New Delhi – 110066.
16. PCDA(Navy) No.-1, Cooperage Road, Mumbai – 400039.
17. CDA(AF), West Block-V, R. K. Puram, New Delhi – 110066.
18. JCDA(AG) Subroto Park, New Delhi – 110010.
19. Director of Audit, Defence Service, New Delhi
20. All Addl CsDA/Jt. CsDA in Main Office.
21. All GOs in Main Office.
22. The OI/C, G-1(M), AT(ORs)-Tech. & G-1/Civil (Tech.)
23. All SAOs/AOs/AAOs/SOs(A) in Gts/Ors Complex.
24. The OI/C, EDP Manual.
25. The OI/C, EDP Centre.
26. Defence Pension Liaison Cell.
27. All Sections in Main Office.
28. Spare copies in file No. Gts/Tech/0148, 148, 0162 & 0158
29. OIC,G -2 Section
30. OI/C, G - 3 Section.
31. OI/C, G - 4 Section.
32. OI/C Grants Revision Cell
33. OI/C O & M Cell
34. OI/C Complaint Cell
35. The OI/C, Reception Centre
36. The OI/C, EDP Centre (Website)
37. The OI/C, DPTI
38. Spare
(S R MEENA)
Jt. C.D.A. (P)
6
No. 17(4)/2008(1)/D (Pen/Policy)
Government of India
Ministry of Defence
Department of Ex-Servicemen Welfare
New Delhi, Dated: 20th January, 2009.
The Chief of the Army Staff
The Chief of the Naval Staff
The Chief of the Air Staff
IMPLEMENTATION OF THE GOVERNMENT DECISION ON THE
RECOMMENDATIONS
OF
THE
SIXTH
COMMISSION – REVISION OF PENSION OF PRE-1.1.2006 ARMED
FORCES PENSIONERS/FAMILY PENSIONERS.
The undersigned is directed to refer to Annexure-II to this Ministry’s letter No.
17(4)/2008(1)/D (Pen/Policy) dated 11.11.2008 as amended vide this Ministry’s letter
of even number dated 11.12.2008 on the above subject matter and to state that in
the said Annexure-II, pension and family pension in respect of Colonel & Brigadier is
higher than that of Major Generals and Lt. Generals due to non inclusion of the
element of Military Service Pay (MSP) in the case of Maj. Generals and Lt. Generals.
This anomaly has been reviewed and it has been decided that keeping in view the
fact that Colonel/Brigadier have been placed in PB-4 and MSP of Rs. 6,000/- is
reckoned in their case for the purpose of stepping up of the pension/family pension,
the pension of Maj. Generals/Lt. Generals may also be regulated under Para 5 of the
Ministry’s above quoted letter dated 11.11.2008 so as to ensure that consolidated
pension is not lower than 50% of the minimum of the PB-4 (Rs. 37,400/-) plus grade
pay of Rs. 10,000/- plus notional MSP of Rs. 6,000/- in the case of Maj. Generals &
equivalent and not lower than 50% of the minimum of PB-4 (Rs. 37,400/-) plus grade
pay of Rs. 12,000/- plus notional MSP of Rs. 6,000/- in the case of Lt. Generals &
equivalent, where the pensioners have full qualifying service including weightage.
Hence, for the purpose of stepping up, the pension of Pre-1.1.2006 retirees with
qualifying service of 33 years will be Rs. 26,700/- in the case of Maj. Generals &
equivalent and Rs. 27,700/- in the case of Lt. Generals & equivalent. Pension to
those Commissioned officers retired with qualifying service including weightage of
less than 33 years, will continue to be proportionate to the full pension based on their actual qualifying service with weightage.
2.
The stepped up family pension would also accordingly be Rs. 16,020/- for
families of Maj. Generals & equivalent and Rs. 16,620/- for families of Lt. Generals & equivalent.
3.
A revised table to the above effect is enclosed as Annexure-II to this letter in
substitution of the Annexure-II (Revised)) to this Ministry’s above quoted letter dated 11.12.2008.
4.
The following amendment in Annexure-III, Table-2 : Family Pension, is also
made-
“The rate of Family Pension in respect of Nb Subedar “A”/”X” and Subedar
“A”/”X” may be amended to read as “5070” and “5190” for 5570 and 5490
respectively”.
5. All other entries remain unchanged.
6. This issues with the concurrence of the Finance Division of this Ministry vide
their UO No. 157/DFA(P) dated 20.1.2009.
7.Hindi version will follow.
Copy to:
As per standard distribution list.
Pension Website Must for Pensioners..Click me
REGISTERED
MOST IMPORTANT CIRCULAR
OFFICE OF THE PCDA (PENSIONS), DRAUPADI GHAT ALLAHABAD
The Chief Accountant, RBI, Deptt. of Govt. Bank Account Central
C-7 IInd Floor Bandre Kurla Complex, P.B. No. 8143 Bandre East,
All CMDs of Public Sector Banks
CMD of ICICI Bank
CMD of HDFC Bank
Military and Air Attache, Indian Embassy Kathmandu Nepal.
The Defence Pension Disbursing Officers.
The Treasury officers.
The Pay and Accounts Office.
Pay and Accounts Office, Government of Maharashtra, Mumbai.
The Post Master Kathua (J & K), Camp Bell Bay (Andaman &
Implementation of Government’s decision on the recommendations
of the Sixth Central Pay Commission – Revision of Pension of Pre
2006 Armed Forces Pensioners / Family Pensioners.
Reference:-GOI, MOD letter No. No. 17(4)/2008(1)/D(Pen/Policy) dated 11.11.2008 and this Office Circulars No. 397 dated 18.11.2008, 398 dated 18.11.2008 and No. 401 dated 18.12.2008
-----*-----*-----
Annexure – II of the Ministry of Defence letter No. 17(4)/2008(1)/D
(Pen/Policy) dated 11.11.2008 which was modified/substituted vide Ministry of Defence letter No. 17(4)/2008(1)/D (Pen/Policy) dated 11.12.2008 is further substituted by enclosed Annexure II vide MOD letter No. 17(4)/2008(1)/D
(Pen/Policy) dated 20.01.2009(copy enclosed), which is self explanatory.
In Annexure-III, Table - 2 of MOD letter dated 11.11.2008, the rate of
family pension in respect of Nb Subedar Group ’A’/’X’ and Subedar Group ’A’/’X’
Nb Sub Group “A”/”X”
Subedar Group “A”/”X’”
The words and figures “under Para 5.1” as appearing below the Table but
above the Notes of Annexure –I
(Pen/Services) dated 11.11.2008 may be deleted as it has no relevance to Para
5.(Para 5.1.not in existence)
4.
It has come to the notice that some of the PDAs while consolidating the Pension/family pension under Annexure –I to MOD letter dated 11.11.2008 are
not stepping up the pension/family pension vide Annexure –II and Annexure-III
to MOD letter where it is beneficial than the pension under Annexure -I in
respect of the commissioned officers / PBOR. They are resorting only to the
consolidation of pension as per the Annexure –I. Such action on the part of the
PDAs, in particular to Banks, is not in accordance to the Government Orders,
leads to complaints from the Pensioners/ Family Pensioners and has been viewed
seriously by the Government as it is affecting the morale of the Ex Service men.
Detailed instructions in this regard already exist in Para 6 of this office circular
No. 397 dated 18.11.2008.
However, it is once again reiterated that the PDAs may invariably adhere
to the following steps while revising the pension/family pension with effect from
1.1.2006.
(i)
First, determine the basic pension from the records held and consolidate
as per Annexure –I to MOD letter No.17 (4)/2008(1)/D (Pen/services) dated
11.11.2008.
(ii)
Thereafter check the pension so consolidated against the minimum
pension authorised under the protection clause as in Annexure – II in respect of
the commissioned officers and Annexure –III in respect of Personnel Below
Officers Rank with reference to rank last held and qualifying service. The
pension/family pension as per Annexure –II or Annexure-III as the case may be,
if beneficial, is to be paid with effect from 1.1.2006.
5.
Lt General holding appointment of Army Commander and Vice Chief of the
Army Staff in Army and equivalent rank in Navy and Air Force were granted
higher rate of pension on their retirement after 1.3.1978.Pension Payment Order
(PPO) in their respect do/do not indicate the specific appointment they held on
the date of retirement. However, while revising their pension on implementation
of Fifth CPC, the Corrigendum PPO in each case indicate the appointment held by
the Lt General as Army Commander or Vice Chief of Army Staff (VCOAS).PDAs
are therefore, requested to look into their records and revise the pension of
Army Commanders/VCOAS accordingly vide Annexure –I read with Annexure –II
to MOD letter 11.11.2008 as now substituted. Where the PDAs are not able to
locate the Corr PPO revising pension for Army Commander/VCOAS with effect
from 1.1.1996, in their record, the officer may be requested to provide his copy
of PPO(Photocopy may be retained by the Officer) and pension may be revised
and simultaneously the case may be referred to the Pension Sanctioning
authority concerned for confirmation of the revised rate of pension with effect
from 1.1.2006.
6.
In Annexure-I of MOD letter dated 11.11.2008, consolidated rate of
pension for basic pension of above Rs. 13000/- but less than Rs. 15000/- have
not been indicated due to the fixed scale of pension. In cases where existing
pension is more than Rs. 13000/- the same shall be consolidated as per
provision of Para 4 of MOD letter dated 11.11.2008.
2
7.
Further, in some cases the quantum of pension indicated in Annexure –III
to MOD’s letter No.17 (4)/2008(1)/ D (Pen/Policy) dated 11.11.2008 as
circulated vide this office Circular No. 397 dated 18.11.2008 quoted under
reference, in respect of Naik and Havildar having less qualifying service than
their full terms of engagements plus admissible weightage works out to be less
as compared to the one shown for the rank of a Sepoy. This is due to higher
weightage of 10 years admissible to a Sepoy as compared to the rank of Naik
and Havildar, the admissible weightage for whom is comparatively less viz. 8
years and 6 years respectively. Therefore, where even if each of them have
rendered equal number of years of actual qualifying service, the qualifying
service for pension with weightage in the case of Sepoy will be more by 4 years
as compared to Havildar and by 2 years as compared to Naik. The prorata
reduction in the quantum of admissible pension will thus be more in the case of
Havildar by 4 years and 2 years for Naik as compared to the Sepoy even if they
render equal number of actual qualifying service.
It is further clarified that the said Annexure-III is not the ultimate
determinator for the entitlement of pension and in case the revised pension as
per Annexure –I to the MOD’s letter dated 11.11.2008 happens to be more
beneficial than the one indicted in the Annexure -III ibid, more beneficial
pension will be payable. However, in case the pension consolidated as per
Annexure –I read with para 4 of MOD letter dated 11.11.2008 is less than the
amount indicated in Annexure –III, the pension protection as indicated in these
tables will be given. The rate of pension in Annexure –III is protective and not
the entitlement.
8.
Appendix ‘A’ of Circular No. 397 dated 18.11.2008 has been slightly
modified. Now the Pay Bands in respect of PBOR and Commissioned Officers
introduced in 6th CPC with effect from 1.1.2006 are also included in this
Appendix ‘A’ for information. The modified Appendix “A” is enclosed for
information of all concerned.
9.
It is observed that during implementation of Ministry of Defence letter
dated 11.11.2008 (Circular NO 397 dated 18.11.2008), several queries are being
received from various corners.
Therefore,the following further clarifications/instructions are issued for the smooth implementation of Ministry of Defence letter on the subject:-
(i)
As per existing rule, pension of TS Naik/Hony NK and Hony Havildar is
Re 1/- less than pension admissible for NK and Havildar for the same length of
qualifying Service and group of pay in which he was last paid respectively. It is
therefore, clarified that the rate of pension shown in Annexure III (modified
parity of pension) may be reduced by Re 1/- while comparing revised pension for
TS Naik, Hony Naik and Hony Havildar between Annexure –I and Annexure-III –
Table 1.
(ii)
Havildar granted Hony rank of Nb Subedar and retired prior to 1.1.96 are
drawing consolidated pension taking into account the additional pension of
Rs 100/- pm with effect from 1.1.1996 as per MOD letter dated 14.07.1998.The
scheme of improvement in pension of PBOR introduced with effect from 1.1.2006
vide MOD letter No.14 (3)/2004-D(Pen/Sers) –Vol –III dated 1.2.2006 and No.
14(3)/2004-D(Pen/Sers) –Vol V dated 2.5.2006 was not beneficial to Havildar
3
granted honorary rank of Naib Subedar. However, Havildar retired on or after
1.1.96 and granted Hony rank of Naib Subedar and who are in receipt of
additional pension of Rs 100/-pm with pension for Havildar, during revision of
their pension as per orders of Improvement of Pension of PBOR this additional
pension of Rs 100/- is included in RCP shown in table No.6, 18 and 24 of Circular
No.350 dated 19.5.2006. Thus the pension of Havildar granted Hony Nb Sub
whether retired prior to 1.1.96 or on or after 1.1.96, their revised pension as per
orders of Improvement in Pension of PBOR i.e. Circular No.350 may be
consolidated under Annexure –I of MOD letter dated 11.11.2008. Neither further
additional pension of Rs 100/- will be taken for consolidation in such cases nor
will it be paid further in addition to the consolidated as per Annexure I or
stepped up pension where rate of pension is beneficial in Annexure – III.
(iii)
PBOR discharged prior to 1.6.1953 may be equated to PBOR of “Y” group
as there were no groups prior to 01.06.53. Therefore revised pension as in
Annexure –III in respect of those PBOR who retired prior to 01.06.53 may be
treated equivalent to Gp ‘Y’.
(iv)
An Artificer rank of the Navy will be treated in Gp ‘X’ of that rank.
(v)
For the purpose of modified parity as per Annexure – III, Gp ‘V’ in Air
Force and Naval Aviation and Sub Marine Sailors other than those on Gp ‘A’ rate
of pay in Navy, will be treated as Gp ‘Y’ of that rank and service.
(vi) Certain ranks and their abbreviated form as indicated in the PPOs are
given in this office Circular No. 362 dated 01.02.2007.The alternative names as
well as connected abbreviation are given below:-
Rank Also Known As
Sepoy Craftsman(Cfn),Rifleman(Rfn),Sapper(Spr),Guardsman
(Gdsm),Signalman, Para Trooper (PTR), Recruit
(Rect),Gunner(GNR),Pioneer (PNR), Sowar (SWR),
Grenadier(GDR) etc Lance Naiks are also Sepoy.
Naik Lance Dafadar or NK or L/Dafadar
Havildar Dafadar, Hav, Dfr
Nb Subedar Jamadar
Subedar Risaldar
Subedar Major Risaldar Major
(vii) In cases where Armed Forces Officers/Personnel Below Officer Rank died
in service or retired and died later after 1.1.1999, in their case Ordinary Family
Pension at enhanced rate is payable to the family member. In such cases
enhanced rate of Ordinary Family Pension is to be consolidated under Annexure
–I only and be payable upto the period notified in the PPO.
4
10.
All the Pension Disbursing Authorities are requested to intimate the
progress of consolidation/Revision of Pension/Family Pension as on 31.01.2009
in the enclosed proforma as Appendix “B”. In the case of Banks, the Paying
Branches of Bank shall render the progress report through their Link Branch /
Zonal Office (LHO in case of SBI). The Link Branches will consolidate the report
for the Paying Branches under their jurisdiction and Zonal Offices will consolidate
the progress report for the Link Branches under their control and submit the
report to the Shri D C Hansda, IDAS, Dy. CDA (P), Group Officer Audit
Section, Office of the PCDA (P), Draupadi Ghat, Allahabad by
28.02.2009.Thereafter, progressive monthly report may please be
rendered by the end of the month to the nominated officer indicated
above.
11. This circular has been uploaded on PCDA (P) website
www.pcdapension.nic.in for disseminated across the defence pensioners
and PDAs.
No. Grants/Tech/0165-VIII
(S R MEENA)
Dated: 02.02.2009
Jt. C.D.A. (P)
Copy to :-
1.
Director General Re- Settlement
2.
All Record Offices/Regiment. Corp.
3.
Bureau of Sailors, Cheetah Camp, Mumbai.
4.
Air Force Record, Dhaula Kunwa, Delhi Cantt.
5.
Rajya Sainik Welfare and Re settlement Boards
6.
Ex Servicemen league.
7.
All Defence Pensioners Associations.
As the pensioners/family pensioners might not be aware about the precise reasons
leading to the stated variation in the quantum of pension as shown in Annexure –III in the case of Naik and Havildar vis a vis Sepoy. It is requested that the position as brought out in Para 7 above may be suitably explained to the Naik/Havildar pensioners. It may be clarified to them that the said Annexure – III is not the ultimate determinator for the entitlement of pension and in case the revised pension as per Annexure –I to MOD letter dated 11.11.2008
happens to be more beneficial than the one indicated in Annexure –III ibid, more beneficial pension will be payable.
2.
Consequent upon the implementation of recommendations of Sixth CPC, the
enhanced rate of ordinary family pension shall now be payable for a period of ten years, without any upper age limit from the date following the date of death of the personnel, to the family of a personnel who dies in service. These provisions will, however, not apply in cases where the period of seven years for payment of enhanced family pension has already been completed as on 01.01.2006 and the family was in receipt of normal rate of ordinary family pension on that date. There will be no change in the period for payment of enhanced family pension to the family in the case of death of a pensioner i.e. 7 years from the date of
5
death or till attaining the age 67 years whichever is earlier. Where, however family pensioner
was in receipt of Enhanced rate of Ordinary Family pension on or after 01.01.2006
consequent upon death of Armed Forces Personnel in service he/ she may be advised to
contact his/ her Record Office in the case of a PBOR and CDA (O) in the case of officers to
refer his/her case for enhancement of period of payment by 3 years through a Corrigendum
PPO to his/her Pension Disbursing Authority.
8
The Dy. Secretary, Govt. of India, Ministry of PPG & P (Deptt. of P & PW), Lok Nayak
Bhawan, New Delhi.
9 Director (Pensions), Govt. of India, Ministry of Defence D(Pen/Sers), Sena Bhawan,
Wing ‘A’ New Delhi.
10. Army HQrs AG’s Branch, PS-4(b) DHQ, PO New Delhi – 110011.
11. AHQ GS Branch, TA Directorate, DHQ PO New Delhi – 110011.
12. Naval HQrs, PP & A, DHQ PO New Delhi.
13. DPA, Vayu Bhawan, New Delhi – 11.
14. Air HQrs Ad PP & P – 3, West Block-VI, R. K. Puram, New Delhi – 110066.
15. Shri A. K. JENA, IDAS, Dy. CGDA(AT-II), O/O the CGDA, West Block-V, R. K.
Puram, New Delhi – 110066.
16. PCDA(Navy) No.-1, Cooperage Road, Mumbai – 400039.
17. CDA(AF), West Block-V, R. K. Puram, New Delhi – 110066.
18. JCDA(AG) Subroto Park, New Delhi – 110010.
19. Director of Audit, Defence Service, New Delhi
20. All Addl CsDA/Jt. CsDA in Main Office.
21. All GOs in Main Office.
22. The OI/C, G-1(M), AT(ORs)-Tech. & G-1/Civil (Tech.)
23. All SAOs/AOs/AAOs/SOs(A) in Gts/Ors Complex.
24. The OI/C, EDP Manual.
25. The OI/C, EDP Centre.
26. Defence Pension Liaison Cell.
27. All Sections in Main Office.
28. Spare copies in file No. Gts/Tech/0148, 148, 0162 & 0158
29. OIC,G -2 Section
30. OI/C, G - 3 Section.
31. OI/C, G - 4 Section.
32. OI/C Grants Revision Cell
33. OI/C O & M Cell
34. OI/C Complaint Cell
35. The OI/C, Reception Centre
36. The OI/C, EDP Centre (Website)
37. The OI/C, DPTI
38. Spare
(S R MEENA)
Jt. C.D.A. (P)
6
No. 17(4)/2008(1)/D (Pen/Policy)
Government of India
Ministry of Defence
Department of Ex-Servicemen Welfare
New Delhi, Dated: 20th January, 2009.
The Chief of the Army Staff
The Chief of the Naval Staff
The Chief of the Air Staff
IMPLEMENTATION OF THE GOVERNMENT DECISION ON THE
RECOMMENDATIONS
OF
THE
SIXTH
COMMISSION – REVISION OF PENSION OF PRE-1.1.2006 ARMED
FORCES PENSIONERS/FAMILY PENSIONERS.
The undersigned is directed to refer to Annexure-II to this Ministry’s letter No.
17(4)/2008(1)/D (Pen/Policy) dated 11.11.2008 as amended vide this Ministry’s letter
of even number dated 11.12.2008 on the above subject matter and to state that in
the said Annexure-II, pension and family pension in respect of Colonel & Brigadier is
higher than that of Major Generals and Lt. Generals due to non inclusion of the
element of Military Service Pay (MSP) in the case of Maj. Generals and Lt. Generals.
This anomaly has been reviewed and it has been decided that keeping in view the
fact that Colonel/Brigadier have been placed in PB-4 and MSP of Rs. 6,000/- is
reckoned in their case for the purpose of stepping up of the pension/family pension,
the pension of Maj. Generals/Lt. Generals may also be regulated under Para 5 of the
Ministry’s above quoted letter dated 11.11.2008 so as to ensure that consolidated
pension is not lower than 50% of the minimum of the PB-4 (Rs. 37,400/-) plus grade
pay of Rs. 10,000/- plus notional MSP of Rs. 6,000/- in the case of Maj. Generals &
equivalent and not lower than 50% of the minimum of PB-4 (Rs. 37,400/-) plus grade
pay of Rs. 12,000/- plus notional MSP of Rs. 6,000/- in the case of Lt. Generals &
equivalent, where the pensioners have full qualifying service including weightage.
Hence, for the purpose of stepping up, the pension of Pre-1.1.2006 retirees with
qualifying service of 33 years will be Rs. 26,700/- in the case of Maj. Generals &
equivalent and Rs. 27,700/- in the case of Lt. Generals & equivalent. Pension to
those Commissioned officers retired with qualifying service including weightage of
less than 33 years, will continue to be proportionate to the full pension based on their actual qualifying service with weightage.
2.
The stepped up family pension would also accordingly be Rs. 16,020/- for
families of Maj. Generals & equivalent and Rs. 16,620/- for families of Lt. Generals & equivalent.
3.
A revised table to the above effect is enclosed as Annexure-II to this letter in
substitution of the Annexure-II (Revised)) to this Ministry’s above quoted letter dated 11.12.2008.
4.
The following amendment in Annexure-III, Table-2 : Family Pension, is also
made-
“The rate of Family Pension in respect of Nb Subedar “A”/”X” and Subedar
“A”/”X” may be amended to read as “5070” and “5190” for 5570 and 5490
respectively”.
5. All other entries remain unchanged.
6. This issues with the concurrence of the Finance Division of this Ministry vide
their UO No. 157/DFA(P) dated 20.1.2009.
7.Hindi version will follow.
Copy to:
As per standard distribution list.
Pension Website Must for Pensioners..Click me
Subscribe to:
Posts (Atom)