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Monday, 27 February 2017

SUPPLY OF MEDICINES FROM ECHS POLYCLINICS

Indian Military Veterans

TSEWA/ECHS/1                                                   26 Feb 2017

To:
The Union Minister of Defence
Ministry of Defence, Govt of India
South Block
New Delhi -110011

Respected RakshaMantriji,

     We the Ex-Servicemen Community are grateful to you for Ex-Servicemen Contributory Health Scheme (ECHS) which has given us world class medicare to 52 lakh Ex-Servicemen and their family members. We are aware ECHS being a new scheme, there are bound to be some teething problems. Over period of the last 14 years many improvements have taken place in ECHS. Few problems and suggestions to improve the ECHS is given in the following paragraphs for your kind consideration and issue of suitable instructions.

Lack of Medicines. With introduction of IFA system, the availability of medicines have become major problem in ECHS Polyclinics and Military Hospitals (MH).MH Secunderabad, Golconda  and ECHS Polyclinics in Secunderabad, Golconda & Bowenpally do not have adequate quantities of medicines. The situation has come to such a sorry pass that lowly paid pensioners of the ranks of Sepoy, Naik and Havildar and their widows are spending Rs 2,000 to 3,000 every month to purchase medicines.The ECHS is a cashless medical treatment facility given to Ex-Servicemen and widows of Ex-Servicemen. The IFA especially in Secunderabad do not accord financial concurrence to the local purchase of medicines and rejects these demands on flimsy grounds. This is causing lot of heartburn amongst the ESM community not only in Secunderabad but rest of the country. The supply of medicines through reputed pharma companies need to be introduced without any delay.

IFA System. This IFA system needs to be thoroughly reorganised as they have usurped powers of Competent Financial Authority on the specious plea of financial prudence. IFAs question justification of a requirement which is not in their purview. They are to ensure correct method of purchases has been adopted in local purchase of medicines not supplied by Armed Forces Medical Stores Depots and see that no loss to the state occurs due to adoption of incorrect methods of procurement of medicines at extravagant prices. IFA Secunderabad questions the medical competence of specialist and super specialist doctors as to how a particular medicine is prescribed without an iota of medical knowledge. This can be called Accountant Terrorism. IFAs are only financial advisors who should not be permitted to question justification of procurement of medicines. They charter of duties be limited to check the method of procurement and not the need of procurement of medicines. Many Corporate hospitals are refusing to admit ECHS members as IFAs are not clearing their bills. Financial prudence should not result in loss of precious lives because lack of medicines. Because of stubborn attitude of IFAs who exercise powers without any semblance of responsibility, it is your ministry which is getting a bad name.

Military Hospitals (MH). ECHS came about as MHs are unable to provide medicare to ever increasing number of Ex-Servicemen and family pensioners due to their limited manpower. If ECHS is also brought under MHs, then the staff strength of MHs to take on extra load needs to ensured.

On Call Facility to MHs. Due to excessive load, MHs are unable to look after even serving soldiers. Like in Corporate hospitals, there is a need to permit Commandants MHs to have specialists on call like in Corporate hospitals at reasonable remuneration.

ECHS Hospitals. Corporate hospitals carry out unnecessary diagnostic tests and retain patients for longer duration than required. The bills at times are inflated with needless medical procedures. The answer is construction of ECHS hospitals in phased manner wherever land is available in the premises of MHs. Even then we need the Corporate hospitals as some medical procedures such renal, knee replacement, cardiac and brain related diseases are not cost effective if carried out in ECHS hospitals due to very few patients.

Time for Getting Referral of Patients Admitted in Empanelled Hospitals. The existing provision of getting referral from OiC ECHS Polyclinic of those patients admitted in empanelled hospitals in emergency condition within 48 hrs is found to be too less. Many veterans have children settled abroad and the spouse finds it difficult to get the referral within 48 hours. Empanelled hospitals insist on an attender to be present with the patient all the time and the spouse cannot leave the patient. The spouse finds it difficult to get someone to run around to get referral papers cleared by OiC ECHS Polyclinic, Specialists of MH and Commandant of MH in 48 hrs.The time limit therefore be enhanced to 96 hrs.

Post Audit of Bills. All bills of ECHS be made post audit so that IFA does not stop functioning of ECHS.

Sir, if these problems are looked into and suitable improvements are instituted 25 lakh ESMs and family pensioners will ever be grateful to you and your ministry.
Profound regards,
                                                                         
                                                       Yours Faithfully,
                                                       (Brig CS Vidyasagar, Retd)
                                                       President, T SEWA

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