Archaic CGHS (Central Govt.Health Scheme)should beurgently made senior citizen friendly.
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(a)Back-ground:-All Govt. Officers including the present serving Additional Health Secretary & all the Staff/Doctors posted in the CGHS Establishment including the politicians & judiciary anyhow have to retire from active government service & have to tolerate the same red-tapist hell called CGHS. Then it is not understood why despite avowed aim of Government to make citizens lives better with proper health-care etc., why these Officers presently holding the charge of CGHS do not strive it to make a better system comparable to similar public health systems in Australia/USA/Canada or in South American countries where the Govt. health system is on par with private health services, unlike India? Of course, with their purely personal influence, they may get things done quickly, but what about the fate of lakhs of retired central govt. staff who must have served in various positions for over 20-30 years?
MISTRUST ON OWN GOVT.STAFF:-Solely with an eye on MIS-USE & MISTRUST& perceiving collusive Corruption/malpractices by the CGHS beneficiaries or CGHS Staff, an elaborate re-tapist system of checks & vigilance has been devised, right from consultation to final treatment of CGHS beneficiaries- who are nothing but ex-or present Govt.staff & reputed present or ex-judiciary & publicly served ex-or present Members of Parliament & exemplary freedom fighters etc. How can this country run purely on the basis of mis-trust of such vast workforce presently serving or served earlier? merely because those presently in power at designated positions, cannot control private players in the field?
(b) CGHS Beneficiaries:- Lakhs of Central Government staff serving & retired, freedom fighters, members of parliament both present and ex-members, Both present & past Hon'ble Judges of Supreme Court/High Court, Ex-governors/Vice Presidents, apart from employees of autonomous bodies covered under CGHS Delhi constitute CGHS beneficiaries covering the entire length & breadth of India.
(c) CGHS as actually administered in field level:-But this CGHS scheme is the most badly administered with huge bureaucratic red tape involved in just getting OPD referral or getting medicines or being treated as in-patient on cashless basis. Here most of the Doctors selected & posted over a period of time perform mere Clerical duties rather than intellectually applying their knowledge on identifying and treating the CGHS beneficiaries especially the old & senior citizen patients. It may be because their expertise and higher qualifications acquired after joining the health service are not recognised by the Government with non-delegation of commensurate powers of referral/treatment/diagnosis, even some of the best Doctors want to.
(d) Defective referral system:- Entire system of referral involves making merry-go-round trips to CGHS & empanelled private Hospitals/diagnostic centres, even when the condition of senior citizens/freedom fighters is not such that they come all the way in the hope of getting cashless treatment/medicines from knowledgeable Doctors, but face enormous problems, by being routinely turned away by lower non-medical staff or even by attending Doctors on lame excuses of time being over or medicines unavailable or requisite diagnostic equipment non-working or they feel that the patient's problems are age-related and does not need any referral/diagnosis/treatment except as a way of white-washing. Many such cases I have personally seen at the stench coming ill maintained several CGHS dispensaries at Hyderabad, where even the 90 year old freedom fighter coming from over 70-80 kms by bus/train has to go back due to their being late/concerned Dr.not available/or some or all medicines not available(to come again to collect later)- or the time for taking medicines of low value is over(hence better to purchase from outside & hence discouraged not to file reimbursement bills).
(e) Patently wrong OPD referral system:- Even for OPD referrals, despite the patient telling he has a problem & wants to be referred to a specialist empanelled hospital, the attending low qualified Dr. tries to apply his uncalled for knowledge & bluntly misbehave with very senior citizen patients not to hallucinate with non-existent health problem as they perceive it. When confronted, the attending Drs. lament that they have not been given adequate powers, or have perennial shortage of staff, or equipment/diagnostics are not working & hence patients need to get themselves privately tested elsewhere.
(f) Stinking & ill equipped over-burdened State Govt.Hospitals/health facilities:-Or else the patients are forced to follow the long procedure of referral from specialist State/Central Govt. Hospitals(like AIIMS), who however, despite request either do not refer the patients to CGHS empanelled diagnostic/Hospitals on the specious excuse that they have the non-functional though dilapidated stinking facilities which have to be first tried even on the dying old aged patient (even though due to heavy public rush in the State Govt.hospitals, for simple pathological/endoscopic diagnosis etc. far off dates of over a month are given to undertake the tests).
(g) In such circumstances, the CGHS beneficiary is left helpless as I have many times was subjected to, despite paying a huge one month salary towards corpus of CGHS & many pay from year to year. Compare the stinking CGHS dispensaries(often hired premises having dirty toilets)/specialised CGHS hospitals(at Chennai/Delhi & some other places) with private empanelled hospitals with the world class treatment & facilities available therein. Possibly the CGHS Doctors openly envy & compare themselves with Drs./specialists of Private Hospitals minting money for the entire problem, despite they themselves getting huge central govt.salaries for practically doing nothing except passing away time with their secure job & time bound promotions. May be they wish to do private practice just like Drs.of State Govt. Hospitals.
(h) Hence my suggestion, close down all CGHS pharmacies where generic medicines only are available & red-tapist indent system for medicines not in stock is being routinely followed compelling even senior citizens to make merry go rounds to the CGHS dispensary & instead have recognised/empanelled private medical stores supplying generic/specialised medicines at CGHS fixed rates are made available free of cost on credit basis, to those with appropriate prescription of CGHS dispensary/hospital/empanelled hospitals etc.
(i) Do away with innumerable detailed cghs approved prices for various minimal procedures/pathologies/consumables/various procedures where only most of the time of CGHS staff is wasted delaying approval and pay the bills to empanelled private medical hospitals. Instead, fix up a price range within which these procedures etc. cost & to amicably settle & pay the bills to them promptly. Of course, an element of corruption & collusion with CGHS & empanelled medical institutions may not be ruled out, but not at all having trust at the own Staff is not the remedy to the problem of corruption which exist in every govt. deptt. having discretionary powers, which have to be controlled by creating an appropriate mechanism.
State of ESI Hospitals in Bhopal of elsewhere: Thinking that Main ESI Hospital of Bhopal being in my vicinity & being under Central Govt. Ministry of Labour & Employment, may be on par with Govt.hospital as specialists are available for referral to CGHS empanelled diagnostic/Hospitals etc. when I visited the Hospital, I was spell bound to see it literally stinking with Urine smell everywhere with the entire huge hospital very dirty & unclean & the Doctors chambers laden with dust with broken chairs & the entire pathology/x-ray & other facilities non-functional or unused with the same useless system of referral to BHEL main hospital being followed in case of helpless workmen working in private sector industries etc. Anyone can easily fear contaminated disease while going for treatment or referral in such a stinking place called Hospital? What can be done about it despite having such huge building, just like CGHS/State Govt. Hospitals/health-care institutions?
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