2. GOVT APPROVAL
• APPROVED ON 30 DEC 2002.
• IMPLEMENTED WEF 01 APR 2003.
• AUGMENTATION OF 106 ARMED
FORCES CLINICS AT MIL STNS AND
EST OF 121 NEW ARMED FORCES
POLYCLINICS AT NON MIL STNS.
2
3. CONCEPT
OUTSOURCING
EMPANELLED HOSPITALS/NURSING HOMES
DIAGNOSTIC CENTRES/ DENTAL CLINICS/
LABORATORIES/REHABILITATION CENTRES
EXISTING INFRASTRUCTURE
• COMD AND CONTROL STRUCTURE
• SERVICE HOSPITALS/MI ROOMS
• PROCUREMENT / SUP OF MEDICINES , MED EQPT
AUGMENTATION
• ECHS CENTRAL ORG, REGIONAL CENTRES AND POLYCLINICS
• FINANCES 3
6. CURRENT STATUS
ALL 227 POLYCLINICS OPERATIONALISED.
MEMBERSHIP
VETERANS - 6,12,211
DEPENDANTS - 14,12,411
TOTAL BENEFICIARIES - 20,24,622
12.54 LACS PRE APR 2003 RETIREES YET TO
BECOME MEMBERS.
6
7. MEMBERSHIP DATA AS ON 29 FEB 08
CATEGORY NOS %
PRE APR 2003 RETIREES 3,45,530 16.78
POST APR 2003 RETIREES 2,25,750 11.26
FAMILY PENSIONER 40,931 01.96
TOTAL ESM 6,12,211 30.00
FATHER 64,347 03.21
MOTHER 1,00,510 05.00
SPOUSE 5,49,169 27.00
DAUGHTER 2,98,694 14.88
SON 3,99,691 19.91
TOTAL DEPENDANT 14,12,411 70.00
7
TOTAL BENEFICIARIES 20,24,622
8. YEAR WISE INCREASE IN
MEMBERSHIP
FY MEMBERS TOTAL
(AFV) BENEFICIARIES
2004-05 81,864 2,86,074
2005-06 2,65,019 9,01,065
2006-07 4,12,476 14,76,920
2007-08 6,20,000 21,00,000
(Estimated) 8
9. CURRENT STATUS
COST PER ECHS BENEFICIARY IN THE YEAR
2006-2007 IS RS 2,698/- AS COMPARED TO
RS 5,108/- IN CGHS.
PERS AVAILED MEDICAL FACILITIES :-
• 2003-2004 - 35,568
• 2004-2005 - 7,18,907
• 2005-2006 - 13,81,976
• 2006-2007 - 18,64,028
• 2007-2008 - 42,39,132*
(*UPTO 29 FEB 08) 9
10. TRENDS: PER CAPITA EXPDR
(OVERALL REVENUE)
FY TOTAL MEMBERS EXPDR TOTAL EXPDR PER
EXPDR (AFV) PER BENEFICIA BENEFCIARY
(In Cr) MEMBER
RIES (Rs)
(Rs)
2004-05 82.86 81,864 20, 038 2,86,074 5736
2005-06 181.78 2,65,019 10,481 9,01,065 3062
2006-07 320.80 4,12,476 9470 14,76,920 2698
2007-08 489.91 6,20,000 9512 21,00,000 2333
(Estimated)
10
11. CURRENT STATUS
88% OF THE BENEFICIARIES
TREATED IN POLYCINICS,
5% IN SERVICE HOSP AND 7% IN
EMPANELLED HOSP.
1002 HOSPITALS EMPANELLED IN
152 STNS (496 EMPANELLED
BETWEEN SEP 06 AND OCT 07).
11
12. ECHS PATIENTS REFERRED TO
HOSP NATIONAL STATISTICS
YEAR TOTAL NO OF PATIENTS REFERRED PATIENTS REFERRED
PATIENTS SEEN TO SERVICE HOSP TO EMPANELLED
FACILITY
2003-04 35,708 3,669 (10.27%) 987 (2.76%)
2004-05 7,92,422 52843 (3.57%) 34,083 (2.30%)
2005-06 14,81,817 1,08,132 (2.9%) 82,648 (2.21%)
2006-07 32,29,544 2,06,370 (6.39%) 1,84,603 (5.71)
2007-08 42,39,132 2,11,108 (4.98%) 2,92,076 (6.89%)
12
13. AGE –WISE MORBIDITY
TRENDS
AGE GROUP % OF TOTAL
SICK REPORT
0-40 YRS 27%
41-60 YRS 40%
61 YRS & ABOVE 33%
13
14. YEAR WISE EMPANELMENT
FIN YEAR HOSP DIAG TOTAL
CENTRE
2004-05 151 65 216
2005-06 148 53 201
2006-07 196 62 258
2007-08 226 61 287
CGHS / RLY 33 07 40
EMP
TOTAL 754 248 1002
14
15. STATUS OF LAND ACQUISITION AND
CONSTR OF POLYCLINICS AS ON 10 MAR 08
Mil Non-Mil Total
POLYCLINICS 106 121 227
LAND ACQUIRED 105 31* 136
CONSTR COMPLETED 62 05 67
CONSTR IN PROGRESS 15 02 17
NOTE : 1. FUNCTIONING FROM GOVT/CONSTRUCTED BLDGS - 130
2. FUNCTIONING FROM HIRED BLDGS - 97
*A1 DEFENCE LAND – 21. 15
16. OPERATIONALISATION OF ECHS
POLYCLINICS
POLYCLINICS 2003-04 2004-05 2005-06 2006-07 TOTAL
MILITARY 36 61 09 - 106
NON 11 44 65 01 121
MILITARY
TOTAL 47 105 74 01 227
16
17. CONSTR OF ECHS POLYCLINICS
POLY- 2003-04 2004-05 2005-06 2006-07 2007-08 TOTAL
CLINICS
MIL - - 11 35 16 62
NON - - - 03 02 05
MIL
TOTAL - - 11 38 18 67
17
18. LIST OF NON MIL POLYCLINICS WHERE
LAND ACQUIRED
S. REGIONAL STATE COMD POLYCLINICS TYPE LAND
NO CENTRE ACQUI
SITION
1 JAMMU HP WC MANDI C A1
2 CHANDIMANDIR CHANDIGARH WC CHANDIGARH B A1
3 CHANDIMANDIR PUNJAB WC ROPAR B A1
4 CHANDIMANDIR PUNJAB WC HOSHIARPUR A A1
5 NEW DELHI HARYANA WC YAMUNANAGAR C A1
6 NEW DELHI HARYANA WC GURGAON A A1
7 NEW DELHI DELHI WC NEW DELHI A A1
(LODHI ROAD)
8 LUCKNOW UP CC ALIGARH D A1
9 LUCKNOW UTTRAKHAND CC ALMORA B A1
18
10 JABALPUR UP CC PRATAPGARH D A1
19. LIST OF NON MIL POLYCLINICS WHERE
LAND ACQUIRED
S. REGIONAL STATE CO POLYCLINICS TYPE LAND
NO CENTRE MD ACQUIS
ITION
11 Jabalpur UP CC Ghazipur B A1
12 Patna Bihar CC Muzaffarpur C A1
13 Patna Bihar CC Dharbanga D A1
14 Pune Maharastra SC Sholapur C A1
15 Pune MP SC Bhind D A1
16 Pune Maharastra SC Satara C A1
17 Pune Maharastra SC Thane (Nerul) C A1
18 Chennai Tamilnadu SC Tiruchirapalli C A1
19 Hyderabad AP SC Guntur C A1
19
20 Hyderabad AP SC Chittur C A1
20. LIST OF NON MIL POLYCLINICS WHERE
LAND ACQUIRED
S. REGIONAL STATE COMD POLYCLINICS TYPE LAND
NO CENTRE ACQUI
SITION
21 Kochi Kerala SC Kozikode C A1
22 Chandimandir HP WC Hamirpur B C
23 Chandimandir HP WC Una C C
24 Chandimandir Punjab WC Ludhiana A C
25 Jaipur Punjab SWC Muktsar C C
26 Jaipur Rajasthan SWC Jhunjhunu A C
27 Pune Maharastra SC Kolhapur B C
28 Chennai Tamilnadu SC Vellore A C
29 Chennai Tamilnadu SC Kanchipuram C C
30 Chennai Tamilnadu SC Krishnagiri C C
20
31 Chennai Tamilnadu SC Nagapattinam D C
21. CONSTR OF POLYCLINICS
SERVICE NO OF POLYCLINICS
MIL NON MIL
TOTAL CONSTR TOTAL LAND CONSTR
ACQD
ARMY 89 53 117 31 05
NAVY 07 01 02 - -
AIR 10 08 02 - -
FORCE
TOTAL 106 62 121 31 05
21
22. EMPLOYMENT OF CONTRACTUAL
STAFF AS ON 01 MAR 08
S.No Appt Auth Emp %
1. OIC 227 214 94.27
2. Med Specialist 176 87 49.43
3. Gynaecologist 28 16 57.14
4. Medical Officer 375 301 80.27
5. Dental Officer 255 223 87.45
6. Para Med Staff 767 669 87.22
7. Non Med Staff 992 956 96.37
22
Total 2820 2466 87.45
23. PROPOSAL TO OVERCOME THE PROBLEM
CRITERIA PRESENT PROPOSED
MAX AGE FOR 65 YRS 70 YRS
CONTRACTUAL 55 YRS 60 YRS
SERVICE
-MO/OIC
-OTHER STAFF
WORK EXPERIENCE 03 YRS LESS THAN 3 YRS TO
BE SANCTIONED BY
CENTRAL ORG
WORKING HRS FOR 05 HRS GOC-IN-C EMPOWERED
MO/SPECIALISTS/ TO EMP FOR 02 TO 03
GYNAECOLOGISTS HRS WITH
PROPORTIONATE
23
REDUCTION IN WAGES
24. ADDL ALLCES PROPOSED FOR
MO/MED SPL IN REMOTE AREAS
• REMOTE/HILL AREA
COMPENSATION ALLCE – RS 3000/- PM.
• TRAVELLING ALLCE – RS 2000/- PM.
24
27. OVERALL EXPENDITURE (CAPITAL)
(Rs in Cr)
CODE HEAD 2003-04 2004-05 2005-06 2006-07 2007-08
4076/107 MA
(CAPITAL)
LAND Nil Nil Nil 0.07 0.10
CONSTR OF Nil 0.46 4.91 4.77 05.00
BLDG
MEDICAL Nil 4.56 11.90 15.38 03.00
EQPT
TOTAL Nil 5.02 16.81 20.22 08.10
(G TOTAL) (50.15)
NOTE: ONE TIME SANCTION FOR CREATION OF INFRASTRUCTURE : Rs 122 Cr
27
28. FUND POSITION: FY 2007-08
(Rs in Cr)
HEAD MA EXPDR
(JAN 08)
REVENUE
SALARIES 25.91 21.57
MEDICINES 185.69 151.59
MED TREATMENT 263.11 193.80
OTHERS 15.20 12.82
TOTAL 489.91 379.78
CAPITAL
LAND 0.10 0.05
CONSTRUCTION 5.00 02.30
MED EQPT 3.00 02.69
TOTAL 8.10 05.05
28
29. FUND POSITION: FY 2007-08
(Rs in Cr)
HEAD MA EXPDR (JAN 08)
REVENUE
SALARIES 25.91 21.57
MEDICINES 185.69 151.59
MED TREATMENT 263.11 193.80
OTHERS 15.20 12.82
TOTAL 489.91 379.78
CAPITAL
LAND 0.10 0.05
CONSTRUCTION 5.00 02.30
MED EQPT 3.00 02.69
TOTAL 8.10 05.05
29
30. OTHERS INCLUDE
MOV OF PERS AND STORES
CONTINGENCY EXPDR
INFORMATION TECHNOLOGY
MAINTENANCE OF EQPT
NON-MEDICAL STORES
PUBLICITY
REVENUE WORKS
30
31. SAVINGS TO THE GOVT
(Rs in Cr)
Receipts 2004-05 2005-06 2006-07 2007-08 Total
(Feb 08)
ECHS 63.88 54.76 49.31 49.90 217.85
Contribution
Savings on 6.71 20.81 41.75 55.26 124.53
FMA (approx)
Total 70.59 75.57 91.06 105.16 342.38
31
33. PROPOSALS
ESTABLISH 181 NEW POLYCLINICS.
15 MIL MED FACILITIES IN REMOTE AREAS
TO BE AUTHORISED ECHS INCREMENT -
TYPE ‘E’ MIL STATION POLYCLINIC.
CONVERT 11 MIL TYPE POLYCLINICS TO
NON MIL TYPE.
UPGRADE 14 POLYCLINICS.
33
35. REVISION OF CGHS RATES
ECHS RATES FOR PAYMENT TO
EMPANELLED HOSPITALS HAVE TO BE
IN CONFORMITY WITH CGHS RATES.
CGHS REVISED ITS RATES IN
NOV 06 FOR DELHI AND IN JUL 07 FOR
REST OF THE COUNTRY.
35
36. REVISION OF CGHS RATES
REVISED RATES FOR NEUROLOGY/
NEUROSURGERY,ONCOLOGY/ONCOSURGERY,
NEPHROLOGY, UROLOGY, GASTRO-INTESTINAL
SURGERY ARE NOT ACCEPTABLE.
REVISED RATES FOR CARDIOLOGY, JOINT
REPLACEMENT AND OPHTHALMOLOGY (EYE)
ONLY ARE ACCEPTABLE IN DELHI. IN SOUTHERN
INDIA EVEN CARDIOLOGY RATES ARE NOT
ACCEPTABLE.
36
37. REVISION OF CGHS RATES
THE RATES FOR OVER 90%
TREATMENT AND DIAGNOSTIC
PROCEDURES IN ALL REGIONS HAVE
BEEN REDUCED.
INTER-CITY VARIATION IN RATES AND
ALSO BETWEEN CITIES UNDER SAME
GROUP.
37
38. COMPARATIVE ANALYSIS OF OLD AND REVISED CGHS
RATES
PROCEDURE CGHS RATES NAME OF
OLD NEW CITY
% REDUCTION
Consultation Rs 61 Rs 30 51 Delhi
Rs 70 Rs 25 64.3 Pune
Rs 50 Rs 20 60 Meerut /
Allahabad
Nephrology/ Genitourinary Surgery
Nephrectomy Rs 17,900/- Rs 12,000/- 33 Delhi
Rs 19,600/- Rs 12,000/- 38.8 Bangalore/
Chennai
Retroperiton Rs 35,000/- Rs 28,000/- 20 Delhi
eoscopy 38
Nephrectomy
39. PROCEDURE CGHS RATES NAME OF
CITY
OLD NEW % REDUCTION
Joint Replacement Surgery
Total Hip Rs 68,000 Rs 45,000 + 34 Bangalore/
+ Implant Implant Chennai /
Replacement
A1 Cities.
Total Knee Joint Rs 91,000 Rs 68,000 + 25.3 Bangalore/
+ Impant Implant Chennai /
Replacement
A1 Cities.
Neurosurgery
Excision of Lobe Rs 50,000/- Rs 37,000/- 26 Bangalore/
Chennai
Craniotomy with Rs 50,000/- Rs 31,500/- 37 Bangalore/
evacuation of Chennai
Haematoma 39
40. PROCEDURE CGHS RATES NAME OF
CITY
OLD NEW %REDUCTION
Cardio-thoracic Procedures
Patent Rs 1,01,000/- Rs 73,200/- 27.6 Delhi
Ductus Rs 85,000/- Rs 25,000/- 70.6 Pune
Arteriousus
Coronary Rs 87,500/- Rs 85,000/- 2.9 Delhi
Balloon Rs 93,000/- Rs 60,000/- Bangalore/
35.5
Angioplasty Chennai
(Stent Cost
Rs 70,000/- Rs 30,000/- 57.1 Nagpur
Extra)
Rs 93,000/- Rs 30,000/- 67.8 Pune
Coronary Rs 1,48,500/- Rs 85,000/- 42.8 Mumbai
Bypass
Rs 1,33,650/- Rs1,30,000/- 2.8 Delhi
Surgery
Rs 1,40,000/- Rs1,10,000/- 21.5 Pune 40
41. PROCEDURE CGHS RATES NAME
OF CITY
OLD NEW % REDUCTION
Neuro Surgery
Excision of Rs 30,000/- Rs 24,000/- 20 Delhi
Cervical Inter
Vertebral Discs
Meningomyelocele Rs 50,000/- Rs 32,000/- 36 Delhi
Paediatric Surgery
Tracheo Rs 29,492/- Rs 20,150/- 31.7 Delhi
(Oesophageal
Fistula Correction
Surgery)
Diaphragmatic Rs 20,200/- Rs 12,600/- 37.7 Delhi
Hernia Repair
(Thoracic or
Abdominal 41
approach)
42. PROCEDURE CGHS RATES NAME
OF CITY
OLD NEW % REDUCTION
Diagnostic Procedures
MRI Head With Rs 8,000/- Rs 3,500/- 56.3 Delhi
contrast
MRI Head Rs 5,000 Rs 2,500/- 50 Delhi
Without
contrast
CT Whole Rs 5,580/- Rs 3,400/- 39.1 Delhi
abdomen with
contrast
CT Whole Rs 4,185/- Rs 2,092/- 50.1 Delhi
abdomen
without contrast 42
44. INTER CITY VARIATION IN RATES
PROCEDURE HYDERABAD PUNE DELHI
CARDIOLOGY/CARDIO-THORACIC
Balloon Rs 74,950/- Rs 30,000/- Rs 1,05,000/-
Angioplasty
with Valvotomy
Coronary Rs 85,000/- Rs1,10,000/- Rs 1,30,000/-
Bypass Surgery
Closed Rs 40,000/- Rs 20,000/- Rs 1,10,000/-
Valvotomy
Patent Ductus Rs 35,000/- Rs 25,000/- Rs 73,200/-
Arteriosus
44
45. INTER CITY VARIATION IN RATES
PROCEDURE HYDERABAD PUNE DELHI
ONCOLOGY & ONCOSURGERY
Carotid Body Rs 15,000/- Rs 22,000/- Rs 28,500/-
Excision
Total Rs 20,000/- Rs 22,000/- Rs 28,400/-
Laryngectomy
Parapharyngeal Rs 22,500/- Rs 21,000/- Rs 28,500/-
Tumour
Excision
45
46. INTER CITY VARIATION IN RATES
PROCEDURE HYDERABAD BANGALORE DELHI
CHEMOTHERAPY CHARGES
SINGLE DRUG Rs 200/- Rs 500/- Rs 400/-
THERAPY PER
DAY
MULTIPLE DRUG Rs 300/- Rs 600/- Rs 650/-
THERAPY PER
DAY
INFUSIONAL Rs 500/- Rs 750/- Rs 750/-
CHEMOTHERAPY
46
47. EFFECTS OF REVISION OF RATES
MOST OF THE REPUTED
HOSPITALS HAVE DISCONTINUED
TREATMENT OF ECHS PATIENTS.
INDIFFERENT ATTENTION BY
HOSPITALS WHICH ARE STILL
EMPANELLED (BECAUSE OF LOW
REMUNERATION).
47
48. ACTIONS TAKEN
REVISED RATES IMPLEMENTED WITH
EFFECT FROM 01 DEC 07.
ISSUE RAISED WITH RM THROUGH
CHAIRMAN COSC.
FOLLOWING DIRECTIONS RECEIVED ON
03 MAR 08 :-
REVERT TO PRE REVISED RATES.
CASES ALREADY SANCTIONED WILL NOT BE
REOPENED. 48
50. IMPORTANT ISSUES
• CGHS RATES.
• SHORTAGE OF MANPOWER AT
POLYCLINICS.
• PROCESSING OF BILLS.
• AVAILABILITY OF MEDICINES AT
POLYCLINICS. 50
51. IMP ISSUES - DIFFICULTIES FACED BY
VETERANS
• LONG WAITING PERIODS AT HIGH PRESSURE
POLYCLINICS.
• CONGESTED WAITING AREAS.
• SHORTAGE OF MEDICINES.
• MEDICINES ON DISCHARGE FROM HOSPITAL.
• NON- AVAILBILITY OF POLYCLINICS IN RURAL
AREAS.
• NOT BEING REFERRED TO CIVIL HOSPITALS.
• NON AVAILABILITY OF ACCN FOR PATIENTS /
51
ATTENDANTS.
52. IMP ISSUES - NATURE OF
COMPLAINTS BY VETERANS
MED TREATMENT
AT POLYCLINICS
ILL TREATMENT.
SHORTAGE OF STAFF.
LONG WAITING HRS.
LACK OF INFRASTRUCTURE.
AT SERVICE HOSP
INADEQUATE FACILITIES.
ILLTREATMENT.
NON REFERRAL TO EMPANELLED FACILITY.
52
53. IMP ISSUES - NATURE OF
COMPLAINTS BY VETERANS
AT EMPANELLED HOSP
INADEQUATE FACILITIES.
ILL TREATMENT.
COST OF TREATMENT FULLY/PARTLY
CHARGED.
NON ISSUE OF MEDICINES.
GEN / MISC
AYURVEDA TREATMENT.
DENIAL OF TREATMENT AT EMPANELLED
HOSP DUE TO LOW CGHS RATES. 53
54. IMP ISSUES - NATURE OF
COMPLAINTS BY VETERANS
RE-IMBURSEMENT
EMERGENCY RE-EMBURSEMENT CLAIM
NOT/PARTIALLY PASSED.
TRAVELLING ALLCES.
POLICY
ADDL PCs.
CHANGE OF PARENT PCs.
EMPLOYMENT.
54
55. REMEDIAL MEASURES
• REVISION OF CGHS RATES.
• SHORTAGE OF MANPOWER
AT POLYCLINICS.
AT HIGH PRESSURE STNS / SERVICE
HOSPS.
• DELAY IN PROCESSING OF
BILLS.
• OVERCHARING BY EMPANELLED
HOSPS. 55
56. REMEDIAL MEASURES
AVAILABILITY OF MEDICINES
AT POLYCLINICS.
EXTRA SPACE FOR POLYCLINIC
AT HIGH PRESSURE STNS.
EST OF DENTAL LABS.
EXPANSION OF ECHS.
56
57. REMEDIAL MEASURES -
REVIEW OF POLICIES
• PROCEDURES MADE USER- FRIENDLY
MEMBERSHIP FORM.
ISSUE OF MEDICINES - 90 DAYS/TAC.
CHANGE OF PARENT POLYCLINIC.
ISSUE OF DUPLICATE SMART CARDS.
ASSESSMENT OF DISABILITY OF SPECIAL CHILD.
TREATMENT AT ‘OTHER’ STATIONS.
CONDONING DELAYED REPORTING OF OCCURENCE
OF EMERGENCY.
57
REFERAL POLICY.
58. REMEDIAL MEASURES -
REVIEW OF POLICIES
• SUPER SPECIALITY TREATMENT IN
EMPANELLED HOSPITALS CAN BE
REVIEWED BY SAME SPECIALIST.
• SIMPLIFIED PROCEDURE FOR TREATMENT
IN REMOTE AREAS.
• ADVISORY COMMITTEES CONSTITUTED AT
ALL STNS FOR PERIODIC INTERACTION
WITH VETERANS AND EMPANELLED
HOSP.
• FEEDBACK FORM INTRODUCED. 58
59. MISC POINTS
REVIEW OF ECHS AND
PERFORMANCE AUDIT.
EXTENSION OF ECHS TO NEPAL.
SCHEME EXTENDED TO INDIAN
COAST GUARD AND DSC.
FREE CARDIAC OPDs.
59
60. REMEDIAL MEASURES
CASE FOR AUTH OF ADDL MANPOWER
TAKEN UP WITH MOD.
ADDL STAFF SANCTIONED FROM ARMY’S
WELFARE FUND.
REVISION OF TERMS OF ENGAGEMENT
AND PAY AND ALLCES.
VACANCIES OF 75 DOCTORS SHIFTED
FROM LOW PRESSURE TO HIGH
PRESSURE POLYCLINICS.
60
61. CASE TAKEN UP WITH MOD FOR
AUTH OF ADDL MANPOWER AT
POLYCLINICS
FOLLOWING ADDL MANPOWER
PROPOSED:-
SPECIALISTS - 44
PARA-MED - 732
NON – MED - 320
61
62. REQMT OF PART TIME SPECIALISTS :
HIGH PRESSURE STNS
S. STATION REQUIREMENT
NO Med Cardio- Onco- Ortho Total
Spl logist logist Surgeon
1. DELHI CANTT 1 1 1 1 04
2. SOUTH DELHI - - - 1 01
3. NOIDA 1 - - 1 02
4. GURGAON - - - 1 01
5. PUNE 1 1 1 1 04
6. KOLKATA 1 1 1 1 04
7. CHANDIMANDIR 1 1 - 1 03
8. LUCKNOW 1 1 - - 02
9. MUMBAI 1 - 1 - 02
62
10. CHENNAI 1 - - 1 02
63. REQMT OF PART TIME SPECIALISTS :
HIGH PRESSURE STNS
S. STATION REQUIREMENT
NO Med Cardio- Onco- Ortho Total
Spl logist logist Surgeon
11. BANGALORE 1 1 - 1 03
12. HYDERABAD 1 1 - - 02
13. KOCHI 1 - - 1 02
14. TRIVANDRUM 1 - - - 01
15. COIMBATORE 1 - - 1 02
16. JALANDHAR - 1 - 1 02
17. AMRITSAR 1 - - 1 02
18. GUWAHATI 1 - - - 01
19. JAMMU 1 - - 1 02
20. AMBALA 1 - - 1 02
63
TOTAL 17 08 04 15 44
64. ADDL MANPOWER FOR ECHS
POLYCLINICS AT MIL/NON MIL STNs
PARAMEDICS TYPE A & B TYPE C & D
POLYCLINICS POLYCLINICS
MIL NON MIL MIL NON MIL
NURSING ASST 02 02 03 02
DENTAL ASST - 01 01 01
RECEPTIONIST* 01 - 01 01
CHOWKIDAR* - 01 - 01
TOTAL 03 04 05 05
NOTE - * NOT AGREED BY MOD. 64
65. ADDL STAFF SANCTIONED/EMP
FROM ARMY’S WELFARE FUNDS
FOLLOWING ADDL STAFF EMP OUT OF
ARMY’S WELFARE FUNDS:-
SPECIALIST - 05
PARA-MED - 56
NON-MED - 47
TOTAL EXPDR - RS 229.45 LAC
PER ANNUM 65
66. REMEDIAL MEASURES
CASE FOR AUTH OF 28 CONSULTANTS
AND 54 CLKS TAKEN UP WITH MOD.
ADDL STAFF SANCTIONED / EMP FROM
ARMY’S WELFARE FUND.
MOD REQUESTED FOR ADDL MANPOWER
FOR SERVICE HOSP AS SUGGESTED BY
DGAFMS.
66
67. ADDL MANPOWER FOR AFMSDs/ SERVICE HOSP
TOTAL MO PHARMACIST/ AMB CLK PEON/ TOTAL
NO OF SKT ASST MAZDOOR
HOSP
SERVICE HOSP
HAVING LARGE 18 - 18 - 18 - 36
DEPENDENCY OF
ECHS MEMBERS
DGLP FUND OF
RS 2-4 CRORE
06 06 06 - 06 06 24
DGLP FUND OF RS 4
CRORE AND ABOVE 5 5 10 - 10 10 35
TOTAL
29 11 34 - 34 16 95
AFMSD
3 03 09 03 03 - 18
GRAND TOTAL
32 14 43 03 37 16 113
67
70. ADDL STAFF SANCTIONED/EMP
FROM ARMY’S WELFARE FUND
FOLLOWING ADDL STAFF EMP OUT OF
ARMY’S WELFARE FUNDS :-
CONSULTANTS - 16
CLERKS - 38
TOTAL COST PER ANNUM – RS 55.08 LAC
70
71. REMEDIAL MEASURES
NO SHORTAGE OF FUNDS.
CASE TAKEN UP WITH MOD FOR
ENHANCEMENT OF LP POWERS OF OIC
POLYCLINICS.
AUTH OF LP POWERS TO OIC
POLYCLINICS IN MIL STNS.
CASE TAKEN UP WITH CGDA FOR
APPOINTING IFA FOR ALL SERVICE HOSP.
71
72. REMEDIAL MEASURES
PROCUREMENT OF MEDICINE. CASE
BEING TAKEN UP WITH MoD FOR THE
FOLLOWING
EMPANELLMENT OF CHEMIST BY SEMO.
VALIDITY OF RATE ENQUIRY FOR SIX
MONTHS.
ENHANCEMENT OF FINANCIAL POWERS OF
SEMO FOR PURCHASE OF ECHS
MEDICINES.
72
73. REMEDIAL MEASURES
AUTH OF CONSULTANTS AND CLKS
FOR HIGH PRESSURE STNS. PENDING
SANCTION EMP FROM ARMY’S
WELFARE FUNDS.
POSTING OF ADDL ARMY OFFRS AT
CENTRAL ORG AND SELECTED STN HQs.
ENHANCEMENT OF DELEGATED
FINANCIAL POWERS PROPOSED TO
MOD.
73
74. PROPOSED FINANCIAL POWERS
REIMBURSEMENT OF MEDICAL EXPDR
COMPETENT FINANCIAL LIMITS (WITHOUT
FINANCIAL AUTH CONSULTATION)
EXISTING PROPOSED
STN CDR (COL/LT 20,000 40,000
COL)
STN CDR (BRIG) 50,000 1,00,000
SUB AREA CDR 1,00,000 1,50,000
SUB AREA (I) 1,00,000 3,00,000
AREA CDR 2,00,000 3,00,000
CORPS CDR Nil 4,00,000
ARMY CDR 4,00,000 5,00,000
VCOAS 5,00,000 8,00,000 74
75. REMEDIAL MEASURES
PAYMENT ONLY AS PER CGHS RATES.
THOROUGH SCRUTINY OF BILLS AT
SUCCESSIVE STAGES.
HOSPITALS ADVISED NOT TO INFLATE
BILLS FOR EARLY PROCESSING.
ADVISORY COMMITTEES FORMED AT ALL
STNS.
75
76. REVISED CHANNEL OF BILL
PROCESSING
SUBMISSION OF BILLS BY EMPANELLED FACILITY
POLYCLINIC
Payment
SEMO
STN HQ
For bills beyond CFA
power of Stn Cdr Sanction for
payment of
REGIONAL CENTRE Bills beyond
ECHS CFA powers
of Stn Cdr
CFA 76
77. ANALYSIS OF COMPLAINTS FROM
01 APR 07 TO 29 FEB 08
NATURE OF COMPLAINTS QUARTER TOTAL
Q-1 Q-2 Q-3 JAN -
FEB 08
RE-IMBURSEMENT 38 20 35 13 106
MEDICAL TREATMENT 34 38 35 23 130
SHORTAGE OF MEDICINES 05 04 14 - 23
AGAINST FUNCTIONARIES 01 11 15 03 30
(ECHS)
SUPREME COURT 49 57 61 05 172
JUDGEMENT FOR PRE 1996
FUNCTIONING OF ECHS 09 13 14 17 53
ON POLICY MATTERS 40 33 79 57 209
TOTAL 176 176 253 118 723 77
78. MEDICAL TREATMENT
Ist Qtr IInd Qtr IIIrd Qtr JAN - Total
FEB 08
AT POLYCLINICS 19 13 11 07 50
AT EMPANELLED 02 05 04 08 19
FACILITY
AT SERVICE HOSPITAL 04 06 07 03 20
GENERAL (WITHOUT 09 14 13 05 41
ANY SPECIFICATION)
TOTAL 34 38 35 23 130
78
79. SHORTAGE OF MEDICINES
Ist Qr IInd Qr IIIrd Qr Total
SOUTHERN COMMAND 01 01 05 07
EASTERN COMMAND 01 - - 01
WESTERN COMMAND 02 01 03 06
CENTRAL COMMAND - 01 03 04
SOUTH WEST COMMAND - 01 01 02
NAVY - - - -
AIR FORCE 01 - 02 03
TOTAL 05 04 14 23
79
80. ANALYSIS OF POLYCLINICS
S/ TYPE NO OF % OF TOTAL ESM % OF
No OF POLYCLINIC POLYCLINIC POPULATION TOTAL
CITY ESM
POPU-
LATION
1. A/A1 23 10.13 3,04,221 14.10
2. B/B1/ 40 17.62 3,83,855 17.79
Capital
3. Others 164 72.24 14,68,526 68.09
80
82. EXTENSION OF ECHS TO NEPAL
APPROX 90,000 ESM FROM INDIAN ARMED
FORCES IN NEPAL.
ECHS NOT APPLICABLE IN NEPAL.
ON DIRECTIONS OF RM A TEAM VISITED
NEPAL TO STUDY THE FEASIBILITY OF
EST ECHS AND EMPANELLING HOSP IN
NEPAL.
82
83. MAJ RECOMMENDATIONS
NINE POLYCLINICS TO BE EST – FIVE IN PHASE - I AND
FOUR IN PHASE – II.
ECHS REGIONAL CENTRE TO BE EST AT KATHMANDU.
TO FUNCTION UNDER DA.
ALL PROCEDURES OF ECHS AS APPLICABLE IN INDIA
TO BE FOLLOWED WITH FOLLOWING VARIATIONS.
FIN POWERS TO BE EXERCISED BY DA AND
AMBASSADOR.
RE-IMBURSEMENT TO EMPANELLED HOSP UNDER
FIN POWERS OF DA AND AMBASSADOR.
BULK MEDICINES TO BE SUP BY AFMSD/AMSD.
LP OF MEDICINES UNDER POWERS OF DA AND 83
AMBASSADOR.
84. ZONES AND DISTRICTS
• FOR ADM IT IS DIVIDED INTO 14 ZONES AND 75 DISTS
09
15
37802
41 7914
2501
3402
NEPALGANJ
GORKHA
TAMGHAS
BESISAHAR 2339
3204 17798
7170
2933 PHIDIM
3024
1708
84
85. ZONE WISE STATE OF PENSIONERS AS ON
31TH DECEMBER 2007
SL NO ZONE NO OF INDIAN ARMY TOTAL
PENSIONERS
1 MAHAKALI 15 15
2 SETI 41 41
3 BHERI 2501 2501
4 RAPTI 3204 3204
5 LUMBINI 17798 17798
6 DHAULAGIRI 7914 7914
7 GANDAKI 37802 37802
8 NARAYANI 3024 3024
9 BAGMATI 3402 3402
10 JANAKPUR 2339 2339
11 SAGARMATHA 2933 2933
12 KOSHI 7170 7170
13 MECHI 1708 1708
14 KARNALI 09 09
85
GRAND TOTAL 89860 89860
87. CONSIDERATIONS FOR EST OF
NEW POLYCLINICS
DISTRICTS WITH VETERAN POPULATION
MORE THAN 1500.
RURAL / REMOTE AREAS WITH VETERAN
POPULATION OF 800.
TYPE ‘E’ MIL POLYCLINICS AT LOCATIONS
WITH VETERAN POPULATION MORE THAN
400.
ADDITIONAL POLYCLINICS PROPOSED IN
SOME LARGER CITIES. 87
88. ECHS INCREMENT - TYPE ‘E’ MIL
POLYCLINIC
,,
MO - 01
NURSING ASSISTANT - 02
DRIVER - 01
MOBILE MEDICAL VAN - 01
88
89. REGION WISE SUMMARY
PROPOSED NEW POLYCLINICS
COMMAND EXISTING PROPOSED TOTAL
SC 89 51 140
EC 18 28 46
WC 40 40 80
CC 52 50 102
NC 05 05 10
SWC 23 22 45
TOTAL 227 196 423
89
90. REGION WISE SUMMARY PROPOSED
NEW POLYCLINICS
COMMAND PCs PROPOSED
MIL NON MIL TYPE ‘E’ TOTAL
SC 01 47 01 49
EC - 23 05 28
WC 03 37 - 40
CC - 46 06 52
NC 01 02 02 05
SWC - 21 01 22
TOTAL 05 176 15 196
90
91. PROPOSED NEW POLYCLINICS
TYPE WISE
S. NO TYPE OF PC NO OF PCs
1. A N/MIL 01
2. B N/MIL 05
3. C N/MIL 08
4. D MIL 06
5. D N/MIL 161
6. E MIL 15
TOTAL 196
91
92. PROPOSED TYPE ‘E’ POLYCLINICS
S. POLYCLINIC MIL COMD REMARKS
NO FACILITY
1. POONCH MH NC REMOTE
2. KARGIL FD AMB NC REMOTE
3. ABOHAR MH SWC RURAL
4. RANIKHET MH CC RURAL
5. DHARCHULA ADS CC REMOTE
6. JOSHIMATH FD AMB CC RURAL
7. AMLA (MP) AF HOSP CC RURAL
8. PACHMARHI MH CC RURAL
(MP)
92
9. LANSDOWN MH CC RURAL
93. PROPOSED TYPE ‘E’ POLYCLINICS
S. POLYCLINIC MIL COMD REMARKS
NO FACILITY
10. KALIMPONG MH EC REMOTE
11. MISAMARI MH EC REMOTE
12. TEJU (AP) ADS EC REMOTE
13. ALONG (AP) ADS EC REMOTE
14. BINAGURI (WB) MH EC RURAL
15. BIDAR AF HOSP SC RURAL
93
94. PROPOSED EQUIPMENT FOR
ECHS TYPE ‘E’ POLYCLINIC
• NEBULIZER • SYRINGE NEEDLE
DESTROYER
• OXYGEN
CONCENTRATOR • MICROSCOPE
• SUCTION MACHINE
BOTH BTY & • ECG MACHINE
ELECTRICALLY OPTD
• ELECTRIC BOILING • MONITOR WITH
WATER STARILIZER DEFIBRILLATOR
94
95. PROPOSED EQUIPMENT FOR ECHS
TYPE ‘E’ POLYCLINIC
• DIGITAL BLOOD • X- RAY VIEW BOX
PRESSURE MACHINE
• AMBU BAG
• GLUCOMETER WITH
CONSUMABLES • MULTIPURPOSE
FOLDING STRETCHER
• DRY PAPER
BIOCHEMISTRY • MINOR SURGICAL SET
• OTHER MINOR
• MALARIA DETECTION KIT EQUIPMENT SET
95
102. PROPOSED TYPE ‘E’ POLYCLINICS
S. POLYCLINIC MIL COMD REMARKS
NO FACILITY
1. POONCH MH NC REMOTE
2. KARGIL FD AMB NC REMOTE
3. ABOHAR MH SWC RURAL
4. RANIKHET MH CC RURAL
5. DHARCHULA ADS CC REMOTE
6. JOSHIMATH FD AMB CC REMOTE
7. AMLA (MP) AF HOSP CC RURAL
8. PACHMARHI MH CC RURAL
(MP)
9. LANSDOWNE MH CC REMOTE
102
103. PROPOSED TYPE ‘E’ POLYCLINICS
S. POLYCLINIC MIL COMD REMARKS
NO FACILITY
10. KALIMPONG MH EC REMOTE
11. MISAMARI MH EC REMOTE
12. TEJU (AP) ADS EC REMOTE
13. ALONG (AP) ADS EC REMOTE
14. BINAGURI (WB) MH EC RURAL
15. BIDAR AF HOSP SC RURAL
103
108. BANDIPUR
BARAMULA ‘E’
Badgam
E
RAMBAN
KISHTWAR
REASI
DODA
AKHNOOR
NAGROTA GUJROO
BARI BRAHMANA INDEX
EXISTING PCs 108
RED (08)
SAMBA
ADDL PC s BLUE (06)
113. HIMACHAL PRADESH
CHAMBA
BAKLOH
SHAHPUR
YOL
PALAMPUR
JOGINDER NAGAR
DERA
HOSHIARPUR GHUMARWIN
RAMPUR
INDEX
NAHAN EXISTING PCs 113
RED (08)
ADDL PCs BLUE (09)
131. SURATGARH
RAJGARH
CHIRAWA
BHUWANA
BEHROR
NIM KA THANA
SHERGARH
SANGANER
HINDAUN CITY
(JALIPA)
INDEX
EXISTING PCs RED (17)
131
ADDL PCs BLUE (12) 57
139. VETERAN PENSIONERS OF DELHI
(AS PER KSB)
NORTH 1246
NORTH WEST 9137
NORTH EAST 4983
WEST 2908
SOUTH WEST 14535
SOUTH 3737
EAST 2491
CENTRAL 1245
NEW DELHI 1246
TOTAL 41528
139
140. COMPARISION WITH CGHS - DELHI
MEMBERS DISPENSARIES/ AVERAGE
POLYCLINICS DEPENDENCY
CGHS 3,58,749 87 3808
ECHS 41528 2 20764
140
179. POLYCLINICS IN WEST BENGAL
POLYCLINICS MIL NON MIL TOTAL
EXISTING 05 03 08
PROPOSED 02 06 08
TOTAL VETERANS – 66,458 179
180. KALIMPONG ‘E’
BENGDUBI
WEST BENGAL BINAGURI ‘E’
RAIGANJ
BAHRAMPUR
KRISHNANAGAR
BARRACKPORE
SALT LAKE
BARUIPUR INDEX 106
EXISTING PCs RED (08)
ADDL PCs 180
BLUE (08)
187. ESM PENSIONER OF SIKKIM
AS ON DEC 06 (AS PER KSB)
S/ NO OF
DISTRICT
NO PENSIONR
1 GANGTOK 905
2 GYALSI/GEYZING (W) 301
3 NAMCHI (S) 365
TOTAL 1571
187