For the State General Secretaries & District / Divisional Secretaries of AIPRPA

URGENT - ON CGHS 

Dear CHQ Office Bearers / State General Secretaries / District & Divisional Secretaries of AIPRPA!

Comrades, As per the decision of the NCCPA National Executive Meeting held at Chennai on 5.8.2018, we have to submit a note on CGHS to facilitate the JCM National Council Staff Side Secretary Comrade Shiv Gopal Misra and the other Standing Committee member Comrade KKN.Kutty (both are the President and Secretary General of NCCPA also) to submit a note to the Health Secretary for a detailed dialouge on CGHS. 

Accordingly we have to submit the note immediately. A draft prepared by the General Secretary based on the discussions in the Central Managing Committee of AIPRPA is placed here under for your study. 

Kindly study the same and email to the General Secretary in the aiprpachq@gmail.com without delay for inclusion or addition or deletion etc in the draft:

CGHS Related issues for redressal with the Health Ministry

1.      CGHS in all Revenue States:

As a matter of rule, all State Capitals should contain a CGHS Centre. There are some States traditionally not having a CGHS centre like the States of North Eastern Region. In addition due to bifurcation of some existing States, a situation has developed wherein some States do not have Additional Director offices and some State Capitals like the Capital City of Andhra have no CGHS Wellness centres even. We propose that as a matter of policy all State Capitals should have CGHS and all major States Should have the office of the Additional Director CGHS. These creations are not to be viewed with the parameters of expenditure involved but on policy.

2.      Recognizing referral hospitals and Clinics in all Districts:

CGHS is now opened for all P&T Pensioners living in non-CGHs areas also. P&T Pensioners are known to be present and living in all districts of the country. We can understand that CGHS wellness Centres cannot be opened in all Districts. But CGHs has a panel of private referral hospitals and in some cities there is a big list of such approved hospitals. Similar is the case with the Clinics and labs for pathological tests for the beneficiaries. The condition is that these hospitals and Clinics should agree to charge at the CGHS rates. We propose that at least one referral hospital and one or two clinics in each district  should be recognized or approved on the same condition. If this is accepted as a policy then the Pensioners Associations can approach different hospitals and Clinics in each district  to ensure at least one renowned hospital  and Clinic enter the list of empanelled hospitals and Clinics. This will go a long way to help the Pensioners to take treatment without straining themselves to undertake a long journey to reach out the CGHS city for any treatment.

3.     Merger of Postal Dispensaries with CGHS:

The 7^th Pay Commission has repeated the recommendation to merge the existing Postal Dispensaries with the CGHS. Similar recommendation was made by the 6^th CPC also. As a follow up to the recommendation of 6^th CPC and the efforts of several organizations, the Government had merged certain number of Postal Dispensaries with the CGHS. But the yardstick applied was that such merger will be made only in those centres where already a CGHS Dispensary is functioning in the same centre. This has caused many more Postal Dispensaries left out of the merger with CGHS. The Postal Dispensaries cannot cater to the needs with equal efficiency like that of the CGHS. Therefore repeatedly the Pensioners were urging for merger of remaining Postal Dispensaries also. Fortunately the 7^th CPC recommended such a merger in order to strengthen the CGHS system. We learn that the recommendation is under the consideration of the Government departments. We propose that a favourable decision be expedited and all remaining Postal Dispensaries be merged with CGHs so that these Postal Dispensaries can function as CGHS Dispensary under the CGHS system more efficiently. This will end the prevailing discrimination to the pensioners on the issue of in-patient treatment in addition to the discrimination on payment of subscription for out-patient treatment.

4.      CGHS beneficiary rates commensurate to the year of retirement:

P&T Pensioners living in non-CGHS areas were not allowed to join CGHS due to the prohibitory orders of the Health Ministry and not due to the whimsicalities of the P&T Pensioners. Now after the recommendations of the 7^th CPC and due to Court intervention at Kerala, the Health Ministry has taken back the prohibitory circulars. All the P&T Pensioners are not permitted to join CGHS. But the question is they are to remit the subscription at the rate finalised after 7^th CPC. The enhanced rate of subscription is understandable for the serving employees and the pensioners retiring now after getting higher salaries of 7^th CPC. But fixing the same 7^th CPC rates for the past Pensioners especially those who had retired long back is a bit unjustified. We propose that the past pensioners as a one-time measure may be permitted to join CGHS on remittance of subscriptions at the rates prevailing on the month of their retirement.  Without such a gesture, many past pensioners will be hesitating to join the CGHS as the remittance of subscription is huge for most of them.

5.      CGHS Contribution for Postal Pensioners of Andhra &  Telangana:

A peculiar situation has arisen in the State of Andhra and Telangana after the permission for the P&T Pensioners to join CGHS has come about. By virtue of a Court order, the non-CGHS area Pensioners of Postal Department were allowed to join CGHS by a periodical remittance of subscription for six monthly term. Accordingly they were remitting once in six months and getting the benefit of CGHS during the  past years. Actually many pensioners have already remitted subscription for more than a period of 10 years. As per rules of CGHs those who remit subscription for a  period of 10 years are issued with a “Life Card” to take treatment for the entire life time of the Pensioner and his/her spouse. Now after the general permission granted to join CGHS for P&T Pensioners, the remittance once again at the new rates are demanded to be remitted by the Pensioners who have already remitted for more than 10 years. This is totally unjust. We propose that the P&T Pensioners of both Andhra and Telangana should be provided with the ‘Life Card’ in CGHs if they have already remitted subscription through six month terms for ten year period. Similarly those who have not remitted yet for 10 year period may be asked to remit the balance in one lump sum as a one- time measure at the old rates for issue of “Life Card”.

6.      Reconsidering the norms of appointment of Specialists in major metro cities:

The existing norms for appointment of Specialists in major metro cities are totally inadequate to treat the number of patients in CGHS. For example in Chennai City with more than 1,00,000 CGHS beneficiaries, only one Eye Specialist Doctor is in place. This Specialist is being rotated between two Centres at K.K.Nagar and Annanagar Wellness Centres during the week. The number of eye patients are more in number and the rush and the availability of Specialist only on selective days of the week is causing extreme hardship to senior citizens especially octogenarians and septuagenarians. This issue was taken up with the Additional Director CGHS at Chennai City, which was turned down on the basis of existing norms. The issue was represented by AIPRPA to the Director General of CGHS also. But till date there is no progress. We propose that the norms should be liberalized if they are not commensurate with the number of patients to be treated.

7.      Medicines:

Currently in almost all CGHS centres in different States, the patients are not supplied with all the required medicines immediately after consulting the Doctors. Even routine medicines like the tablets for Blood Pressure and Diabetis are not available on the first visit of the patients. Local Purchase is ordered and the patients are asked to come back again after three days for those medicines. This is causing unnecessary travel strain on the aged patients besides the patients remain medicine less for some days. If this is a condition in one city only, we can take up locally with the Additional Director for redressal. But this condition is prevalent in many States like Tamilnadu, Andhra and Telangana etc. Therefore we propose that suitable arrangements as in the past should be made to stock sufficient medicines for supply to the patients on their first visit to the CGHS Dispensaries.