Wednesday, January 12, 2011

ECHS - LATEST INPUTS, KIND COURTESY NAVAL FOUNDATION

From: harindersingh [mailto:admiralharinder@gmail.com]
Sent: 10 January 2011 09:10
To: Kamboj_cs@yahoo.co.in
Subject: Fwd: Official Minutes of the Meeting / Discussions with CPS and MD,ECHS

Dear Members,

Please refer to our earlier email copied below, forwarding the Agenda that we had prepared for the meeting with CPS/ MD,ECHS and our minutes of the meeting.Copies of the earlier attachments have also been retained.for your convenience.

We have since received the minutes of the meeting and are attached. Some of the points of interest have been highlighted in red. (NFDC CPS Minutes of Meeting Jan 11.doc)

We are pleased to report that we have made substantial headway in providing better facilities for the Veterans and propose to build on the decisions taken at this meeting , with NHQ/ECHS in the future.

Warm regards

Vice Admiral Harinder singh
President NFDC

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Dear Members,

There has been some delay in promulgating these minutes as we were waiting for the official record of discussions and which have still not arrived. As some members of NFDC wanted a feed -back, a summary of the discussions held is attached.

Also attached are the Copy of the Agenda Points given in advance to the ECHS and a Copy of the brief given by Capt Narayanan of the ECHS, Navy at the meeting.

Copy of the official minutes will be forwarded on receipt pl.

Warm regards


Vice Admiral Harinder Singh,
C 26, Sector 23,
Noida 201301

0120-2412412 9811668776
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Tele : 2410 1319

ECHS/012A/INF 22 Dec 10


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)

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