The Central Government Health Scheme (CGHS) is providing comprehensive healthcare facilities to the Central Government employees and pensioners and some other select categories of persons in 25 cities across the country. Government has taken a large number of initiatives over last few years to improve the functioning of CGHS which have yielded positive results. However, the Ministry has also been receiving suggestions, representations and complaints on various aspects of the functioning of this Scheme.
The complaints reported from different States are generally of similar nature and can be broadly classified in the following categories:
- The number of private hospitals on the panel of CGHS in some cities including Thiruvanathpuram, Kerala, is not adequate.
- The number of CGHS dispensaries is not adequate.
- Need to cover more cities under CGHS.
- Shortage of doctors and staff in dispensaries.
- Impolite and rude behavior of dispensary staff.
- Delay in supply of indented medicines.
- Overcharging and denial of credit facility by empanelled private hospitals.
- Disruption in services due to break down in internet connectivity.
- Delay in settlement of Medical Reimbursement Claims.
- Delay in issue of plastic cards.
- Non- supply of Ayurvedic medicines, etc.
Government has taken the following initiatives to improve the services of CGHS to its beneficiaries:
- ‘Continuous Empanelment Scheme’ has been revived in all CGHS locations to empanel more number of eligible private hospitals and diagnostic/ imaging centres. The process of empanelment has also been decentralised by delegating powers at the city level.
- CGHS beneficiaries residing in non-CGHS areas have been allowed to avail follow up and inpatient medical treatment in hospitals recognised under CS (MA) Rules and ECHS.
- Ministry has mooted a proposal for opening at least one dispensary in the capital of the States where CGHS is not in operation.
- CGHS engages retired Government doctors on short term contract basis to address the shortage of doctors wherever required. The powers to engage retired doctors on contract basis have also been delegated at city level.
- Instructions have been issued to the doctors and other staff to be polite and courteous in their behaviour towards the beneficiaries.
- There is a provision to penalise the authorised local chemists for delay in supply of indented medicines.
- Appropriate actions are taken against the defaulting hospitals for overcharging and denial of credit facility.
- Instructions have been issued to provide consultation/treatment even in case of breakdown of internet connectivity. Instructions have also been issued to create standby arrangement to ensure uninterrupted services.
- Continuous monitoring of MRCs are done at the level of Additional Directors to ensure timely settlement. Time limit of 45 days has been fixed for final settlement of MRCs.
- The requirement for referral /permission for diagnostic tests/investigations has been done away with.
- ‘SMS-Alert’ system has been introduced by CGHS for close contact with CGHS beneficiaries
- CGHS beneficiaries can avail medical consultation and medicines from any CGHS Wellness Centres across the country.
- Biometric System for recording attendance has been introduced in CGHS to ensure punctuality.
The above information was submitted by Min of Health & Family Welfare in reply in Rajya Sabha