Friday, September 25, 2009

Temp Attachment Card ECHS

From: brig sateesh kuthiala
Sent: Thursday, 24 September, 2009 3:11:20 PM
Subject: Temp Attachment Card ECHS

We have been receiving numerous complaints concerning the Temp Att Card required by Veterans who have to relocate temporarily to stations other than the Parent Polyclinic. Whereas we have in consultation with the ECHS been successful in working out a revised SOP (as given below)regarding the TAC some doubts still remain.

The Temp Att Cert (TAC) is reqd for issue of medicines for LONG durations. There is no other purpose.

We had prepared a proposal , but due to apprehensions of large scale uncontrolled sick reports (beneficiaries from peripheral areas) at polyclinics in NCR and in large cities, the proposal has been withheld. It was seen that there was a significant population that came to Chandigarh, for instance, to draw their medicines probably because the supply position there was better. One alternative proposal (to the one given below) is that for the first month only 7 days medicine will be issued at a time. After the first month when the revised load due to the new entrant has been catered for 30 days medicine can be issued as for all other dependants.

May I invite views from veterans ASAP. Please be brief and to the point. PLEASE DO NOT BE ABUSIVE OF THE ECHS no matter how dissatisfied you are.

(Brig SC Kuthiala, Member ECHS Division IESM) Email ID -

Monday, September 21, 2009

Three Month's issue of medicine by Brig Kuthiala

From: brig sateesh kuthiala

Date: Mon, Sep 21, 2009 at 10:13 AM

Subject: FW: Three Month's issue of medicine

To: krish seth

My dear Gen, I read the assurance given by you to Chander Kamboj on Report my Signal and am therefore writing to you to bring you upto date on the issue. I had attended the ECHS seminar at Chandimandir 16 Jul and was part of the panel that put across the ESMs view of ECHS. The AG had issued instrs for issue of 3 months medicine to chronically ill patients requiring long term treatment. The Dr at the polyclinic was reqd to prescribe these medicines (for three months) after seeing the patient. The DGAFMS issued his own letter negating the AGs letter on the plea that it was unethical to issue medicines for long periods without a monthly review and also because it was not possible to issue medicines in bulk because it upset the already in vogue demand cycle. I had responded at the seminar (the above point was made by the DGMS Army who was part of the same panel) that in my personal case (Angioplasty) my Dr at Escorts always prescribed medicines and asked me to come back for a review after 6 months. The Polyclinic Dr was free to and infact should check and then prescribe 3 months. I also stated that practically at the Noida polyclinic I was always permitted to draw my 3 months quota by the Gynaecologist. This drew a laugh but the DGMS Army was not keen on pursuing the matter further. Subsequently I have learnt that the AG and DGAFMS have discussed the matter but the DGAFMS is sticking to his guns. Since medicines are procured through Med channels the DGAFMS has a veto. The supply cycle arguement is faulty. To ensure that there isnt a sudden spurt in demand all one has to do is break the entire patient population at a polyclinic into three. For eg at Noida Month one could be for issue of the 90 day quota only to patients with names A to H the others get 30 days. Month two 90 days for patients with names I to P and so on . The complete cycle would stabilize in just three months.

Please read the mail below to get a first hand feel of the actual problem.
Brig Sateesh Kuthiala

Dehradun (MH) ECHS Polyclinic has a goodlooking new building with a 'naturally heated' waiting hall for officers..without exhaust or windows....imagine the plight of the veteran officers and ladies.....the waiting period extends upto 2 hours + at times!!!!! The toilets located 50 mtrs away in the open cannot be used thru the year.
Coffee/tea vending machine has been removed. There is NO canteen / coffee shop to cater for the needs of the patients. The only, old canteen is located some 1 km away!

MEDICINES are 'usually' NA.....what to talk about 3 months issue. When querried, the reply is, "Contact the Comdt MH / lack of funds / etc etc".

FUNDS - surely adequate funds are bein allotted vis a vis the dependancy. Even when the 'best' salts are NOT
being purchased, how can the funds fall short?

Dehradun (MH) ECHS Polyclinic has been awarded as the Numero Uno Polyclinic. What are the yardsticks, QR,
was patient opinion obtained? NO! I was at Pune and drew medicines from ECHS Polyclinic earlier this year. If they can stock/issue 'better' medicines - why not at the so called #1 Polyclinic? Surely the 'same' authorization
has been given to all.

This matter of high handedness must be addressed at the higest forum at the earliest in the overall interest.

Harassment of ECHS users

The harassment of ECHS users with reference to the policy on three nonth issue of medicine vs one month, changed over recently, has caused us deep concern.
While the establishment's reasoning of 'ethical issues' and logistics etc is understood, it needs to be appreciated that in healthcare (primarily a service industry), aspects of 'client satisfaction and ease' need to be paramount. It is in this that the 'regimentation' system, essential in service life, needs to make way in the 'second innings' -veterans in need of an empathetic assistance for healthcare, even at the cost of adjusting procedures.

There are many cases of the immense pain and inconvenience to veterans. It needs to be pointed out that these refer to SENIOR officer veterans living in metros. One shudders to think how bad the situation would be for 98% veteran population living in isolated rural areas; particularly for semi literate, aging JCO/ OR veterans!!
There are many others. I got a call from Col Narainan in Chennai, close to 90 years of age, helplessly complaining of how difficult it is to go 25 Km to the ECHS Polyclinic, to get medicine. AND spending MORE on transport than the cost of medicine!! If it were 90 days issue, it would perhaps mean cost effectiveness, AND less journeys, difficult to undertake at his age. To top it up, one cant delegate collections to even the spouse. So he and his 80 year old wife, both chronically sick/ ill, trudge to the Polyclinic every month!! SAD you will agree.

This case must be forcefully taken up with ECHS HQ for onward projection and resolution. If processes need to be changed, so be it. BUT Patient interests NEED to BE PARAMOUNT. A rethink on this, and reversion to the old system is required. Who else can an ex serviceman look to for support than his erstwhile comrades in arms?
Retirement in any case, is a future reality for ALL current corp of serving soldiers.............and in attending to these issues, we can only have a win win situation.

With Warm Regards,
Col RP Chaturvedi (Retd)

3 months medicine for veterans by Lt Gen KM Seth

From: krish seth

Sent: Sunday, 20 September, 2009 7:30:55 PM

Subject: ECHS - TWO IMPORTANT EMAILS FROM IESM - EMAIL 684/2009 - 20 SEP 09 - (R to S)
My Dear Chander,
I am pained to read about the hardships being faced because the medicine is now being disbursed only for thirty days as against 90.I will personally take up this issue with our chief and if required would meet the Hon Minister of Defence.
Great job being done by you all.
Gen Seth.

With Best wishes.

(Lt Gen KM Seth, Former Adjt General, Former Governor of Tripura,and Chhatisgarh from June 2000 to Jan 2008.)

Wednesday, September 16, 2009

RR Situation by Maj Gen Satbir Singh

Dear Brig Kuthiala

1. Six years have gone by, the ECHS has many problems. The scheme which was to improve the quality of health care of ESM and reduce burden on the service hospitals has ended up causing harassment and inconvenience to ESM. You are aware that as per our terms and condition, the ESM and his spouse are to be provided health care by the Govt (Service hospitals) till we go away from this world. ECHS gave benefits for dependent parents and children. If surgical measures are not adopted, we will end up in chaotic situation. I wish to quote one example. On Saturday 12 Sep 2009 I and my wife happened to go to RR. What I saw and went through does not behove well for ESM health care. The RR has refused to accept ESM, even those who were already under treatment at RR. They say, we should go to empanelled hospitals. You all are aware, all good hospitals have withdrawn from the ECHS for non payment of bills and other reasons. If RR does not accept ESM, where will they go? Secondly the procedure for getting RR referral and with in RR is too tedious.
2. Friends, as one grows old, the need for health care increases. It is the ESM in large numbers who would need to visit medical establishments for health care. If good civil hospitals are not coming forth and military hospitals like RR, Base hospitals and other military hospital don’t accept ESM, where are we going to go?
3. Brig Kuthila, IESM came to being only when other organizations were not able to address issues for the welfare of ESM. Let us not worry about what other ESM organisatiions will do. Let us delver and build up ESM confidence in IESM. If we succeed in doing so, all ESM will start looking up to IESM. Any positive suggestions will have to be accepted by the ECHS MD, the service HQs, MOD and the Govt.
4. Let us go ahead and prepare a good paper on ECHS and take up the issues on Op Immediate Basis.

With Kind Regards,

Jai Hind
Yours Sincerely,

Maj Gen (Retd) Satbir Singh, SM
Vice Chairman Indian ESM Movement
Mobile: 9312404269, 0124-4110570
Email :

IESM ECHS Division Concept Paper #1

From: Rakesh Prasad Chaturvedi

Date: Tue, Sep 15, 2009 at 8:45 AM

Subject: IESM ECHS Division Concept Paper #1

To: Brig Kuthiala , air marshal rai , george kuruvilla ,

A Concept Paper on the Aims/ Objectives, Organization and Work Philosophy of the IESM ECHS Division is attached.
The names of Region/ Polyclinic Liaison Cells (RLC AND PLC) members have been separately forwarded to the MD ECHS for formal dissemination under his authorization. You are requested to await confirmation on this, before proceeding with any liaison with ECHS functionaries. This will be confirmed by ECHS Div HQ soon.

Of the many volunteers who offered their services for this noble venture, most have been adjusted in one of the Liaison Cells. We are still a long way from full representation in ALL Regions, and expect more veterans to step forward to assist the venture. RLC and PLC heads may please immediately start locating and forwarding to ECHS Div HQ, names of volunteer veteran Officers, JCOs and OR (and equivalents in Navy and Air Force), to give us 2-3 members for manning each RLC and PLC.

While presently our communications will continue on personal e mail ids, we will shortly switch to institutional mail ids /groups.
In the interim, you are requested to Prefix ECHS Div in the subject line, to facilitate filing/ creating folders.
Coordination guidelines would follow soon.

Report My Signal is requested to disseminate this, with request that user queries / suggestions may please be addressed to respective Region/ Polyclinic Liaison Cells (where existing) - Annexure 1 of Concept Paper refers. Thanks.

With Warm Regards,
Col RP Chaturvedi,
A-35, Sector 36,
Noida 201303.
Mob: +919891279035
CONCEPT PAPER #1 dt 11Sep 09
Evolving our Aim/Goals to Achieve, Organizational Matrix and Work Philosophy
1. With continually rising cost of medical care and simultaneous depleting income, Healthcare is a major concern for veterans.

2. Aware of this, the Indian Ex Servicemen Movement (IESM) has established an ECHS Division to address and assist ESM Healthcare issues.

3. The Division is chartered to assist in the creation of the Finest Healthcare system for ESM.

4. Two points need to be made.
a) Finest Healthcare system is a subjective term. To measure our progress in its creation, we need to establish WHAT constitutes ‘FINEST HEALTHCARE’. Some constituents are listed in para 5 as benchmark, so we know what we are aiming at. The ECHS Division will endeavour to achieve these.

b) While ESM concentrations are identifiable in certain regions, there are areas that are not sufficiently populated with ESM, to justify
setting up of ECHS polyclinics. Consequently creation of an effective Healthcare grid will need to address thin ESM habitations in isolated /remote areas.

5. Essentials of ‘The Finest Healthcare System’.
a) Clean, comfortable polyclinics with hygienic facilities for drinking water, toilets and spacious, ventilated waiting areas with adequate seating.

b) Speedy Registration.

c) Empathetic staff and Doctors. ECHS is basically a ‘Service Industry’. The ‘Comfort and Feel Good of the client (patient) comes FIRST – Always and Every time.

d) A Prioritization system for patients in distress/ Senior Veterans and those needing urgent attention.

e) Quick consultation with Doctor and issue of medicine.

f) Expeditious procurement of NA medicines. Intimation to patient about availability.

g) Issued medicines to have sufficient residual shelf life.

h) Simplification of processes to ensure patient is not harassed / made to run around for referrals, approvals etc.

i) Simple processes to ensure empanelled hospitals and not the patient , run around to get approvals/ intimations etc. Polyclinic to be the Single window for all the patient’s requirements.

j) Speedy processing and clearing of hospital bills.

k) Speedy processing and clearance of patient reimbursements.

l) Monitoring and Performance Audit of Empanelled Hospitals.

m) A support system to render advice including legal, to ‘wronged’ veterans to file consumer complaints in case of default/ deficiency in services at any level of the medical chain.

6. In case of any dispute/doubt on what is to be done, the Patients’ convenience and comfort must be the supreme, overriding, deciding factor ALWAYS AND EVERYTIME.

7. Organization of ECHS Division. Ensuring the desired constituents discussed above, necessitates presence of ECHS Division representatives at every level of ECHS HQ/ Polyclinics. . (For Organization of ECHS refer to ECHS Information Brochure 2008 OR visit ECHS website ). The following organization is therefore planned.

a) IESM ECHS Division HQ at Delhi, forming part of the IESM Core Group. Comprises of

Air Marshal Kuldeep Rai, AVSM 9818601740
Rear Admiral George Kuruvilla, VSM 9447508936
Brigadier Sateesh Kuthiala 9811660251
Colonel RP Chaturvedirp 9891279035
Hony Lt Kameshwar Pandey pandeykameshwar@gmail.com9811059825

b) Region Liaison Cells collocated with ECHS Region Centres. Presently 13. 15 more are on the anvil. List of Region/ Polyclinic Liaison Cell members is attached as Annexure 1. Only stations highlighted in Yellow have been represented so far, based on available volunteers.

Jammu (J&K, HP, Punjab)Jaipur (Rajasthan, Haryana, Punjab)
Chandimandir ( Punjab, HP)Lucknow ( Uttaranchal, UP)
New Delhi (NCR, Haryana)Jabalpur ( MP, Chhatisgarh, UP)
Pune (Goa,M’rashtra,Guj,MP,UP, Raj) Patna (Bihar, Jharkand, Orissa)
Chennai (Tamil Nadu, A&N)Kolkata ( West Bengal, Sikkim)
Kochi ( Kerala, Lakshdweep)Guwahati (Assam , NE states)
Hyderabad ( AP, Karnataka)

c) Polyclinic Liaison Cells collocated with ECHS Polyclinics. ECHS Brochure/ website refers.

d) Volunteers at Polyclinics.

8. Working Philosophy. The ECHS Division is basically a ‘User Interface’. It works on the premise that the ECHS organization is as keen to improve functioning as any other professional organization, which indeed the Defence services are. Its approach consequently would be based on close interaction with both, the ESM, as users, and the ECHS as the provider of health services. It is vital therefore that ECHS Division members exercise high grade diplomacy and cordiality in ensuring anticipated changes rather than assume a role of ‘auditors/ inspectors/ nambardaars/ union leaders’ which WILL be counterproductive. We want improvements and have little place for crass, undisciplined and rude behaviour/showdowns. Our role has to be participative and constructive. Diplomacy and finesse’ is called for. We therefore need volunteers with a cool, balanced temperament.

9. Duties.
a) ECHS Division HQ.
i) Will maintain CLOSE contact with both, the Region Liaison Cell and ECHS HQ, to provide an apex ‘bridge’ between the user and provider.
ii) Will identically interact with other Governmental bodies/ organizations in pursuit of an effective healthcare system for ESM.
iii) Will evolve necessary plans, presentations and instructions to guide the ECHS Division efforts.

b) Region Liaison Cell.
i) Will identify and recommend to ECHS Division, volunteer veteran (Officers, JCO and OR (and equivalents in Navy and Air Force)) to be nominated as members of Region and Polyclinic Liaison Cells.
ii) Will remain in close touch with the ECHS Region Centre and the Polyclinic Liaison Cells, and assist in resolution of ESM Healthcare problems in consultation with the two.
iii) Will keep IESM ECHS Div HQ apprised of problems not resolved with Region Centre.
iv) Will liaise with local Station HQ informally to expedite any issue affecting ESM healthcare.
v) In case of any veteran being admitted / evacuated to their geographic area, visit and seek a feed back.
vi) Assist in any consumer court/ legal issue with service provider.

c) Polyclinic Liaison Cell.
i) Will maintain regular and cordial contact with the ECHS OC, staff and IMPORTANTLY, the users- patients. Will act as bridge between the two, to ensure patient care and problems are expeditiously attended to.
ii) Feedback and assistance of Region Liaison Cell will be sought in case resolution locally is not possible/ working out.
iii) Will identify volunteers who wish to help out in making ESM care comfortable. While details will need to be worked out locally, the following duties may be possible.
· Assisting with Reception/ Registration, particularly when ECHS staff may be on leave etc.
· Guiding / explaining to patients, issues related to prescriptions, latest instructions, administrative problems etc.
· Prioritizing of patients who may be in need of urgent attention.
· Assisting out with administration in liaison with RWAs.
· Helping / escorting the elderly if required.
· Visit / seek feedback on efficacy of treatment at empanelled hospitals.

10. Monitoring. A Monthly Report from RLC to Div HQ, on E Mail, will indicate:
a) Satisfaction levels at polyclinics, deficiencies of medicines, amenities etc.
b) Cases to which ‘neglect’ can be ascribed.
c) Details of NA medicines including period for which NA.
d) Any QC issues.
e) Any misuse cases.

11. Conclusion. Even God is said to help those who help themselves. Our philosophy to organize the Finest Healthcare for ESM revolves around this. While interactive confabulations WILL continue with ECHS staff/ HQ at all levels, we perceive that the REAL difference to OUR healthcare would emerge from a participative involvement.
Annexure 1 (Refers to
Para 7b of Concept Paper #1 )

(Updated to 11 Sep 2009)

Contact No
Contact No 2
E Mail ID

Opinder Singh

Ravi Bedi

Gp Capt
KS Raghavchari, VM

RB Nair

Abhay Bhargava

Wg Cdr
Raman Sopory

BS Mehta

Lt Col
VD Patil

Wg Cdr
AB Bhushan


Rajesh Dua

Saranjit Sahney

Lt Col
MS Yohannan

Lt Col
Mary Yohannan

Sqn Ldr
M Rajan*

NR Kurup

Lt Col
Pradeep Goyal

Lt Col
RS Tripathi

DK Uberoy

CM Harnal

Lt Col
DK Sharma

Una, HP
Lt Col
Rajinder Singh

Sunday, September 13, 2009

Second opinion from Specialists

Dr. Veena

dateSun, Sep 13, 2009 at 12:08 AM

subject:Second opinion from Specialists

hide details 12:08 AM (0 minutes ago)

Have you ever tried fixing a meeting with a super-specialist in a hospital ?
It has always been difficult to meet the super specialists like Cardiologist, Oncologist, Urologist (or any other specialist). Even if you get to meet the specialist, the interaction time is so little that you hardly get time to clarify all your doubts.
To solve this problem, HealthcareMagic has recently launched its Super Specialist Opinion Service. Now you can talk over phone to a Senior Cardiologist or Oncologist or a Neurologist or get a reply from these super specialists over Email. You can email your medical reports so that the specialist is aware of your case in advance.
You can directly select your super specialist, view his profile and send him an email/request for a phone call at HealthcareMagic.
This may be an important service if someone known to you is already diagnosed with a serious problem and wants to talk to a specialist to get his opinion.
Best Regards,

Hearing and Speech clinic offers military discount to faujis

Saturday, September 5, 2009

Hearing and Speech clinic offers military discount to faujis and families
Ritu Chaudhary, a highly experienced Audiologist and Speech Pathologist (Formerly with PGI Chandigarh) with more than 15 years of experience, offers upto 15% discount on selected models of hearing aids for defence personnel and their families at her clinic.

All advanced hearing tests and methods of speech therapy are available at the clinic which is also fully equipped with latest state-of-the-art computerised equipment for diagnosis and rehabilitation of hearing loss.

Readers located in North India may want to make use of this facility. Ritu Chaudhary’s Hearing and Speech Clinic is located at:

SCO 65, First Floor, Sector 20-C (Tribune Road)
Chandigarh -160020

Wednesday, September 9, 2009

Emergency Cases Echs by Brig Kuthiala

From: sateesh kuthiala []

Sent: Tuesday, September 01, 2009 6:35 PM


Subject: emergency cases echs

Dear Gen, cases such as att bring a bad name to the org and nullify the excellent work being done by all of you. we had a meeting of ESM from all over the country recently- chennai, kerala, bangalore ,rajasthan,haryana,HP, punjab etc. the common refrain seemed to be the negative attitude of OIC polyclinics. some veterans expressed strong views on some OICs whom they even named.The OIC polyclinic is obviously the frontman for all dealings with veterans and therefore his importance. in this particular case (Ashvini) a message needs to be sent out. also please see how this offrs problem with regards to dialysis thrice a week can be resolved to his satisfaction ASAP. Thanx

Brig Sateesh Kuthiala