Wednesday, August 11, 2010


Rakesh Prasad Chaturvedi
show details 7:40 AM (9 hours ago)

Reference Veteran Harsh Pant's mail below..........
This is definitely a very Positive Attitude..........We need to help ourselves.
The second mail from Veteran Mehandru suggests issue of glucometers to diabetics. The suggestion is good and is being forwarded to Hq ECHS. Hope this comes through. Its like an ATM card ............both, the bank AND the consumer benefit. Polyclinics would benefit in reduced loads at labs and perhaps costing in the long run. It would be great convenience to users, by no means getting any fitter with age.

From: Harsh Pant []
Sent: 10 August 2010 05:18


I am diagnosed with NIDDM.
I spend Rs 10/- for my Fasting report. May I share how:-
Syringe and vial for collection are taken from ECHS.
I go at 0600 h (6 A.M.) to a private lab close to my house.
All I ask the technician is, in lighter vein, to be a "khatmal" draw blood and load it in the ECHS vial. He normally does not ask for any remunaration-I pay him in gratitude.
Have my morning cuppa tea at 0615. Go comfortably to ECHS after B'fast- get the PP sample taken there and deposit the Fasting sample.
Collect report next day.
No problems for me. No objection by ECHS.
Your discretion in case it should be passed on.

With warm regards and Best wishes
From: swastikgreens []
Sent: 10 August 2010 10:39


The experience of veterans makes a sad reading and we owe it to them to put our heads, hearts and hands together and set the system run smoothly. Some of the possible steps may be considered..

Since clearing of hospital bills seems to be the demon we must streamline it and lay down a time limit for clearance of bills after which the bills must be deemed ‘passed’.

Pending this we have to contact both empanelled and other super speciality hospitals and seek their assistance to provide facility to veterans at subsidised rates or alternately.

The veteran pays as per the ECHS rates and himself claims the bill money paid by him. Rather tough for us to bear but can be of use when no other avenue is open.

We must allowed to consult/get diagnosis from any super specialist of our choosing by paying ourselves and get the recommended treatment /medicines through ECHS.

Diabetics seem to be the worst hit. They require regular sugar level checks..Fasting,PP,3 AM,..before dinner ,after dinner. and random as advised by the specialist. They must be given a Glucometer once in 3 years and a pack of 25 strips every 3 months to relieve their ordeal. This is the way they test in the best specialist hospitals also. For Gurgaon the diabetes specialist on panel visits Rockland for 2 hours thrice a week but a full fledged Diabetic Centre Sitaram Bhartiya Research institute is not on panel even though the offer comprehensive packages to diabetitce esp veterans.

The point requiring immediate attention is the travelling of veterans from bus stops to ECHS and back .The sick and aged have to trudge along for good 5 km or so one way and get back again in rain,sun or cold by most uncomfortable means or on foot mostly having to carry the month’s CSD stuff also..

We have to immediately provide ,to begin with amenity transport from the unit running the show and the two CSD stores from canteen profits and along with contact corporate,,TATAS,MAHENDRAS etc to lend a helping hand. Let us really take care of the men we commanded.

Now Let US FACE THE BALL. G of I,MOD,RRM OR P.M cannot be expected to come to our resecue because we are APOLITICAL...the neuteral......
The ECHS has all the senior , talented and well known officers as members we must request them to contact the various hospitals , corporates and NGOs and seek maximum help and co-orperation. This can be our only hope to find solace and do our duty to the vateranse.

Major Mehandru

With Warm Regards,
Col RP Chaturvedi,
A-35, Sector 36,
Noida 201303.
Mob: +919891279035

Sunday, August 8, 2010


From: avtar singh
Sent: 04 August 2010 23:32
To: K K Pun chi; Kamboj

Dear All,

I have been projecting difficulties in getting treatment from ECHS Poly clinic.

Before I put forth my views I would like to state that only success that Govt has achieved by introducing ECHS is to segregate veterans from serving counterparts.

For a simple high fever during silent hours one has to visit Base hospital at Delhi.
Again Sir for specialised treatment like problem in ear nos throat one is again referred to Base hospital which is about 40 KM from east Delhi .
At Base hospital he treatment may entail a number of visit.

Not the least an arthritis patient has also to follow the same drill. He will first be referred to Base hospital and from there to R & R.

If a veteran from east Delhi visit Base hospital using auto he has to spend Rs 250 and by Taxi it is double the amount.

Also It makes economic sense to get your self traeted by a docto nearby rather than taking this circutous route.

There is an urgent need to

(a) Position specialists of all fields at ECHS on selected days if not full time.
(b) Veterans beyond certain distance from service hospiktal should be given option to be referred to empanelled hospital.

I do not foresee this to happen during my life time


Avtar Singh

Lt Cdr

Views By Cdr R Pathak

From: Ravindra Pathak []
Sent: 06 August 2010 02:09
To: Rakesh Prasad Chaturvedi
Cc: REPORT MY SIGNAL (Chander Kamboj); Brigadier Dharam Prakash; rajkadyan; Kuthiala SC Brig; Vinod Patil; vk talwar

Dear Sir

My suggestion is that Nerul/Upanagar/Thane and other polyclinics be treated as Non MH stations and local doctors be empaneled.

Certainly a MH so difficult to reach can not make these polyclinics as MH dependent.

May be this will solve some of the problems.

Vinod may take up at the meeting on Monday.



Cdr Ravindra Waman Pathak I.N.(Retd)
Member and Coordinator IESM Pension Cell
(Mobile 919822329340)
1 Surashri, 1146 Lakaki Road, Shivajinagar, Pune 411016
Tel 91 20 25655792
Military Veterans visit


From: Rakesh Prasad Chaturvedi
Sent: 06 August 2010 00:01
To: REPORT MY SIGNAL (Chander Kamboj)
Cc: Brigadier Dharam Prakash; rajkadyan; Kuthiala SC Brig; Vinod Patil; Ravindra Pathak; vk talwar


Thanks for bringing the good work of some good doctors to notice of the larger ESM community. I am sure this is a good model for the others to emulate.
The contracting of empaneled hospittals, and location of teh polyclinic is a local station matter and HAS to be resolved in consultation with them.

I am copying this to the members of RLC Cdr Pathak, and Col Patil, both in Pune, and our PLC member at Mumbai, Cdr VK Talwar, with request to take it forward.
The bit about the need for more Polyclinics in Mumbai, since L of C are TWO cutting across the city, which makes lateral movement time consuming, had been earlier pointed out by Cdr Talwar, and perhaps the matter HAS been taken up with local authority last year. Where it stands now, I am not aware.
However a new polyclinic IS being set up at Navi Mumbai as part of the 197 new ones coming across India.
With Warm Regards,
Col RP Chaturvedi,
A-35, Sector 36,
Noida 201303.
Mob: +919891279035
Skype: rakesh.prasad.chaturvedi


From: Brigadier Dharam Prakash
Sent: 05 August 2010 10:22
To: rajkadyan;; Kamboj Chander

Dear Raj & Kamboj,

ECHS Nerul, Navi Mumbai is located over 40 km from INS Ashvani. Taking into consideration travel time and the wait at INS Ashvini, it’s almost a complete day’s activity when ESM are referred for specialist OPD consultations at ASHVINI. No hospital in vicinity has yet been empanelled though the process is on for some hospitals.

In order to obviate difficulties experienced by ESM & families, some IESM members approached local EYE, ORTHOPAEDIC & GYNAECOLOGIST to provide OPD consultations to ESM locally, they are providing such consultations free to ESM fraternity as social obligation to Defence personnel. We appreciate such gesture.

We thought we share our experience with others who may like to replicate.

Brigadier Dharam Prakash (Retd)
B-401, AWHO Complex, Sector 9
Nerul, Navi Mumbai, 400706.
022 27703854 (R), 022 27700341 (Fax)

Views bY AVM RP Mishra

From: RP Mishra []
Sent: 05 August 2010 01:57

This is with reference to the mail of Major Mehandru on the above subject. As per my knowledge, a member can go to any non-empanelled good hospital with the approval of ECHS Authorities,and claim re-imbursement of the bill limited to ECHS rates.
AVM RP Mishra

Views by Gp Capt SS pathak

-----------From: Suhas phatak []
Sent: 06 August 2010 09:08
To: R P Chaturvedi

Dear Sir,
In addition to what is stated below, I also feel that the entire fraternity of AMC officers with their expertise gained in service and those who are not gainfully employed should be pooled in to attend medical camps in their surrounding villages/towns/ districts entirely for the benefit for citizens free of charge. It is our CSR activity.The present state of affairs in public & general hospitals is well known. Mr Desai of Medical Council of India even gave license to practise medicine to all unauthorised students and gained lot of money.

We can really give back to Society.
Gp Capt SS Phatak

iesm and echs by Maj Gen Satish Chandra

From: Satish Jalota []
Sent: 05 August 2010 04:25
Cc: Kamboj Chander
Subject: iesm and echs

I have read the suggestion from Maj Mehandru. Very good idea.
The iesm group takes the suggestions but does not give any feed back.

Recently I had sent some points which had gone to the GM echs and AG , even before IESM came into being.

Communication----why a second phone without STD facility cannot be there in a Poly? There are recieve only phones too.
Why the entire ECHS Org has Mobiles but no number for us to contact them in emergency?
Why the Fax is switched off at night ?
Why there is no toll free number for a region?
Answers are simple: the serving officers running the org do not want to be disturbed.
Solution If there are no funds, ask people to donate money. Have the will and a plan.I ahve

Civil Hospitals
1 Continue with present system. It suits the Babus.
2 Accept the suggestion from Mj Mendru.
3 You fix your charges and I pay the balance, but let me go where ever I want to go. My recent experience with Max and Medanta has been wonderful.
4 Get ESMS from our mecical services to guide the serving officers in the ECHS Org and Station HQ, to be flexible.

Hearing Aids
This area is real racket. One or two vendors have grabbed the field. Even if I need a simple and low cost machine, they want to sell a high value stuff. THE SOLUTION LIES IN getting in more vendors, at least for AUDIOMETRY and arriving at correct solution. Then, the favoured ones by the ECHS should be asked to produce that stuff. ( THESE

Maj Gen Satish Chandra(Retd)
Ex Technical Adviser Defense-London and Director , National Range for Missiles.
+91 9810355010

Monday, July 5, 2010

Donation of Ambulance by family of late Lt Col Gev Eduljee

Donation of Ambulance by family of late Lt Col Gev Eduljee

From: Avula Bharath Bhushan []
Subject: ECHS Secunderabad

Dear Sirs
I had missed mentioning a few details in my mail of yesterday.

Donation of Ambulance by family of late Lt Col Gev Eduljee

The Sub Area Commander Maj Gen KD Singh and other retired senior officers -Air Marshal Nair,AVM PK Mani , Admiral Pestonji and others were present . Capt Viraf and Mrs Edulji handed over the keys of the ambulance to Maj Gen KD Singh who handed it over to Col Basha the OIC ECHS Secunderabad.

Date: Sat, 3 Jul 2010 14:34:44 +0000


3.- Donation of an Ambulance -the most notable and very noble and heart moving gesture was made by the family of Late Lt Col Gev Edulji ( his son Viraf is a serving Capt in the Indian Navy)-The ambulance was donated yesterday 2 jul 10 at a simple function and was handed over to Lt Col Basha ( OIC ECHS -ref Photograph

Wednesday, June 30, 2010

Concessional Ambulance Service for ECHS members Pune District

From: [] On Behalf Of Ravindra Pathak
Sent: 29 June 2010 20:53
Subject: [CoreGpIESM] Concessional Ambulance Service for ECHS members Pune District [1 Attachment]

Dear All
We are all aware that we Veterans are not entitled to Ambulance service from Military Hospitals and ECHS cover starts only after you reach the polyclinic or hospital. Indian Ex Servicemen Movement Pune Core group has been trying to get concessional Ambulance service for ECHS members for some time now.

We have recently been able to get concessional rates of 30% for use of Ambulance kind courtesy Columbus Ambulance Service.

We will be making efforts to get more ambulance service providers to also give such concession.
I am also enclosing Tel numbers of other Ambulance service providers and Empanneled hospitals at Pune.

I request that others at various district places also make such an effort to get this service going in their town.

ECHS Cell: Could you take up this with ECHS authorities to have the regional centers or Commands follow up and get such service at various places.


R W Pathak
Cdr Ravindra Waman Pathak I.N.(Retd)
Member and Coordinator IESM Pension Cell

Sunday, June 13, 2010

ECHS Help Desk

ECHS Help Desk...Click to View

CLICK ON WELFARE.........a scroll down menu would show up.........CLICK ON ECHS........then POLICY on MEDICAL. A Referral Procedure would show up. Its signed by current MD Maj Gen Srivastava

IESM ECHS Division Feedback for improvement of ECHS Services Quarter Ending Mar 10

IESM ECHS Division
Feedback for improvement of ECHS Services
Quarter Ending Mar 10

Part I- Mission and Terms of Reference(No change from earlier Feedbacks)
With the increasing cost of healthcare, and depleting income post retirement, issues concerning Health are obvious areas of concern to veterans.
The ECHS, designed on lines of CGHS providing healthcare to Civil Services Government employees are a big help in this regard. However, given the spread of ESM habitations, and the sheer numbers of ESM, certain innovative/ out of box thinking is essential to ensure that this fundamental right of ESM is guarded.
It is assumed that ‘numbers’ should give US a bargaining leverage with reference to private hospitals / establishments, provided we are able to become a ‘commercial possibility’, and are therefore able to drive a bargain to our advantage. Implicit in this statement is the possibility of better rates, at point of usage delivery for health products/ medicines and modernizing of our polyclinics and processes.
Responding to this requirement, the Indian Ex Servicemen Movement (IESM) constituted an ECHS division, as ESM user interface with ECHS. Accordingly Region Liaison Cells (RLC) and Polyclinic Liaison Cells (PLC) have been created, to provide this user interface at all levels. With ‘eyes and ears’ at the grass root level, and with an ESM apex at NCR, it is believed that a reasonable feedback would be available on a continual basis, to the MD ECHS and accordingly to the AG and the DGAFMS, to be able to create the finest healthcare system for the ESM; perhaps surpassing the CGHS

Essentials of ‘The Finest Healthcare System’. (No change from Earlier Feedbacks)

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.
n) 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.
Part II- Review of Previous Feedback Points
Feedback from RLC/ PLC So Far
Major Areas of concern .

(a) TAC. On being issued the Smart Card the ESM were assured that the card would be usable Pan India. In actual practice however, a Temporary Attachment Certificate (TAC) is required when a user wishes to use polyclinic facilities other than his/ her own. It has been opined, both formally and in informal discussions, that the Smart Card MUST be honoured Pan India. Software experts confirm that the present card HAS the potential to be so used. Irrespective of this, a NEW ECHS card is being introduced that as per ECHS authorities, would overcome this problem.THIS POINT IS A CARRY OVER FROM FEEDBACK OF OCT 09.
(c) Financial Reimbursement in Emergency Admissions. A case has been reported wherein Lt Col Joglekar-a veteran got admitted to an empanelled hospital in Pune in a cardiac emergency. An emergency referral was obtained two days later, but he died in hospital. The officer’s wife was asked to pay which she did. Later, when the ECHS paid the hospital, the latter refunded PART of the payment made by the lady. Question arises
i) If the hospital knew that the officer was an ECHS member, WHY did they ask the widow to pay?
ii) When they got the payment from the ECHS, why was the ENTIRE amount charged from the lady NOT refunded to her? In all fairness, it should have been. AND if the bill was cleared BY THE Polyclinic in parts, why was she not advised how much and why the deductions were being made? Regrettably the local authorities have not responded to her queries in this regard.
(d) Issue of Three Months Medicine. With chronic ailments, medicines are prescribed for long durations and patient asked to report for review in say six months, one year. As medicines continue for the same duration, it would be greatly helpful for the patient to be given (at the doctor’s discretion), medicine for three months. This requirement is pertinent also to patients proceeding abroad for long durations. But more importantly, is relevant to patients in outlying, rural areas, who often need to travel 150-200 km to the polyclinic. Two illustrative cases are attached as Annexure 1. It is strongly recommended that in interests of effective patient care, up to 90 days medicine MUST be permitted to be issued at the doctors’ discretion. THE CASE HAS BEEN FOLLOWED UP AT THE APEX LEVEL. THE PROBLEM IS PERCEPTIONAL, WITH DGAFMS PRINCIPALLY DISAGREEING WITH THE PROPOSAL ON ‘ETHICAL GROUNDS’. THIS HOWEVER RUNS CONTRARY TO GOI LETTER NO MH & FW, O.M. No. S-11011/8/99-CGHS(P), dt 13.10.1999, ISSUED TO CLARIFY A SIMILAR SITUATION IN CONTEXT OF CGHS. THE CASE IS BEING FOLLOWED UP. IN A MEETING WITH AG, IT WAS BROUGHT UP BY US, AND SOME OTHER ESM ORGANIZATIONS WHOSE REPS ALSO ATTENDED THE MEETING.
(e) Dis-empanellment of Quality Hospitals. While initial perspectives envisaged good and reputed hospitals for in house treatment of ESM, the delays in clearing their bills by ECHS has resulted in their gradual weaning away. To correct this - IT IS HEARTENING THAT ECHS HAS SUCCESSFULLY CARRIED OUT TRIALS FOR INTRODUCTION OF TPA METHODOLOGY IN THEIR OPS. IT IS HOPED THAT THIS WOULD OVERCOME THE PROBLEM OF DELAYED PAYMENTS. THIS WAS CONFIRMED DURING OUR MEETING WITH AG (mentioned above).
(f) NA Medicine. While it is appreciated that ‘exact’ brand prescribed by an empanelled hospital OPD may not be immediately available, those prescribed after a hospital admission must be immediately disbursed to the patient. It has been suggested that on discharge, a patient may be issued medicine from the hospital itself for up to one week, and billed for in the hospital bill. As for others, procedures for NA procurements may be refined to expedite its issue. The ECHS division of IESM, is encouraging a system of veteran volunteers to assist ESM patients at polyclinics, and one of their contributions is proposed to be to inform veterans through sms, phone etc that their NA medicine have arrived. ECHS supply chain on its part must plan on ‘Point of Usage’ delivery of medicine, as against stocking and transporting medicine which adds to cost and delays. With an All India network of pharmaceutical companies, this should be negotiated. This would reduce requirements of storage, and guard against medicine going overage. It may even be a good measure to have pharmaceutical companies establish pharmacies on contractual basis/ outsourced in close proximity of polyclinics. IT IS HEARTENING TO LEARN THAT ECHS IS CONTEMPLATING CHANGED LOGISTIC SUPPLY CHAIN MANAGEMENT INCLUDING OUTSOURCING TO OVECOME STOCKING/ SUPPLY PROBLEMS. THIS POINT IS A CARRY OVER SINCE OCT 09.
(g) Pharmacists. Currently pharmacists are not on the establishment of polyclinics, and where posted, are on a lower scale of pay than their counterparts in nursing services. It is felt that their emoluments and aspects of desired retention need careful attention. THIS POINT IS CARRIED FORWARD FROM THE FEEDBACK OF OCT 09.
(h) Dental Care. O P D Dental care is being provided by the ECHS. However, referral facilities for dentures & other specialised requirements are outsourced but are practically non-existent in the E C H S system (there is ONE dental care facility empanelled in NCR- ONE! At Delhi), the rates are fixed in a manner to deter any worthwhile establishment from seeking empanelment. It is recommended that this be reviewed upward. We have volumes and should be able to strike a bargain in rates. THIS POINT IS CARRIED FORWARD FROM THE FEEDBACK OF OCT 09.
(i) Manning/ Organizing for Effectiveness. Present ad-hoc /improvised manning of the Rs 720 crore ECHS, based on offsets is clearly undesirable. Its effect on the Operational effectiveness aside, it deprives the scheme of continuity and growth. It is recommended that GOI approval for a dedicated authorization for the ECHS be taken up. THIS POINT IS CARRIED FORWARD FROM THE FEEDBACK OF OCT 09. IT IS HOWEVER INFORMALLY LEARNT THAT SUCH A COMMITTTEE IS BEING SET UP TO ATTEND TO THIS SERIOUS CONGENITAL ANOMALY.
(j) The Polyclinics. Polyclinics are the ‘delivery points of service’ from the ECHS. It is essential they be well laid out, suitably equipped and efficiently and empathetically manned. Some suggestions in this regard are
i) The layout/ design of Polyclinics should be standardized in consultation with an architect specializing in hospital layouts. Should be adopted Pan India.
ii) It should cater for enough space for comfortable, ventilated, protected from vagaries of weather, waiting areas. Enough rooms for the facilities and provision clean drinking water, sufficient conveniences and storage.
iii) It should lend itself for expansion.
iv) Criteria for selection of OC Polyclinic must include being net savvy, and possessing an understanding of service industry - preferably that of healthcare services.
v) Must have LAN connectivity to ensure optimal smart cards usage, pharmaceutical inventory control and correct demand procedures. This WILL ensure cost effectiveness.
(k) Compensating Military Hospitals for In-house Treatment.
i) Service hospitals (MHs) are authorised & scaled as per the Garrison strength (authorised soldiers only) of the station. ESM are entitled for indoor treatment under specified provisions, as an exception. ECHS was conceived & sanctioned in view of large number of restrictions for treatment of ESM as per the GOI rules vide the RMSAF (Regulations for Medical Services of the Armed Forces).
ii) With gradually increasing number of ECHS patients being admitted to MHs, since inception of the scheme, the load on these units has increased. The staff strength at MHs, particularly the Group D staff is consequently inadequate. All patients invariably complain of poor cleanliness, poor service by safaiwallas, ward boys & ayahs. On the other hand, ECHS has been advised to use the spare capacities of the MHs & rightly so. However in view of the aforesaid problems of staffing/ resourcing, patients do not get the best care which they deserve.
iii) To compensate the MHs ECHS should authorise payment of a nominal amount, say Rs 500/- for each ordinary bed occupied per day to the MH & Rs 1000/- per day for ICU beds. All expensive consumables for eg catheters, stents etc should be paid for by the ECHS. The money paid from ECHS at these nominal rates will bring huge savings to the ECHS in comparison to the Empanelled Civil Hospitals which charge Rs 2000/- to Rs 4000/- per day. At the same time, these funds could be used towards qualitative improvements in patient care and cleanliness.
iv) To improve the facilities of the MH concerned this money should be retained by the MH Commandant, properly accounted for, and utilised only for improvement of facilities for ECHS patients. It could be used for additional hiring of safaiwallas, ward boys and ayahs etc.
l) Staffing Pattern at Polyclinics. The present pattern of having type A,B, C and D polyclinics requires a relook. After 5 years the load on polyclinics should be well known. High pressure polyclinics need to have additional staff based on their dependency. Noida , Gurgaon and Chandigarh are in excess of other type A polyclinics. THIS POINT IS CARRIED FORWARD FROM THE FEEDBACK OF OCT 09.
m) OPD Treatment in Off Hours. There is a definite need for permitting empanelled hospitals to undertake OPD treatment after Polyclinic closing hours. An acceptable system (of either having Polyclinic Doctor on Call/ permitting OPD outsourced needs to be put in place. THIS POINT IS CARRIED FORWARD FROM THE FEEDBACK OF OCT 09.
n) Locating Polyclinics. The intricate logistics and difficulty of ‘getting to’ the polyclinics in some stations, eg Mumbai, have been reported by veterans. Apparently the need to utilize existing infrastructure for polyclinics overlooked the ‘convenience’ of users. As the latter becomes more important with age, it is felt that this needs higher priority. In Mumbai for instance, both, the ‘time and space’ aspect of travel, and the road/ rail alignments needed to be borne in mind while firstly, locating polyclinics AND secondly, working out Area dependencies. It is recommended that as a start, this be studied, coopting inputs / assistance from local IESM ECHS Division representatives. THIS POINT IS A CARRY OVER SINCE JAN 10.
o) Tenure and QR of OC Polyclinics. It has been suggested by veterans that a contract of one year is inadequate for OC Polyclinics. By the time he learns the job, its time to move on. It has been recommended that it should be five years. It has also been suggested that OC Polyclinic must be one who is computer savvy, and has had at least two years in the civvies street, before assuming this appointment. This exposure would give him/her, an empathetic understanding of the handling of staff/ clients (ESM). THIS POINT IS A CARRY OVER SINCE JAN 10.


Relocation of Polyclinic Needed. Gahmar in Gazipur distt, UP, is one of the largest villages in Asia. Referred to as the SOLDIERS’ VILLAGE, it has the unique distinction of having 2-3 members of each family in the defence forces of India. There are fair number of World War II veterans..........some as old as 104 years. The nearest polyclinic is at Gazipur, the district Hq, approx 50Km away. It is felt that this needs relocation to Gahmar, considering the village’s substantial contribution to the Defence forces, and the ESM population there.
Loss of ECHS Membership Card. There is a need to evolve a procedure that enables continuous ECHS support even without the card. There is also a requirement to review the current ECHS rules that dictate a ‘cancellation’ of membership when a card is lost the second time. With a photo attached to the card and Biometric checks built in, it is reiterated that such restrictions are not needed.
Integration of Existing Healthcare Services . Neither serving personnel, nor their dependents are eligible for ECHS benefits. In the circumstances, a separated family member has queried as to what does a separated family/dependent family do when the nearest service hospital facilities are over 125 kms from the selected place of residence? There may be an NCC unit located close by and so...even in their case neither servicemen nor their families can avail of the services of the ECHS. That stated, however, they are treated on 'humanitarian grounds.
This anomaly needs to be addressed. Carrying this further, there is a need to explore a nationwide integration with CGHS empanelled facilities if not their clinics.
Upgrade of Hospital Accomodation. A point often projected is regarding upgrades of hospital accommodation beyond the ‘entitled class’. It is understood that this stays a personal adjustment between the ESM patient and the hospital. Currently, hospitals are charging difference between the Full rates between the two rents (ie Full Rental of Room to which upgrading MINUS the rent of accommodation entitled). It is suggested that such contingencies be built into the contract with hospitals and they be required to charge the differential at the contracted rates.
Hospitalization while Abroad. There have been instances of veterans being admitted to hospitals while abroad. Present rules do not permit reimbursement/ coverage for them. It is suggested that a modality be worked out on lines of Non Empanelled hospitalizations, wherein, in such cases at least ECHS rates of local hospitals be reimbursed to them.
Empanelling Hospitals. Very many hospitals are currently empanelled for specific for Cardio only OR Iconology only. It is felt that such contractual agreements of part empanelment deprive ESM of majority of services available with the hospital. At the same time, the hospital benefits in cashing in on the more commercially viable services. It is suggested that a ‘package contract’ specifying rates etc be projected to the hospitals, and a ’package’ be offered to ECHS users. While the hospital would lose out in some services, profit in some and cut even in others, such standardized contracts across the country would immensely benefit ECHS users. We have numbers, which is a marketing cantilever.


Case of Cpl Bhandari’s Reimbursement. It will be recalled that following an accident, an AF veteran (Cpl Bhandari) at Jabalpur was admitted to a hospital (empanelled/ Non empanelled stayed a confusion for sometime even for us – the ECHS website does not mention it) by his son’s friends, as the latter is at Dubai. Hospital bill was cleared by the patient on discharge. When his son mailed to the IESM ECHS Division narrating the case, we advised him to submit the bill to the Polyclinic, which was done, wherein we were advised by Polyclinic to submit it to the Hospital who would follow up with them. It was then that we learnt that it is an empanelled hospital which in order to overcome delays in bill clearing has resorted to having patients pay and then claim and reimburse to the patient. Despite constant follow up, the Hospital did not budge from their stand that they would refund ONLY the amount received from the ECHS. Such malpractices by hospitals seem commonplace countrywide, as was earlier witnessed in Mrs Joglekar’s case (see Feedback Oct 09). After being constantly harassed by the Jabalpur hospital , Cpl Bhandari’s family has taken a decision to take the hospital to a consumer court, purely on principles. As per them, though the road would be tough, and even though ‘money’ is not the issue, they would like to do it in larger interest of the ESM community. Our salute to them, and we hope their effort will be backed suitably by the ECHS.
Mrs Joglekar’s Reimbursement. It will be recalled that Mrs Joglekar was made to clear the hospital bill after her husband expired in hospital. After prolonged follow up, while she got the ECHS rates refunded, the full amount paid by her was not refunded to her. At our behest, she took up the case with Station Hq and ECHS. The case is presently stuck up with Region Hq who needs to revert to the ECHS Hq with their comments. (ECHS Hq letter No B/49717-C/AG/ECHS/2767 dated 27 Apr 2010 refers).
Dependency Certificate for absence away from Parent Polyclinic. A veteran pointed out that his mother (herself a military veteran’s wife) faces problems of ECHS support while travelling in NCR, being asked to revert to her dependent polyclinic (BH) even when staying variedly with her sons settled in Noida, Gurgaon and Delhi. It has been clarified by ECHS Hq that such matters can be addressed on Regional basis and the Regional Centre is empowered to issue dependency instructions on a case by case basis.


Excellence is a constant pursuit. While enough ground has been covered in improving ECHS services since inception, creating the “FINEST HEALTHCARE SYSTEM” in the country would still involve constant refinement and respecting client feed back as a challenging opportunity to improve. Question that needs to be asked, to the Armed Forces Health Services hierarchy, to quote

Monday, March 15, 2010

Cpl Bhandari case at Jabalpur

Kuthiala Sir,
This case continues to get deeper into needless issues. WE have been in picture from Day one.
An accident, at the very least with a fracture "would constitute 'emergency'.
On Reporting, there was some confusion about the empanellment. You would recall that till the Polyclinic asked for the documents to be submitted through the hospital, we were thinking we were dealing with a non empanelled hospital. This stage was the first indicator (and we spoke about it in detail) that it was an empanelled hospital with an identical 'pay first, claim and then be reimbursed the ECHS cleared amount' philosophy followed in Mrs Jogelkar's case. While on the issue, you will recall we checked on web and did not find the hospital in the annexure of empanelled hospitals. This deepened the mystery.
Be that as it may, the Hospital had NO business to charge and then reimburse ECHS rates to the veteran. They are ONLY ENTITLED to ECHS rates, including audit deductions if any, and must therefore reimburse the TOTAL amount.
We need to convey to the hospital that there is no getting away from this, and it would be a no holds barred action by us, jointly, to ensure they honor what they are committed to, in being an empanelled hospital.

Case of Cpl Bhandari at Jabalpur..ECHS



Subject: RE: Case of Cpl Bhandari Card No JB0002840 Jabalpur Polyclinic
Date: Sat, 13 Mar 2010 05:50:50 +0000

Dear Sir,

Good morning,

Hope you are doing fine. I have well noted ur comments and recently there was another emergency in my family for my mother and we strictly followed all echs proceedures and traetment was done in empannelled hospital without any issues.

but I would like to highlight that Jabalpur hospital stand on the ECHS patient was so negitive, they had stronglly refused my sister at that time of emergency that we dont take ECHS patient. In the heat of that moment we were force to give first aid to my father as suggeted by the doctor and basis their instructions we went ahead with the surgery without any delay. We have been warned by the doctor that there should be no delay in this treatment.

We were unaware about the ECHS proceedures but hospital and doctors were very much aware that he is an ECHS pateint. On my recent visit to India my sister informed that she her self informed the doctors and Mr. manas about my father is an ECHS pateint. I understand from her that initial two days no charge was imposed for the same reason. after that Mr. manas informed that ECHS patients are not being accepted by this hospital anymore and u have to deposit the cash to go further. At that stage and in that condition for us there was no choice and we went ahead with all the terms of the hospital. Fathers heatlth was more important then anything else. We could not follow up with ECHS at that time as i am the only son work abroad and my friends and sister admitted my father to the hospital.

i stronglly feel all of us have been misguided by the hospital and below points are self explanatory.

A. We have been told no ECHS pateint are accepted in the hospital. Even today if u call Mr. manas rai his stand is same. That means even if it is an emergency hospital reaction will be the same and people like us will not think anything and will go overboard and will do the same and provide the treatment to the pateint.

B. amount collected by us is Rs. 98,875 + may be 1 or 2000 more of the medicine. As per below mail hospital is confirming only 73,340.

I am bit concern on this, as what is going on and why figures are diffrenig at the time of refund. All the originals was submitted by self to Ms. Nidhi (ECHS polyclinic staff at Jabalpur) i only have a copy of those bills will forward you the same for your reference.

As far as cooperation is concern no complaints as my sister now keeping in touch with Jabalpur polyclinic and they have assured the refund. But i think things from the hospital side is bit fishy and i am open to cooperate to take them on a task to ensure people like us do not suffer in that kind of situation. i would appreciate if ECHS help me to find if this emplanned surgery was actually required or hospital has just tried to make money.

awaiting yours.

Wednesday, March 10, 2010

ECHS Chennai: Degradation of Services by Lt Col James

From: James Kanagaraj
Sent: 10 March 2010 12:29
Cc: Kamboj Chander
Subject: ECHS Chennai: Degradation of Services

Dear Brig S. Kutiala,
Today I visited the ECHS located in the premises of MH Chennai and observed its functioning for over 3 hours. There were in all about 200 ESM who were seated (all seats occupied), some milling around the reception and many standing near the counter dispensing medicines. There were only 2 medical officers out of 4 employed. The OIC ECHS ... edited ... has no administrative control over his staff.
The waiting period for collecting medicines in the queue system is 3 to 5 hours as confirmed by the OIC. ESM who wish to collect only medicines are also supposed to queue up for which the waiting period is 5 hours plus.
There seems to be a steady decline in the efficiency of the ECHS. The ESM who desire to get treated for their illness are literally made more sick encountering the hurdles placed by the OIC and his staff. The OIC attitude is the most unfriendly and very bureaucratic. Finally after a debate and heated argument with the OIC which was unfruitful I and my wife left without collecting the medicines with a saddened heart. Truly the Veterans battle in the ECHS is a on going process! There is an urgent requirement for instant redressal of grievances of Ex Servicemen within the ECHS Polyclinic and MH premises.

This is for your kind information.
With regards and best wishes,
James Kanagaraj
Moderator, Report My Signal Blog

Friday, February 12, 2010


From: yoginder sharma
Date: Wed, Feb 10, 2010 at 6:50 AM
To: Rakesh Prasad Chaturvedi

Dear Rakesh,
This case needs to be brought to the notice of all the CHIEFS, PPO's and DFAFMS/DGMS's.

Is indicative of a patronising,prejudice-charged and a toxic mindset towards the Veterans.Even if it be an isolated instance it is imperative that the infection is pre-empted by the Powers-that-be.

Brig Agarwal needs serious counselling and more. Everyone bemoans the inimical attitude of the bureaucrats but what about the 'virus' within !!! If ignored 'it' shall spread.

It is not uncommon to encounter similar situations vis a vis the non-medical fraternity also.Times and values are indeed changing. Every time I make it a point to invoke the appropriate level, even to the point of becoming a nuisance. Have had mixed results which is OK.

Best wishes to you all-you are doing missionaty work..
(Lt Gent YN Sharam, Former Army Commander)

ECHS...woes By Brig J Kaul

From: Jawahar Kaul
Date: Sun, Jan 31, 2010 at 9:53 AM
Subject: Fwd: ECHS

My dear Colonel Chaturvedi,
I must express my deep sense of gratitude to you for the selfless service that you have been rendering to entire community of veterans. Your contribution isn strengthening the IESM movement , arranging blood donation camps and organ donation are praise worthy.

As always it was pleasure talking to you on the phone yesterday . I wish to share with you my personal experience for the treatment of my wife. The aim is to sensitise the environment so that the system improves for the good of all concerned.

My wife Mrs Asha kaul , aged 64 has been having a chronic knee problem for the last few years. She was refereed to R & R on 14 oct 08 and Col ( Now Brig ) EDITED , Senior Advisor ( Surg & Ortho ) then advised total knee replacement of both knees. My wife was not prepared for the major surgery and opted to keep trying other options. The problem over a period time got aggravated and she is not able to bear the pain any longer. She was referred again to R & R on 27th Jan 2010. Since my wife was unable to move , I proceeded to R&R on 28th jan 2010 after fixing an appointment with Brig EDITED , the same specialist who had earlier examined my wife and recommended total knee replacement.

Brig EDITED expressed his reservations in recommending the surgery at an empanelled hospital. The discourse with Brig EDITED lasted nearly one and half hours. Most of the time I was at the listening end. He expressed his distress in dealing with veterans , their requirement for special treatment , and for over riding priority. He felt that ESM community is not loyal to the institution of service , has more expectations from the system than they deserve and having contributed a very paltry sum towards group insurance and expecting too much in return and so on . He felt that retired officers were exploiting the system at the cost of retired PBOR and so on. The last straw was that in case my wife opted to be treated at an empanelled hospital , quoting Brig Agarwal " Gates of R & R would be closed to us for ever " and he repeated this three times during the conversation. This in my opinion is a very harsh statement to be made and deserves appropriate response. There was no provocation from me what so ever to hear so much. It is an indication of attitude towards the community of ESM.

I did my best to dispel the wrong impressions from the mind of Brig EDITED. I tried to explain to him the concept behind the launch of ECHS , need for empannelment of private hospitals , the views expressed by DGAFMS at various forums of how the system has been over stretched by the extra load of Veterans , the deliberations of IESM on this subject and so on and the need for him to think very objectively.

I thought I must share my experience for the larger good of the veterans community.

Warm regards,

Brig J L Kaul ( Veteran )
House No 8, Sect 37, Noida
Mob 9871222023


From: avtar singh
Sent: 09 February 2010 07:21

Dear Sirs,

I wish to bring to your notice that there is an acute shortage of medicines at Loddhi Road Polyclinic. The notice board depicting NA medicine is getting bigger and bigger every time.

The ESM at East Delhi has to travel about 14 kms to reach Polyclinic and to incur an expenditure of Rs 150 by auto.

NA medicines are given only for ten days. Making three trips to get medicine means spending Rs 450 per month.

The medicine prescribed on 1-8-2010 wee not available till 8-1-2010.

I request you to take up matter telephonically with concerned authority to ease the situation and subsequently at monthly meeting

I further request you to consider the following.

CGHS has an arrangement whereby NA MEDICINES CAN BE OBTAINED THROUGH CERTAIN DESIGNATED CHEMIST SHOPS. This is a great relief to the individuals and avoids undue rush at the Poly clinic. Can ECHS have similar arrangements?

Further at Poly clinic individuals are asked to shuttle around various doctors to get Local Purchase medicines approved for purchase. In my opinion this job should be entrusted to Nursing assistant at dispensary who should get the consolidatedapproval and purchase the medicines.

I request that this be promulgated in RMS blog.

Avtar Singh
Lt Cdr

Wednesday, February 3, 2010

Well Done Brig Abhay Bhargava


Dear Chander,

Brigadier Abhay Bhargava has done commendable work and set a fine
example for all the veterans to follow.

My congratulations to Brigadier Abhay Bhargava.

Harbhajan Singh
Lt Gen
From: Virendra Swarup []
Sent: 31 January 2010 01:21
Subject: Well done ...

Dear Brig Abhay,
Kindly accept my compliments for excellent work in helping out our ex-servicemen brethren; keep it up...
May God Bless You,
Take care,
Viru Swarup
5116, East Butler Dr
Paradise Valley, AZ 85253, USA
Air Vice Marshal A Abhayakumar (Retd.) No. 17 1st Main Road Domlur Layout, Bangalore - 560071

ECHS Volunteer

On Sun, Jan 31, 2010 at 1:08 PM, sundara rao wrote:

I volunteer to help ECHS to the max extent possible. My particulars r given below

1. Name Lt Gen C.Sundara Rao (Retd)
2. Age 87 years (GREAT SIR – Chander Kamboj)
3. Date of commission/Seniority Aug 18, 41
4. Date of Retirement 25 Aug 1973
5. Last appointment held DEME (Now DGEME)
6. Place of residence CHENNAI

Lt Gen C.sundara Rao (Retd)

May Joy & Happiness govern your life.
(Thank you General Rao.
Dear ESM, we need many more volunteers for IESM ECHS Division – PLEASE HELP.
If a 87 year old veteran can volunteer why not you???
– Chander Kamboj)
From: IESM- ECHS Div Hq
Date: Sun, Jan 31, 2010 at 4:05 PM
Subject: Re: ECHS
To: sundara rao

Sir, Thanks very much for your kind offer to help in our effort to improve ECHS services. Please find attached herein, the Concept Paper #1 about our planning in this regard. At Chennai Regional Liaison Cell we have Gp Capt Raghavachari, to whom this mail is copied.

With your vast experience and maturity, we feel you can assist a lot, in firstly mobilizing more/ many ESM to join this drive of IESM ECHS Division. The volunteers can help by counselling/advising ESM so that the time the OC has to devote to queries, can probably be saved eg Which are the empanelled hospitals, what is the procedure for ...........etc.A sort of Help Desk, manned through the day, by volunteers devoting say 2 hrs per day/ as comfortable and a sort of rostering being done. Then there are issues of using ones good offices to motivate station Hq to clear bills / indents faster. ............or some volunteers substituting for absent staff at registration desk etc............these are being done at some stations and shortly we would be trying out at Noida polyclinic. Ofcourse, I am sure Gp Capt Raghavahari himself would draw upon your offer to add weightage to our efforts at the RLC.........but then the cutting edge is at Polyclinics..........the main problem we face is the availability of medicines ,,,,,,,,,,,, and an information system to inform the concerned veteran when the NA medicine arrives.........say through an SMS or a 'missed call- call back' system. Possibilities are immense, unlimited infact.

Do please feel free to call me/ mail me for any inputs you feel would benefit us. Thanks again.
With Warm Regards,
Col RP Chaturvedi,
A-35, Sector 36,
Noida 201303.
Mob: +919891279035
Skype: rakesh.prasad.chaturvedi
From: hsingh1 . []
Sent: 31 January 2010 20:27
To: Kamboj Chander

Dear Chander,

Brigadier Abhay Bhargava has done commendable work and set a fine
example for all the veterans to follow.

My congratulations to Brigadier Abhay Bhargava.

Harbhajan Singh
Lt Gen
From: Virendra Swarup []
Sent: 31 January 2010 01:21
Subject: Well done ...

Dear Brig Abhay,
Kindly accept my compliments for excellent work in helping out our ex-servicemen brethren; keep it up...
May God Bless You,
Take care,
Viru Swarup
5116, East Butler Dr
Paradise Valley, AZ 85253, USA
Air Vice Marshal A Abhayakumar (Retd.) No. 17 1st Main Road Domlur Layout, Bangalore - 560071 Tel:80-535-1677


Monday, January 11, 2010

ECHS problems in Mumbai by Veteran Anil Heble

Sent: Tuesday, January 05, 2010 9:08 AM

Dear Sirs

Well said by Veteran Col Chilimbi.

One only needs to live or know Bombay reasonably to realise the impossibility of veterans and their dependents commuting anywhere, the cummulative costs both in time and money and the personal logistics in support of a day long expedition to the ECHS. No wonder, most find it prudent to seek medical attention on payment.

However, neither are problems of Bombay city or the lack of veteran volunteers to man ECHS centres responsible for near failure of ECHS in delivery of health care to the multitude.

Not one planner in his wisdom was even remotely conscious or aware of the immensity of the scheme, both physical & geographical, not to mention the ununiform numerical presence of entitled veterans in far and obscure corners. Therefore what do veterans of remote areas do ? Must they suffer only because its not "viable" to have a centre in the back & beyond of say Rajasthan or MP? Or must they travel regularly every month to get their 30 days prescriptions ?

In any case the scheme wasn't based on veteran volunteer participation and a few volunteers in Bombay or some other place is no salvation for the rest.

Presently ECHS is on oxygen and has degenerated into a farce with unpaid bills in crores to pharma companies, lack of staff / doctors at centres and above all its positioning in the Government's / Army's thinking process.

Someone please have a look at the quality of medecines given by absolutelu unheard of pharmas. Apparently, new pharma companies have mushroomed only for supply to ECHS and I suspect what we get at best may only be placebo's, if at all.

For starters while ECHS continues to exist for metros and where the bulk live, let someone try and superimpose a set up somthing like ECHS for remote areas by:

1. ECHS could issue all entitled with real SMART CARDS that document each visit, each test, every treatment, medecines issued and any and every entry that will prevent misuse.
2. Negotiate and fix rates for every treatment with civil, private & govt hospitals for provision of health care all all places
3. Clear these bills soonest to keep the system alive
4. Involve insurance companies to deal / supervise payments in their respective jurisdiction. They will ensure that the system isn't corrupted. The rather make the buck that permit someone else.

In this vast country the Min of Def cannot manage an equally vast system. Every type of existing health care delivery system will have to be co-opted with ECHS and yet there would be blind spots which could be fine tuned and as one goes along.

In India no system has yet been found to be fool-proof and will be misused but then it will at least have a chance to function.

Lets accept ECHS can't be flogged any more to get it moving except perhaps in Delhi,

Just a thought. Any comments, Gentlemen ?

Warm regards / Anil heble

Problems with ECHS by Col GB Sethi

From: greh bhushan
Sent: Tuesday, January 05, 2010 10:37 AM
To: Col Sushil Chilimbi
Subject: Re: Compare How ECHS has failed ESM!!!!!!!

Dear Brother Anil Helbe,

I am glad people have now started realising the problems they are facing with ECHS. I faced these problems two years back & that too in as people say in one of the best administered Centre ie: Secunderabad, the callous attitude of the Centre Head, substitute medicines, short supplies , come again , Que up for hours together etc, etc

That day was the last that I ever entered in ECHS Secunderabad where you are treated a liability & not a stake holder who has served the country for 30 long years. You have to be a General or Brigadier at least to get a welcome treatment, I am happy for them atleast they hope fully are getting their due.

I had put it up in the mail & circulated at that time & I could visualise that such a situation will arise & it has .

There is a need to reconsider the whole issue & work out a model which shall meet the needs of the soldiers so widely spread on the Indian Soil. We must remember that we in the services get worn out much faster than the masses outside even though we do keep our self fit with the regular regimen that we all follow .

My request to the authorities is to provide this well deserved facility to the Ex- Servicemen with a smile & let them feel that they are cared for.


Col. Dr. GB Sethi.

Health care at Mumbai

From : RP Chaturvedi

I am forwarding this mail to veteran VK Talwar, the PLC member at Mumbai. It is for reasons such as the ones elicited in your mail that we need volunteers (eyes, ears and sinews of IESM ECHS Division). We had earlier got on another chain, some inputs from Carl, which indicate the problems in Mumbai. CAN someone from MUMBAI take on and forward a detailed analysis and recommendation that we may float to MD ECHS? It could ideally be forwarded by RLC at Pune to the ECHS channels, and a cc forwarded to us to follow up here.

Health care in Mumbai

Col Sushil Chilimbi wrote:

Dear Sir,
Healthcare coverage of ESM in Mumbai needs to be crystallized further.
The major requirement of majority of ESM spread across Mumbai and beyond, up to Dahanu, Ambernath and Panvel is not polyclinics but immediate referral procedures for major healthcare problems at the nearest facility available. No ESM located at Vasai, Ambernath or Panvel would have the time or the inclination to waste his/her time for the quota of monthly medicines or the medical care available at the polyclinics. With the almost non available resources at the disposal of ECHS, polyclinics at best should be provided at the existing ESM enclaves.
If ECHS is to be of any use to a vast majority of ESM in Mumbai, empanelment of a large number of civilian medical establishments along the Western, Central and Harbour grids for cashless treatment is a must. CGHS, PSUs and even the State Govt has this arrangement for their employees. ECHS cannot be beggarly, if it has the commitment of our Govt, which claims to be' concerned' about the welfare of its soldiers!!
Warm regards.