Lok Sabha Question No. 1702 (UNSTARRED), answered on 2016-11-25
Subject: Poor Functioning of CGHS
Ministry: HEALTH AND FAMILY WELFARE
Asked by: BHARTRUHARI MAHTAB, SANJAY SHAMRAO DHOTRE

## GOVERNMENT OF INDIA MINISTRY OF HEALTH AND FAMILY WELFARE DEPARTMENT OF HEALTH AND FAMILY WELFARE

## LOK SABHA UNSTARRED QUESTION NO. 1702 TO BE ANSWERED ON 25 TH NOVEMBER, 2016

## POOR FUNCTIONING OF CGHS

## 1702. SHRI BHARTRUHARI MAHTAB: SHRI SANJAY DHOTRE :

Will the Minister of HEALTH AND FAMILY WELFARE be pleased to state:

(a) whether the Government has received a number of complaints regarding poor functionin Central Government Health Scheme (CGHS) in the country;

(b)  if so,  the  details  thereof,  State/UTwise  and  the  reasons  therefor  along  with  the taken/being taken by the Government on such complaints so far during the last three years;

(c) whether the Government has ever conducted any enquiry/audit/study on the f uncti ing of CGHS  facility  in  the  country,  if  so,  the  details  and  outcome  thereof  and  if  not,  the therefor;

(d)  whether  the  Government  has  any  proposal  to  replace  the  CGHS  with  a  Health  Insuran Scheme  (HIS),  if  so,  the  details  thereof  along  wi th  the  time  by  which  CGHS  is  likely  to  be replaced with HIS in the country; and

(e) the other steps taken/being taken by the Government to improve the functioning of CGH the country?

## ANSWER

## THE MINISTER OF STATE IN THE MINISTRY OF HEALTH AND FAMILY WELFARE (SHRI FAGGAN SINGH KULASTE)

(a) & (b): Some grievances have been received from CGHS beneficiaries through grievance portals and other channels regarding functioning of CGHS. These are mainly regarding non - issue of  medicines,  plastic  cards,  shor tage  of  doctors/  specialists  and  long  queue  of  patients Wellness Centres.

Following action has been taken by the government in this regard:

- (i) Appointment of retired doctors on contract basis as a stop gap arrangement to fill th posts.
- (ii) Medicines,  which  are  not  available  at  CGHS  Wellness  Centres  are  procured  throug Authorized Local Chemists.
- (iii) A special drive was undertaken to clear the pendency of issue of CGHS Plastic cards
- (iv) Option for self - printing of CGHS cards for existing CGHS beneficiaries.
- (v) Introduction  of  on - line  registration  for  consultation  at  selected  Wellness  Centres Bengaluru and in one zone in Delhi.
- (vi) Initiation of tele - consultation on trial basis in Delhi from two CGHS Wellness Centres wit specialists of Dr. R.M.L Ho spital.

(c): Regular internal audits and also external audits/studies on the functioning of CG been carried out.

Outcome of some of the important studies are as under:

- (i) Staff Inspection Unit (SIU) was carried out by Ministry of finance for Staf f Pattern Norms based on patient attendance.  Recommendations of the SIU have been implemented.
- (ii) Based on the study carried out by Kaul Committee , computerization of all the CGHS Wellness Centres has been done
- (iii)On  the  basis  of  recommendations  of  the CAG  Aud it  on  procurement  of  medicines, Medical Stores Organization (MSO) has initiated e - tender for procurement of Anti Cancer and  other  Lifesaving  medicines.  It  has  also  been  decided  to  procure  only  L1 medicines under formulary for Branded Medicines.
- (iv) Commi ttee  of  Secretaries (COS)  has  also  been  monitoring  the  functioning  of  CGHS since 2008 and various steps have been implemented to make CGHS beneficiary friendl As  per  the  recommendations  of  COS,  UTI -ITSL  has  been  appointed  as  Bill  Clearing Agency  for  sett lement  of  credit  bills  of  empanelled  hospitals  and  diagnostic  cent pertaining to the treatment of CGHS pensioner beneficiaries.
- (v) The functioning of CGHS is also monitored by the Hon'ble Prime Minister and as per the directions  under 'PRAGATI' ,  the  proces s  of  linking  of  Aadhar  Number  with  CGHS beneficiary Numbers has been started.

A special drive was undertaken to clear the pendency of issue of CGHS Plastic ca Provision has been made for self - printing of CGHS cards by existing CGHS beneficiaries.

- (vi) DAR& PG conducted a study through Quality Council of India (QCI)   to identify of Grievances in Different Ministries and organizations including CGHS and sugges possible solutions.

Based on the inputs so received:

- Financial  Powers  of  Additi onal  Directors  of  CGHS  have  been  enhanced  for  early settlement of medical claims of Pensioners.
- Introduction  of  on - line  registration  for  consultation  at  selected  Wellness  Centres Bengaluru and in one zone in Delhi.
- Aadhar based Bio - metric Attendance f or the staff at CGHS Wellness Centres has been implemented in Delhi and NCR.

(d): No.

(e): The following steps have been taken for improvement in the  functioning of CGHS in country: -

1. Regular Inspection of Wellness Centres is carried out.
2. Monthly  a dvisory  committee  meetings  are  held  for  each  Wellness  Centres  with  CMO (Incharge)
3. Regular monitoring of empanelled hospitals by a team constituted by Additional Direc CGHS of cities for this purpose.
4. Regular meeting of Additional Directors, CGHS wit h pensioner associations.
5. SMS alert facility to CGHS beneficiaries.

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