Lok Sabha Question No. 1389 (UNSTARRED), answered on 2023-02-10
Subject: Complaints against CGHS Dispensaries
Ministry: HEALTH AND FAMILY WELFARE
Asked by: Sangeeta Kumari Singh Deo, Jayanta Kumar Roy

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

## LOK SABHA UNSTARRED QUESTION NO. 1389 TO BE ANSWERED ON 10 TH  FEBRUARY, 2023

## COMPLAINTS AGAINST CGHS DISPENSARIES

## 1389.   SHRIMATI SANGEETA KUMARI SINGH DEO: DR. JAYANTA KUMAR ROY:

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

- (a) whether Government have been receiving regular complaints regarding problems being faced by CGHS beneficiaries such as depleted strength and absence of Doctors/staffs, discontinuation of visit of Medical specialists, lack of infrastructure, nonavailability of medicines, malfunctioning  of  server,  long  queue  of  patients,  working  of  dispensary  in  rented  building, shortage of staff, refusal of private empanelled hospitals, delay in reimbursement of medical claims etc.;
- (b) if so, the details thereof during the last three years, dispensary-wise;
- (c)  whether  there  is  need  to  extend  cashless  facility  provided  to  retirees  under  CGHS  to  all serving employees also and if so, the details thereof;
- (d)  whether  the  Government  proposes  to  consider  to  remove  the  requirement  of  repeated endorsement for all CGHS beneficiaries and if so, the details thereof;
- (e)  whether  the  Government  proposes  to  set  up  separate  hospitals  exclusively  for  CGHS beneficiaries, on the lines of Ministries of Railways and Defence and ESIC and if so, the details thereof along with necessary steps taken in this regard; and
- (f) if not, the reasons therefor?

## ANSWER THE MINISTER OF STATE IN THE MINISTRY OF HEALTH AND FAMILY WELFARE (DR. BHARATI PRAVIN PAWAR)

(a) to (f): The details of complaints on record during last three years are annexed.  CGHS is a subscription  based  scheme  with  a  mandate  to  provide  CGHS  facilities  to  beneficiaries.  The treatment  can  be  availed  from  all  the  Government  Hospitals  and  private  hospitals  empanelled under  CGHS.  Medical  Officers  of  CGHS  provide  healthcare  facilities  in  the  mode  of  family physician.  Regular  clinical  treatment  is  to  be  availed  from  CGHS  Medical  Officers  after consultation from Specialists.

All  CGHS  beneficiaries  are  entitled  to  avail  cashless  treatment  under  emergency  at  private hospitals empanelled under CGHS.

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| Grievance Category                                                    |   Received During 2020 |   Received During 2021 |   Received During 2022 |
|-----------------------------------------------------------------------|------------------------|------------------------|------------------------|
| Extension of CGHS to new Cities and New Areas                         |                     74 |                     75 |                     57 |
| Related to Medicines                                                  |                    250 |                    241 |                    213 |
| Compassionate Appointment                                             |                      8 |                     12 |                      7 |
| Complaints related to CGHS Staff ( including shortage)                |                    164 |                    208 |                    223 |
| Related to settlement of Medical claims                               |                    222 |                    401 |                    392 |
| CGHS CARDS                                                            |                    426 |                    536 |                    514 |
| Requests for Full Reimbursement                                       |                      9 |                     23 |                     16 |
| Complaints against Empanelled Hospitals                               |                    243 |                    341 |                    369 |
| Grievance related to Pension                                          |                     30 |                     56 |                     37 |
| Others ( include infrastructure , buildings, internet , electricity,) |                    648 |                    925 |                    955 |
| Total                                                                 |                   2074 |                   2818 |                   2783 |

Average disposal time of complaints 17 days.