Good tidings for CGHS
V. SWAMINATHAN
The announcement made by the Union Health Minister (“The Hindu”, December 7, 2008) that Central Government Health Scheme (CGHS) centres will be expanded substantially and that each of them will have fully equipped diagnostic laboratory and stand-alone dialysis units which even the general public can use, should be welcomed by all.
Under the scheme, the dispensaries render OPD services and provide specialist consultation in a few disciplines. CGHS has no hospitals of its own and patients needing hospital treatment or other specialist consultation are referred to accredited private hospitals.
The Minister’s statement should set at rest the uncertainty about the scheme created by press reports some time ago that there was a proposal to gradually shift Central government staff to the health insurance system through which they may access CGHS or any other health care provider of their choice. It was reported that while serving employees and pensioners will have the option to continue in CGHS or join the health insurance scheme, new employees (joining after a cut-off date) would be compulsorily brought under the health insurance scheme.
Healthcare provider
CGHS will have to continue, as health insurance does not cover OPD treatment and suffers from shortcomings like age limit, non-coverage of pre-existing diseases and certain ailments in the first year of insurance. CGHS needs to address certain problems and carry out a number of improvements if it is to function in its existing form or as an alternative competitive health care provider. Earlier, patients used to be referred by CGHS direct to accredited private hospitals of their choice for treatment. But now, they have to get the opinion of a State Government hospital before such referral.
This is highly inconvenient, especially to pensioners who, due to their age and ailments, find it an ordeal to wait in long queues in government hospitals which are over crowded. State government hospitals are meant for general public, particularly the poor, and referring CGHS patients to them will only add to the pressure on them. Therefore, the earlier system of direct referral to private hospitals should be restored. Of late, CGHS has stopped paying the bills of its patients to the referral hospitals in full by withdrawing the subsidy amount.
Consequently, a number of leading private hospitals in Chennai, including specialist ones, have opted out of CGHS, causing great hardship to patients. CGHS should restore the payment of the bills in full, if it is to do justice to its patients.
Example of Railways
The above problems will be overcome if CGHS sets up its own hospitals in the metropolitan cities, following the example of the Railways. It is anomalous that Central government, which gives a huge amount of financial assistance every year to the States (more than Rs. 3.9 lakh crore in 2008-09) for various schemes including medical and health, should depend on the State hospitals for treatment of its personnel. Even if a fraction of the amount which it gives to the States is spent by it, it can set up its own hospitals in the metropolitan cities with speciality and super-speciality facilities. Also, CGHS should ensure the timely availability of medicines to its patients.
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