Good explanations and write up by the author but surprised of putting up by him on this forum rather to take up the issue with the ECHS authorities in writing or during the their meetings with the management being an OIC Polyclinic. More so, Why to hide the identity. Let me answer relevant points.
1. ECHS POLYCLINIC should be Treatment Centre rather Referral centres. YES. Then polyclinic required specialists to be employed. There is hardly any in any of the polyclinic . None will be interested with 85000 perks. They will demand min 2.5 to 3 lakhs. So, at least one experienced and well qualified MD Medicine is required in all cat A polyclinics and other polyclinics in the district may refer patient to him. On an average 50 to 60 % of patients are of medicine. Then referring them to empanelled hospitals can be curtailed and can be referred for some tests only.
2. EMPANELLED HOSPITALS. Private hospitals got empanelled for various specialities at the time of empanelment. There is no check after that whether facilities are available or not. Boards are displayed in the polyclinics without ensuring the ground realities. Patient is denied certain treatment for which referred by polyclinics because of NA of specialities in empanelled hospitals, only selective treatment is given. Whose responsibility.?.. No regular check and no audit after empanelment.
3. IT Professional. YES. But in this digital world every one is IT professional provided criteria is laid down for employment with in the authorised strength and suitably employed.
4. RISING EXPENDITURE.
Of course it’s But why.
The problem with the ECHS management is that they have empanelled lot many hospitals. Take the example of Jalandhar or anywhere else, earlier esm were being treated in MH, only one, later when MH express it’s inability to handle esm and widows load , private hospitals were empanelled . Proper study should have been carried out on requirement based. So many hospitals have been empanelled .So what is actually happening , we want all facilities in these hospitals, all specialists , complete infrastructure and other relevant issue.. from where , the hospitals have to earn revenue to meet the requirements. The esm strength is the same and divided in these so many hospitals, so they perforce have to indulge in wrong practice of unwanted tests , procedures and admissions. There should have been two , three or four empanelled hospitals in each district.
5. EMERGENCY ADMISSION.
YES on the higher side and majority admission is not at all fits in emergency norms as laid down.
Patient tends to wait and report to empanelled hospitals after 4 PM after closing down of polyclinic. Very easy for them but why .. Because they are denied referrals by doctor at polyclinics because of fixed percentage of referrals and lack of facilities of various tests and procedures and non availability of specialists.
6. MEDICINE MANAGEMENT. Mismanagement. Why the regular patient is required to go through lengthy procedure ? On an average 70% patients comes to polyclinic for taking regular medicines for which doctors and staff intervention is not required. These medicines are prescribed by specialists of empanelled hospitals . But what’s happening , patients have to stand in queue at reception, then wait for doctor for hours then go to medical store again queue to get medicine. Regular patient data can be maintained in a computer, so that patient go directly to medical store, he checks in the computer system of last issue date and issue the medicine and update records. Very simple. No wastage of time and no load on doctors and other staff.
Approx 10- 15 % patient comes for normal routine sickness for which they have to go to doctors for medicines. Approx 10-15 % patients requires referral either for follow up or few for fresh.
In this way certain percentage of staff at ECHS polyclinic can be cut down to save crores of rupees per year which can be utilised for medicines.
7. NA MEDICINES. Approx 50% of the medicines aren’t available because of shortage of fund . The patient can’t come again to take NA medicine due to old age, distance , time and family member not willing to bring them, perforce buying from market. Data of such patients taking regular medicine be maintained in the system , demanded and procured well in advance from MH or from local market. More so, if substitute medicines can be issued then why not as prescribed , and when certain mg is required , then why double or less.. it speaks lack of responsibility and accountability and the veterans are suffered and harassed.
8.There are many many more points relating to working , behaviour of ECHS staff, timings , refusal to entertain after 2PM , refusal of referral where specialist advised follow up to change, stop or reduce or increase the medicine based on health condition of the patient… The patient is forced to take the same medicine for months by refusing referrals, thus playing with their life.
9. It’s the responsibility of all of us to further strengthen the system and facilities by streamlining the issue with discussions involving veterans and the management from time to time otherwise the Govt will not hesitate to close down ECHS and merge with Ayushman Bharat .
10. I am the Chairman of ESM associations and President TSEWA Punjab and regularly meeting exservicemen associations to get feed back on various issues incl this one of ECHS and doing my best to resolve .