CGHS Has Become A Nightmare For Central Government Employees And Pensioners !

Hospitals are insisting Pensioners to pay in advance for treatment and get reimbursed later, says C. Srikumar, General Secretary, AIDEF


Of late CGHS is being seen in bad light and complaints from the beneficiaries especially from Pensioners are pouring in day by day and sometimes they approach Courts for getting their medical claims fully reimbursed.

C. Srikumar, General Secretary of AIDEF and also a Member of the Standing Committee of the National Council JCM for Central Government Employees told that Central Government Employees Health Scheme shortly called as CGHS was established by the Government of India during the year 1954 to take care of the Health and Medical care of the Central Government Employees and Pensioners. It’s a Contributory Scheme in which the employees contribute a monthly subscription ranging from Rs.250/ to Rs.1000/- per month. The Scheme is applicable to MPs, Freedom Fighters and Supreme Court judges also. Central Government Employees while on superannuation has to pay a lumpsum amount as lifetime contribution for getting the CGHS coverage after retirement.

CGHS has established wellness centres in different parts of the Country in 71 Cities for outpatient treatments. CGHS Empanel Private Hospitals and diagnostic Centre’s who agrees with their terms and conditions including the rates for different treatment and procedures. These CGHS empanelled Hospitals should provide cashless treatment to the Central Govt Employees, their family, pensioner and their family. Initially these Hospitals were giving good medical care to the employees and Pensioners.

Unfortunately for the past few years CGHS has become a Nightmare to the CGHS beneficiaries. Supreme Court on several occasions was critical on the difficulties being faced by the employees and Pensioners at the hands of CGHS. We from AIDEF and through the National Council JCM are repeatedly raising the difficulties being faced by the Employees and Pensioners with the Ministry of Health, but in vain.

The major problems can be listed like this.

  1. Many CGHS empanelled Hospitals including multi speciality hospitals have withdrawn from the empanelment on the ground that the Govt is deliberately not revising the rates of various procedures for years together and not clearing their dues indefinitely.

2. These Hospitals are now insisting the Pensioners to pay the amount in advance for treatment and then get it reimbursed. Where the Pensioners will go for Rs. 2 lacs and 5 lacs at a time

3. The authorities sitting in Health Ministry and CGHS are so insensitive they don’t bother for the Hospitals leaving CGHS and no new Hospitals coming forward for empanelment.

  1. Recent Instructions of CGHS to cap price of implants at 60% of MRP and provide 20% discount on medicines and consumables have further irked the CGHS empanelled Hospitals.
  2. 90% of the rural areas are not covered under CGHS. Even a major industrial town like Katni in MP State is not governed under CGHS. The Pensioners have to travel more than 100kms to reach Javalpur wellness Centre

6. Shortage of Doctors, Specialists, Paramedical staff in Wellness Centres

7. Shortage of medicines, including regular medicines for diabetics, hypertension etc. forces the pensioners to purchase medicines from outside pharmacies and wait for months together for reimbursement

8. Post Corporatisation of Ordnance Factories situation has become worse in Ordnance Factory Hospitals

9. We have every reason to doubt that there is a conspiracy to wind up the CGHS and throw the employees and Pensioners to the mercy of Private Corporate Hospitals

All these issues we have brought several times to the notice of the Govt including Cabinet Secretary. Our PM speaks much about Health care, but his own Government officials are not bothered for his own Government employees and the poor Pensioners health. A complete sanitization of the System is required to be done. The CGHS treatment rates should be revised once in 5 years,taking in to account the inflation rate, Cashless treatment facilities should be ensured in all hospitals, Government should bear 100% of the medical expenditure of employees and Pensioners as directed by Supreme Court several times.

If the Government sit silent without listening to the voice of the employees and Pensioners, then the situation will further become worse and CGHS will become a Nightmare.

Central Government Employees and Pensioners cannot be left to the mercy of the Private Corporate Hospitals. Government should strengthen CGHS by providing all facilities and manpower to the existing wellness centres, establish wellness Centres in all District Headquarters. No sensitive Government will allow its employees and Pensioners to become sick and die prematurely without giving proper medical care.

Situation has reached its peak for the PM to directly intervene or else it will be added in the failure list of the present Government, stated a frustrated and upset Srikumar who himself is a Pensioner and a leader of Central Government Employees.

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