All is not well at CGHS wellness centre

The CGHS wellness centre in Tiruchi, which was set up in 2019 has stopped cashless payments at empanelled hosptials.

Patients dependent on the Central Government Health Scheme (CGHS) Wellness Centre in Tiruchi complain of lack of basic amenities at the centre. The centre, which was set up in 2019 lacks amenities including specialist doctors, diagnostic centres, and has stopped cashless payments at empanelled hospitals, beneficiaries say.

When the CGHS was set up in Tiruchi, employees attached to various central government organisations welcomed the move. Until 2019, they had to travel to Chennai for treatment or referrals. The CGHS is applicable for government employees, pensioners and their family members, MPs, former MPs, and other central government officers and freedom fighters. A CGHS card has to be applied for and following approval, treatment can be sought at the centre. Funds are debited from the compensation of those who opt for the CGHS.

While CGHS Wellness Centres must have specialist doctors where patients can seek consultation and seek approval for medical treatment, the centre also has empanelled a set of private hospitals where beneficiaries can undergo treatment. “It has become like a dispensary with no other use. Medicines for chronic illnesses are issued, but otherwise most beneficiaries visit private hospitals which are empanelled for want of better facilities. Only those who are unable to go to these private hospitals who suffer,” a retired central government employee said.

S. Kamaraj, a retired employee of the BSNL said that they have been instructed to directly visit the empanelled hospitals and not the CGHS. “We have been given a list of hospitals where we can avail treatment,” he said. While the treatment used to be cashless, it is not, anymore, he added.

“Since last year, we have to pay the amount to the hospital upfront, and apply for it to be reimbursed through the CGHS. This is difficult for those who do not have the funds,” he said. Further, the CGHS has a rate card for all diagnostic tests, procedures and medical treatment and the reimbursement is provided in accordance with it. “The cost of treatment differs from hospital to hospital and it is the beneficiaries who are affected as our full amount is not reimbursed,” he said. Amidst a pandemic, these unnecessary norms affect patients’ health, he added.

Su. Thirunavukkarasar, Tiruchi MP, who raised the issue in the Lok Sabha on Wednesday, sought the intervention of the Minister of Health and Family Welfare in improving the facilities at the centre, which serves as the only such facility in the State other than Chennai. The centre also lacks the Siddha and Ayurveda facilities, which many beneficiaries prefer, he said. He urged the Minister to take necessary steps to improve facilities, empanel major hospitals, diagnostic centres, laboratories and set up an AYUSH clinic expeditiously.