EXTRACT FROM 31ST SCOVA AGENDA ITEMS SUBJECT PLACED FOR REPLY
EXTRACT FROM 31ST
SCOVA AGENDA ITEMS
SUBJECT PLACED FOR REPLY
o
Authorisation of
Doctors of Railway Health Units for referral to empanelled private hospitals:- Railway Board vide its
orders NO.2018/Trans Cell/Health/Medical
issues dated 24-1-2019 has
decided that the Railway Beneficiaries may be referred by two doctors for
treatment, & Investigation to private empanelled and other Government
Hospitals, This has left out
the Single Doctor Health Units in cities like Chandigarh as 'not being
authorised to refer the cases to Empanelled
specialized Hospitals and thus compelling the Railway
Beneficiaries to travel long distances from
such cities, towns & areas which have “Single” Doctor Health Units
to reach out to the two authorized Doctors
to get a referral for an ailing patient. The hardship thus continues for
majority of Old age patients to get the requisite treatment. It is requested
that in such cases, the Single Doctor of Railway Health Units may be authorized
to refer the RELHS beneficiaries to private/ empanelled hospitals.
o
Special provisions for
Treatment of RELHS Beneficiaries who are above 80 years of age - Guidelines for special
provision to CGHS Beneficiaries aged 80 years and above and issued vide
MoH& FW OM No. Z-16025/98/2017/CGHS-III dated 11-7-2017. In view of this,
similar guidelines may be issued by Ministry of Railways for RELHS
beneficiaries who are80 years and above.
REPLY BY RAILWAYS - (a) & (b)
The medical facilities of Railway pensioners/ RELHS beneficiaries are catered
through three tier medical care system. Routine tests and medicines are
available in Primary Health Units on day to day basis. Cases which require
specialized test/treating are referred to Sub- divisional/Divisional/Central
Hospitals. In case where these facilities are not available, the patients are
referred to outside Railway Diagnostic Centres/Hospitals.
Railway
has invested huge amount of money in developing diagnostic system and treatment
facility, In specialties where Railway Doctors are not available, private
Railway private Specialists (HVS) on case to case basis. Therefore, if the
suggestion of referral of patients to
private. empanelled hospitals from Health Units is agreed to in all the cases,
the huge investment in infrastructure and manpower in establishing. secondary
and tertiary treatment facilities through Divisional and Central Treatment will
remain underutilized
/ unutilized. Further the retired railway beneficiaries availing the
facility of CTSE are entitled to take treatment in any private empanelled
hospital in case of any emergency without referral.
Since,
CGHS do not have their own specialized centres of treatment for all secondary
and tertiary care, they are required to refer all patients to empanelled
private hospitals. However, in Railways, as specialized centres of diagnostic
tests & treatment are available in house through Sub-
Divisional/Divisional/Centre Hospitals.
(c) - Waiving of
condition of Referral from Railway Doctor of RELHS beneficiaries for OPD
Consultation & treatment in Government Hospitals: - It is requested that
RELHS beneficiaries be not required to get referral from Railway Doctor for
treatment in Centre/ State Government hospitals.
REPLY BY RAILWAYS - (c) Both
Railway serving employees and
RELHS beneficiaries are eligible to take treatment (both OPD & IPD).in Government Hospitals during emergency as per
the provisions laid down in para no.657 of IRMM 2000. The amount paid to such
state/ central Govt. Hospitals is fully reimbursable. The settlement of
reimbursement claims is done as per the instructions issued vide this Office
letter no.2005/H/6-4/PoIicy-II, dated 31.01.2007.
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