The Delhi High Court has rendered an important decision on the subject of Ex-servicemen Contributory Health Scheme (ECHS) on a Public Interest Litigation seeking an egalitarian approach for all ranks based on the averment that “as per policy in vogue, persons who are in possession of White Card (War Disabled/disabled) and Senior Citizens (male 75 years and above, female 70 years and above) are entitled for treatment in ECHS Polyclinics on priority” and that priority is not based upon the rank held in the military on retirement.
Without stating anything for or against, on merits or demerits of the issue, it would be
interesting to hear from the readers on this very complex subject in a military
backdrop.
The questions that come to my mind are:
(i) Though it is fully understandable that some differentiation would
always prevail in a military milieu, how far should it continue after
retirement and in which spheres?
(ii) Is it time to gradually move towards a rank-neutral system in some
aspects after retirement?
(iii) Does the CGHS follow a system of priority based on rank/grade held
prior to retirement?
“6. We can however well imagine the scenario prevalent in the ECHS
Polyclinics, Military Hospitals / Empanelled Hospitals. The same is not typical
of ECHS Polyclinics / Military Hospitals / Empanelled Hospitals only but of all
institutions. We, as a country, ruled first by the kings and chieftains and
later by the British, have it ingrained in us, to respect and give priority in
all walks of life to rank, office and wealth. Rank, office and wealth opens
doors to holders thereof without even there being any provision therefore in
law, Rules and Regulations. Though
our Constitution set the course right by ingraining therein the equality clause
(Article 14) and by
abolishing titles (Article 18)
but the same has not been achieved in practice in the
last more than 65 years.
7. We are in this matter, faced with a practice which is as
ancient as mountains in this country. The said situation in our view cannot be
changed merely with directions of the Court. Such practices, highlighting which
and seeking redressal where against this petition is filed, are found not only
in ECHS Polyclinics but at nearly all places providing services/amenities
of public utility. In our view, the cure thereof is not in Courts. We have for
this reason only not deemed it appropriate to issue notice of this petition and
to give an opportunity to the respondents to show, whether despite being not in
the scheme, elsewhere in the rules and regulations governing Armed Forces,
there is such a distinction as maintained amongst officers and personnel of other
ranks, because even if that be so, in our view, the same cannot continue post
retirement, when both fall in the same category i.e. of ex-servicemen and when
the Scheme does not provide there for. Once the Scheme does not classify its
members according to their rank and does not provide for priority, in the
matter of benefits under the Scheme or in the working of the Scheme, to be
given as per rank, there can be no basis for such sub-classification or
micro-classification or further classification among the class of ex-servicemen
in treatment under the Scheme. The guarantee contained in Article 14 of
equal protection extends, besides to substantive law, to procedure as well.
There does not appear to be any basis for such
sub-classification amongst ex-servicemen in relation to the object of the
Scheme. We may however mention that "Regulation for Medical Services of
Armed Forces-1983" also not providing for any such classification on
the basis of rank and to be rather under the heading "Medical Ethics"
providing that while dealing with a patient, the medical officers primary duty
is always the patients welfare.
8. We are also of the view that even if we were to issue a
direction for all members of the ECHS to be treated equally and even if the
offending display boards were to be removed, the same may not eliminate the problem
inasmuch as, the Doctors/Physicians and other Paramedics are likely to continue
to give priority to the officer ex-servicemen. It cannot be lost sight of that
the Defence Forces, more than any other, are steeped in hierarchy and the
Doctors, Physician or Paramedics of a lower rank are likely to, out of habit
and deference, give priority to those superior in rank, even if ex- serviceman.
9. We have wondered the solution for the problem.
10. The only solution according to us can be by building consensus
and awareness not only amongst those who are imparting / rendering services at
such Polyclinics / Military Hospitals / Service Hospitals / Empanelled
Hospitals but also amongst the members of the Scheme. Not only have the
doctors, paramedics and other staff of such Polyclinics / Military Hospitals /
Service Hospitals / Empanelled Hospitals have to be taught to see patients strictly
as per appointment if permissible or on first come first served basis but the
members of the Scheme also have to be taught to respect the Scheme and to not
seek any priority / favour in the matter of being attended to at the said
Polyclinics / Hospitals. It is only when the ex-servicemen, of whatsoever rank,
if not entitled under the Scheme to preferential treatment, starts respecting
the que and not expect to be attended to first that the requisite correction in
the society can take shape. The same in our opinion can be achieved by sending
circulars, putting up boards / placards at the Hospitals / Polyclinics and by
organizing group discussions, talks etc. on the subject, to build consensus
amongst the providers and beneficiaries of the Scheme.
11. Yet another thought which comes to our mind is of equitably
dividing the time and / or by introducing a system of consulting by appointment
for certain hours of the day so that at that particular time only those with
appointment are attended to and at other times the beneficiaries of the Scheme
are attended to strictly on first come first served basis.
12. The above, but are our meandering of a solution to the issue
and is by no means exhaustive. We are sure that the providers under the Scheme,
being specialist, are better equipped and would be able to come up with a suitable
solution to the problem so as to avoid heartburn amongst a certain category of
ex-servicemen, of being denied equality under the Scheme and which is the cause
of action for this petition.
13. We have faith in the good sense and well meaning intention of
the ECHS organization which as per Chapter-5 of the Scheme is headed by a
Managing Director (Major General) of the Indian Army.
14. We therefore dispose of this petition by directing the
Managing Director of the ECHS to look into the issue raised in this petition
and to address the same in the best possible manner, after considering the
suggestions made by us hereinabove.”