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?
The excerpts from the decision are as follows:
“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.”