CGHS Guidelines

No.RA/Cons/Hyd/09-10/CGHS IV
Government of India
Ministry of Health & Family Welfare
Department of Health & Family Welfare
********



Nirman Bhawan, Maulana Azad Road
New Delhi 110 108, dated the11th June, 2010



To
Additional Directors / Joint Directors
of all CGHS cities



Subject: Guidelines for referrals to CGHS empanelled hospitals in CGHS cities outside Delhi, where there are no Central Government hospitals.

I am directed to state that it has come to notice that CGHS beneficiaries residing in cities covered by CGHS (outside of Delhi) are facing difficulties in getting services of specialists from State Government hospitals and they cannot avail services directly from private empanelled hospitals. After careful consideration of the ground realities, it has been decided to issue the following guidelines for strict compliance:

(1) CGHS beneficiaries must compulsorily be referred to polyclinics wherever set up by the CGHS;

(2) It posts of specialists are lying vacant in polyclinics, GDMOs, who are post graduates may be posted in polyclinics for consultation, and on the basis of the advice / opinion to be tendered by them, CMO i/c, AD / JDs may refer patients to private empanelled hospitals and diagnostic centres, according to the choice of the beneficiary;

(3) In those cities which do not have polyclinics and if GDMOs who are post graduates are available, their services as specialist may be utilised and patients may be referred to the dispensary in which such PG GDMOs are posted or if space is available in a centrally located dispensary, the PG GDMOs may be posted there;

(4) In the event of neither a specialist nor a PG GDMO is available in a city, CMO i/c shall make a provisional diagnosis and refer the patients to private empanelled hospital for specialists’ consultation;

(5) A referral from CGHS dispensary is required every the patient is advised any procedure for investigation;

(6) If any specific treatment / procedure is advised (except in emergency) by private empanelled hospital, it must be counter-signed by CMO i/c before the services are availed, to check possible misuse;

(7) No permission is required in case of emergency, where a beneficiary can avail treatment in a private empanelled hospital, as per existing instructions;

(8) The beneficiary will have to go back to the dispensary where his / her card registered for collection of medicines prescribed by the specialist of the private empanelled hospital. No indent of such medicines will be made, for which similar drugs with same generic formulation available in the dispensary will be supplied, as per standing instructions;

(9) Beneficiaries can purchase prescribed medicines for 3 (three) days only from open market, which shall be reimbursed by the CGHS / Ministry / Department, as the case may be . For requirement of medicines beyond three days, medicines will have to be procured from the dispensaries; and

(10) Once a diagnosis and treatment has been advised by the specialist, doctors in dispensaries may follow up the case instead of referring back after the specific period of the prescription gets exhausted. They have to use their own clinical judgement for follow-up and adjust the dose schedules, if required.

2.This issues with the approval of Director General of Health Services.


Yours faithfully

(R. Ravi)
Deputy Secretary to the Government of India


OM

coc meeting july

To
All Affilates
COC Karnataka

Comrade,
The COC Meeting will be held on 2nd July 2010 at 18 hrs at Income Tax office all Comrades are requested to attend the meeting to discuss the latest developments.
Agenda:
1) To give support to Postal and Income tax employees strike which is scheduled in July 2010
2) Orgainise 12th July program as per Confederation circular
3) any other matter.

Com K.K.N.Kutty Secretary General Confederation of Central Govt Employees and Workers and Com M.S.Raja Secretary Confederation of Central Govt Employees and Workers will address the meeting on current issues.

Please attend in large Numbers,
Please pay the subscription of COC which is due for the year 2009 and 2010 years if not paid.

Comradely yours

P.S.Prasad
General Secretary

THE FIVE GLORIOUS DAYS OF 1960.

K.K.N.Kutty

Secretary General, Confederation of CGE and workers.



On 12th July, 2010, we will organise functions to commemorate the 50th anniversary of the first industrial action of the Central Government employees in the post independent India. It was on 12th July, in 1960, the indefinite strike began on the call of the Joint Council of Action of all Federations, Associations and Unions of the Central Government employees. The trade union movement of the Civil servants was at a nascent stage when the strike was planned and finally executed, even though some of the Federations in the JCA had the great tradition of organising struggles including strike actions even against the colonial Government of Great Britain. In fact it was the strike of the Postal Workers in 1946, which compelled the then British Government to set up the first Central Pay Commission to revise the wages of the Civil Servants, whose real income had been eroded significantly in the war ravaged economy. It is a matter of pride and importance for all of us today to trace the causes and effects of the five glorious days of struggle of 1960 organised by the brave men and women who were central Government employees, who had to undergo tremendous trials, tribulations, agony and render sacrifices of immeasurable value.

The workers and employees under the Govt. Of India had been spread over various industrial and non industrial organisations and departments. The workers in the Railways, Defence and Post and Telegraph Departments were mostly industrial workers and were members of the all India Federations , AIRF, AIDEF and NFPTE respectively. The National Federation of Post and Telegraph employees were the biggest affiliate of the Confederation of Central Govt .employees and workers, which came into existence in 1956. The Confederation had affiliated the Federations, Associations and Unions of both industrial and non industrial workers. Besides NFPTE, the major organisations affiliated to the confederation were the organisations of the P&T Industrial employees, Survey of India, CPWD, Central Secretariat, Income tax, Civil Aviation, Printing and Stationery, Meteorological survey Ministerial and workshop employees, Malaria Institute employees, Indian School of Mines , Audit and Accounts employees , Geological Survey of India etc.

The Confederation raised the issue of grant of dearness allowance in the wake of the uncontrolled price rise of essential commodities which had eroded the real value of wages .In fact the grant of compensation to protect the real wages of the employees in the context of increasing cost of living was one of the recommendations of the First Central Pay Commission. As a corollary to the said demand, the Confederation asked the Government to set up the 2nd Central Pay Commission to revise the wages and determine the methodology of computing the dearness compensation and grant interim relief as the Commission so set up is likely to take time to finalise its recommendations. Since there had been no response from the Government, the Confederation served the strike notice in 1957. Sensing that the demand so raised by the Confederation had elicited the support of the workers the Government set up the 2nd CPC just a day prior to the commencement of the proposed strike action. The Commission so set up granted a paltry sum of Rs. 5/- as Interim relief within a month but took about two years to finalise its report.

Before the 2nd CPC, the employees' organisations, especially the Confederation demanded that the minimum wage in Central Services should not be less than what has been propounded by the 15th Indian Labour Conference, which was held at Shimla in the year 1957 with the participation of all stake holders, viz. The representatives of the Trade Unions, the employers' organisations and the Government. Basing on the formulations suggested by Dr. Aekhroyd, the minimum wage was computed at Rs. 125/- . On the specious ground that the Indian economy had no capacity to bear the additional financial burden that might arise on the acceptance of the demand, the Commission tinkered with the formula itself and quantified the minimum wage at Rs. 70/-on illogical and untenable grounds. This apart, the Commission went on to make recommendations which in effect were to withdraw the existing benefits and privileges, such as it recommended to reduce the number of holiday and casual leave, increased the working hours, revised the employees' contribution on allotment of Government accommodation and refused to recommend any scheme for grant of dearness allowance when the cost of living increases. While the Government acted upon these adverse recommendations, it dilly dallied to take a decision in the matter of even the meagre revision of wages.

The Government's attitude and the disappointing recommendations of the 2nd CPC jacked up the simmering discontent into spontaneous outbursts in the form of protest rallies and demonstrations throughout the country. The refusal of the Prime Minister to meet the Chairman of the Confederation, Com.Nath Pai, the then Member of Parliament even after indicating his willingness to grant an interview earlier, triggered a much stronger and united reaction from the employees. It reverberated amongst the rank and file of all the segments of the Central Government employees with the result, the leaders of the AIRF and AIDEF decided to join hands with the leaders of the Confederation to chalk out a common strategy and approach in the matter of the implementation of the 2nd CPC report. The INTUC affiliated Unions in Railways and Defence, viz,the NFIR and INDWF however remained aloof of these efforts, true to their close links with the ruling party, the Indian National Congress. The AIRF, AIDEF and the Confederation jointly convened a National Convention at Mumbai on 3rd April, 1960, which adopted a 6 point charter of demands and set up the Joint Council of Action to spearhead head the movement. The Convention gave a clarion call to all Central Government employees to unite and prepare for an indefinite strike action in case the Government refuses to settle the charter of demands, which included the following issues.

(i) Dearness allowance to be paid on the basis of the first CPC re commendation @Rs.5/- for every 20 point increase in the 12 monthly average of cost of living index 1947=100 as per the recommendations of the First CPC.

(ii) Minimum wage should be based on the norms prescribed by the 15th ILC

(iii) To set up a standing board consisting of equal representatives from employees' federations and officers of various departments (govt. Nominees) with a neutral Chairman to settle all disputes/claims of any category of employees.

(iv) No curtailment of any existing facilities, rights and privileges

(v) To set up an Arbitration Board and recognise only one union in one industry

(vi) To withdraw the provisions of summary dismissal and punitive actions.

The JCA decided to elicit the opinion of the mass of the employees through a ballot on the proposed strike action. It received overwhelming response from the common multitude of the employees in as much as 90% of the Railwaymen, Defence Workers and P&T employees voted in favour of the strike. The employees of all other organisations, which were affiliated to the Confederation in toto favoured the strike decision. The INTUC affiliated organisations in the Railways and Defence, the NFIR and INDWF which were boasting to represent 70% of the workers of these two Departments, had to eat the humble pie when the strike ballot decisions were announced. It became clear that the workers would even desert their parent organisations in order to join the strike for they resented the Government's untenable stand on issues and the unsolicited support extended by the leaders of the INTUC affiliated Federations to the Govt. Emboldened by the overwhelming support of the workers manifested in the strike ballot verdict, the JCA decided to go ahead with the strike preparation and set up a high powered strike committee consisting of the following leaders;

Peter Alvares: General Secretary, AIRF as the Convenor

S.M.Joshi, President, AIDEF as the Chairman

P.S.R. Anjaneyalu, . Secretary General, NFPTE ,and D.S. Rajarathinam, Secretary General, Confederation and General Secretary, Incometax Federation as members.



The Government however, stiffened its stand in the face of this development by stating that the recommendations of the CPC are to be treated as an 'award' and therefore, the Government would not like to have any negotiations in the matter with the employees' representatives. Government made it clear that they would go ahead with the implementation of the recommendations of the CPC without making any alteration, howsoever warranted it might be. It was pointed out that the stand of the Government is untenable in as much as the Government has not treated the recommendations of various commissions it had set up in the past as awards and especially in the background of a strike notice, the government was duty bound to negotiate and discuss under section 10 of the ID Act or refer the dispute to the National Tribunal under Section 22. Against the unrelenting position taken by the Government the JCA intensified its campaign and the strike became imminent and inevitable. The Government's attitude came in sharp criticism from various quarters, compelling some leading political personalities like Feroze Gandhi (son-in-law of the Prime Minister), R.K. Khadilkar, Ashok Mehta and many others intervening, which resulted in a meeting with the Labour Minister. To ensure that the negotiations to be successful, the JCA agreed to water down its demand for full neutralisation to 50% if the Govt. Is prepared to refer the issue to an arbitrator. Ostensibly to favour the INTUC organisations, the Government insisted upon the unconditional withdrawal of the strike as a pre-condition for any discussion and settlement. The ill advised strategy adopted by the Government left the JCA with no alternative to serving the strike notice. On 21st June, 1960, the notice for the indefinite strike was served indicating that the strike would commence from the midnight of 11th July. i.e. from 12th July, 1960 onwards. The Government responded by instructing the Army and Police Personnel to deal with the situation as violation of law and order. In a meeting of the Party workers, the Prime Minister, Pt. Jawaharlal Nehru asked them to arouse the public opinion against the strike and asserted that his Government would deal with the strike with firmness and strength. It was unfortunate that an erudite and progressive leader like Nehru whose sterling role in Indian Independence movement had endeared him as the closest friend of the working people responded in such a high handed manner to a simple dispute between the Government as an employer and the employees. In a broadcast to the Nation, the Prime Minister went to the extent of describing the strike as a "civil rebellion" required to be put down at all cost and by all means. The subsequent repressive measures unleashed proved how assertive he was. A simple industrial dispute was thus politicised dividing the polity sharply in favour of and against the strike. While the AITUC, HMS and UTUC, the central Trade Unions in the country then, came forward to unequivocally support the strike and set up committees to help and assist the striking workers, the INTUC with its affiliates, NFIR and INDWF did everything to prevent the workers from participating in the strike. Government took unprecedented and stringent measures to suppress the strike. It promulgated the Essential Services Maintenance ordinance and brought all Government departments under its purview and prohibited strike in Government services. On 9th July, 1960 it further issued an executive fiat under the Armed Forces Emergency Duty Act, 1947, specifying that the P & T, Railways, Aircrafts, Ports, Mints and Security Press are vital organs of the community. The large majority of the workers and employees became determined to participate in the strike.

On 11th July, 1960, the leaders of the JCA and thousands of activists throughout the country were arrested and imprisoned. Summary trials were held at the Prison premises. The arrested employees were convicted to rigorous imprisonment extending to period exceeding one and half years. The Government's propaganda machinery, the All India Radio went full blast spreading falsehood about the strike thereby creating an atmosphere of panic. Despite all these, the strike did commence on 12th July at the appointed time and large section of the employees and workers participated in the strike. It was total in the Survey of India, followed by the Audit and Accounts Departrment, Civil Aviation, Post and Telegraph, CPWD, Income tax, Railways, Defence and many other Central Government Departments. The Government unleashed a reign of terror; arresting the leaders and common employees; raiding the Government colonies; compelling the employees to report to duty; detaining those who do not abide; caning and lathi-charging the workers who were demonstrating peacefully before the offices. At Dahod Police resorted to shooting and gunned down five Railway workers. In the face of the unprecedented repression and state terror, the strike continued for five glorious days. To withstand the armed might and state sponsored brutal terror became impossible for the unarmed civilian workers. On the appeal made by Shri Ashok Mehta, the strike was finally called off on 16th July, 1960. Even as per the Government's own admission, more than 500,000 workers were on strike throughout the five days. On 12th July, the strike elicited the participation of more than 12,00,000 workers and employees, i.e. about 56% of the total Government employees participated in the strike action on the first day.

During the five glorious days of strike, 5 comrades were shot dead, another 9 persons lost their life.; 17,780 workers were arrested, 27,000 were suspended, 6000 employees, who had not been conferred with the permanent status were terminated; and another 6000 were dismissed following imprisonment under ESMO and other disciplinary proceedings. The Government's vindictive actions went on unabated. Recognition of 85 Associations, Federations, and Unions were withdrawn. The conduct rules were amended to debar the employees from becoming members of the unrecognised unions; demonstration and any other protest actions were prohibited; for continuing to be the members of the unions whose recognition was withdrawn, many employees were charge-sheeted.

Against the palpably illegal and atrocious decision to amend the conduct rules, Com.E.X. Joseph, Gl. Secretary All India Audit and Accounts Employees Association filed a petition before the Mumbai High Court. The Court struck down Rule 4B of the Conduct rules as violative of Art. 19(1) of the Constitution. This crucial judgement, which became a milestone in the service conditions of the Government employees, especially in the matter of the inalienable right to form associations/unions came as a great relief for all unions and frustrated the Government's notorious plan to wean away the employees from the militant trade unions into the pliable and ruling party sponsored unions of INTUC. The judgement gave a sense of confidence to both the leaders and the rank and file of the workers to fight back the offensive. It was in the background of the confusion created by the amendment to the Conduct rules, the INTUC made its attempt to form a union in the Post and Telegraph Department. Intensive tours were undertaken by the INTUC leaders to woo the victimised employees promising vacation of the vindictive and punitive action on becoming members. It is to the credit of the common P&T workers that they treated these attempts with the contempt it deserves.

Ultimately the Government admitted that the Nation suffered irretrievable loss in as much as 17.6 lakh man-days were lost; 14 persons lost their life; the financial loss was estimated at more than two crores; irreparable damage to the morale of the employees; unfathomable loss of the fair image of the Government itself. In reply to a query put to the then Cabinet Secretary as to what would have been the cost of an agreement on DA in comparison to the losses sustained by the Govt., his audacious reply was "who cares for the loss in Govt."

Obviously there had been no instantaneous settlement of the demands raised in the strike charter, as the strike had to be unconditionally withdrawn in the face of the state sponsored terror. A sense of frustration and anger must have come about in the psyche of the common employees and the grass root level leadership then. But the fact is that the 1960 strike did bring about tremendous attitudinal change in the polity. More and more people began to talk of the necessity of fixing a minimum wage for the workers. The 15th ILC norms got wider coverage and became an important factor in the wage negotiations. Later the Government and the employers had to recognise the need for full neutralisation of the cost of living in the form of DA. Cost indexed wage revision became the order of the day. The debate in the Parliament reflected more and more concern towards workers and the Government which employed the highest degree of repression got isolated and discredited in the eyes of the common people. The icons of Independence struggles tumbled down. Government had to restore the privileges and rights of the employees. It also had to recognise the need for a negotiating machinery to avert the strike and the JCM came into being as a result. The INTUC organisations also had to abandon their approach on worker related issues as in many subsequent struggles, they had to perforce align with the other trade unions in the country. The Government's attitude of treating the Pay Commission's recommendations as "award" had to be changed. The recommendations of the subsequent Pay Commissions were subjected to discussion with the representatives of the Federations and modified. The demand raised by the workers in 1960 to set up a standing board to settle disputes in which the representatives of the Federations could be nominated was conceded in as much as the National and Departmental Anomaly Committees that came into existence after the negotiations on the 5th CPC recommendations did have the representatives of both official and staff side.

The role, prestige and status of Trade Unions in Indian polity became more pronounced after the 1960 strike. It brought about a meaningful change in the industrial relationship as conciliation and negotiations became an integral and unavoidable factor in the dispute redressal mechanism. Let the immortal legacy of the 1960 strike inspire us for it has shown that the indomitable spirit, sense of sacrifice and constant efforts to unite the class moulds the militant and real union.

Red salute to all those comrades who by their supreme sense of sacrifice and militancy wrote the revolutionary saga of the glorious strike of 1960.

(prepared basing on the Notes given and discussion held

with Com.S.K.Vyas, President, Confederation of Central Govt. Employees and workers New Delhi

note on Disciplinary/Vigilance Proceedings.

From

S.Radhakrishna

Sr.Audit Officer(retd)

212 Kaveri, 7th ‘A’ Main

Hampinagar

Bangalore-560104

Ph No. (080)23386661 Mobile (0)9448880921



To

Shri V.K.Velukutty

Deputy Secretary (V.III), DOPT,

Room No.10-B11i North Block

New Delhi-110001



Sir,

I wish to invite your attention to GOI., DOPT Notice F.No.3721312007-AVD.III, inviting suggestions comments for consideration by the Committee of Experts for review of Disciplinary Proceedings. As I have gained some knowledge on disciplinary proceedings because of my long association for more than two decades I felt like giving some suggestions which may be considered as relevant by the committee. The suggestions is attached in the form of note for your consideration.



Bangalore Yours faithfully

14-06-2010 sradhakrishna



Note to
Committee of Experts for examination to expedite the process involved in
Disciplinary/Vigilance Proceedings.
1.The constitution of Experts Committee to examine and suggest measures to expedite the process involved in Disciplinary/Vigilance Proceedings is a welcome move by the Government.
2.The undersigned having attended number of Disciplinary/Vigilance Proceedings in various Departments and Autonomous Bodies following CCS(CCA) Rules and also in CVC in various capacities and maximum being as Defence Assistant I have gained some experience and also an in sight which causes delay in the disciplinary proceedings. With that experience I am sending this note for the consideration of the committee
3.The experience has taught that inordinate delay after the disciplinary proceedings starts is at the stage of verification of documents. This delay mainly occurs in making available the additional documents requisitioned to the Inquiry Officer by controlling officer or custodian of those documents. This delays can be reduced if the Disciplinary Authority brings in all relevant documents and evidence on record to know the truth of the imputations. Though Rule 14(2) prescribes that the purpose of inquiry is to find the truth of imputation of misconduct or misbehaviour against the Government servant and su rule 3(ii) provides for bringing all relevant facts on record, in practice the most of Das are interested in some how prove the imputation against the Government servant rather than finding the truth ensure that all facts which are relevant to the charges which may go in favuor of the Government servant are suppressed. This forces the charged officer to requisition those records as additional documents. Therefore a provision has to be made in the rules and also the DAs should advised to bring all relevant evidence and documents on record even if it is favourable to the Government as the purpose of inquiry is to find the truth. Similarly a time limit should be included in the rules to provide the requisitioned records by the controlling officers or custodians of the records. In fact in RTI Act there is time limit of 30 days for providing the records. Similar time limit can be considered in the inquiry proceedings also.
4.Another area is inordinate delay on the part of Disciplinary Authority to take a decision on the inquiry report. The undersigned had come across a case where the Disciplinary Authority took eight years to take a decision o the report. Though the charged officer was exonerated delay in taking final decision by deprived him of occupying many positions in the department for which he had been eligible and found to be fit also. To avoid such instances and also reasonable delay it is necessary to make provisions for prescribing maximum period by which DA must mandatorily take final decision on the inquiry report.

5.The suggestions given in the background note regarding penalties is welcome. Now the rules provide total liza-fire to the DA in deciding the quantum of punishment. These powers the DAs apply with proper discretion. Not only that the powers of discretion is being utilized for discrimination. This has resulted many times the judiciary to intervene and struck down the punishment as disproportion to alleged misconduct or misbehaiviour. Therefore broad parameters regarding quantum of punishment and misconduct should be considered for incorporation in the rules.
6.Another area that requires consideration is regarding the appointment of inquiry officers. Many a times it is common knowledge that many inquiry officers have know proper knowledge of the procdure and rules. This also causes lot of delay in the proceedings. The officers who are likely to be given such assignment should be properly trained and a panel of such expert officers for conducting the inquiry can be drawn up. It is also better if IOs are drawn form intra department panel of experts to conduct the inquiry.

S.Radhakrishna
Sr.Audit Officer(Retd), I.A. &A.D
212, Kaveri 7th ‘A’ Main
Hampinagar
Bangalore-56-104