CENTRAL INFORMATION COMMISSION
Appeal No.CIC/WB/A/2007/00464 dated 23.4.2007
Right to Information Act 2005 - Section 19
Appellant - Col. N. R. Kurup. Kerala
Respondent - Army Headquarters, Ministry of Defence (MoD)
Facts
:
By an application of 11.7.06 Col. (Retd) N.R. Kurup of Chettemcoon,
Tellicherry, Kerala made an application to the CPIO, ECHS, Adjutant General’s
Branch, Army Headquarters seeking information regarding the functioning of the
ECHS, Polyclinics. On not receiving a response, he moved a first appeal on
30.8.06 before the Director General, DC&W, Army Headquarters, pleading as
follows :
a) “(a) In the absence of any direction in the Briefs on ECHS
published in the website or Government of India orders, that
“the medicines prescribed by the TREATING DOCTOR to
the patient after due examination is to be personally
collected by the patient Authority of MD., ECHS to impose
such inhuman direction to deprive the chronic sick patients
hailing from far away places from the polyclinic, the ECHS
facilities guaranteed by Government in above cases.
b) Authority under which an MBBA doctor who is not the
TREATING DOCTOR of the patient is ordered by the MD,
ECHS to increase or decrease the time-tested dosage of
medicines prescribed by the SPECIALIST TREATING
DOCTOR of the patient without referring the chronic patient
back to the Specialist for opinion.
c) Accountability for damages or deterioration of condition or
loss of life caused by such unethical medical practice by an
MBBS doctor on orders of MD, ECHS.
d) When the GOI orders of 30.12.2002 categorically order
ECHS to ensure that no ESM pensioner is denied ECHS
facilities for ANY REASON, authority under which the Station
Commander, Kannur/MD,ECHS has formulated the present
strategy su moto only to deny this facility fully to ESM hailing
from places far away from the Polyclinic.
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e) Action taken report of MD/ECHS on the Appellant’s
Complaint on practice of unlawful and unethical practice of
Polyclinic resulting in denial of the facilities guaranteed by
the Government of India to ESM hailing from faraway places.
f) Authority of MD , ECHS to over rule the ESM friendly policy
of Government by formulating unauthorised practice to make
it ESM hostile.”
In response to this appeal Col. Kurup received a letter from Col. A.K.
Sharma, Director, HRC dated 28th Sept., 2006 in which he stated that ECHS had
already sent a reply to Col. Kurup through a letter of 12th Sept., 06, a copy of
which was attached. Thereafter Col. Kurup received a detailed reply on 15.12.06
from Col. S. Thapar, Director (Media) for Vice Chief of the Army Staff. Questions
and answers, therefore, read as follows:
S. Question Answer
No.
a. In the absence of any 1. No doctor prescribes
direction in the Briefs on medicines without examining a
ECHS published in the patient or knowing his clinical
website or Government of details.
India orders, that "the
medicines prescribed by 2. Since domiciliary treatment
the TREATING DOCTOR is has not been allowed by the
to be personally collected Govt in ECHS, all patients have
by the patient, Authority of to come to the ECHS Polyclinic
MD., ECHS to impose such for examination by a Doctor.
inhuman direction to Since they come to Polyclinic
deprive the poor old sick they collect the medicines also.
chronic patients hailing
from far away places from 3. In case a patient’s clinical
the polyclinic, the ECHS condition requires examination
facilities guaranteed by by a specialist he is either
Government in above examined by the specialist in
orders. Polyclinic or a specialist in
Military/ empanelled hospital
after being referred from the
Polyclinic.
4. The medicines prescribed by
the treating doctor (including
specialist) are provided to the
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patients from the Polyclinic.
Prescription in civil practice,
including by empanelled
hospitals is by ‘Brand Names’,
where as prescription at
Polyclinic/ Service hospitals are
by ‘Generic Names’ (as
recommended by World Health
Organisation). If required,
Doctors at Polyclinic provide
substitute ‘Generic’ drug with
same composition as prescribed
‘Branded’ drug. This is done as
per Govt Orders since Generic
Drugs procured in bulk are
cheaper (similar policy is
followed by Central Govt Health
Scheme).
5. Chronic patients are also
required to be periodically
reviewed by the treating Doctors
before prescribing the drugs
again. Frequency of reviews is
based purely on professional
opinion of treating doctor. This is
for the benefit of the patient since
there may be a requirement to
change the drug/ dosage
depending upon medical
condition of the patient. As per
directions of Director General of
Armed Forces Medical Services,
Servicing Armed Forces
personnel are reviewed by the
doctor every month even if they
are suffering from chronic
diseases.
6. Though review of a patient
may be carried out by a
Polyclinic Medical Officer,
change of the dosage of
medicine prescribed by a
specialist is usually always
carried out by the concerned
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specialist. However, in certain
situations, to prevent
deterioration in a patient’s
condition Polyclinic Medical
Officer may change the dosage if
the specialist is not available. In
such a case the patient is
referred to the concerned
specialist at the earliest
opportunity.
7. The collection of medicines by
the patient as a policy is also
necessary to prevent misuse.
8. In view of the petition made by
you, an exception was made by
allowing your representative to
collect drugs vide ECHS letter
No. B/49706/MOD/AG/ ECHS
dated 12th Sep 06. This was an
amelioration of your problem
projected by you to the President
of India through e-mail on 16th
July 06 and received by ECHS
on 7th Sept 06 from MOD.
b. Authority under which an See above
MBBA doctor is ordered to
increase or decrease the
time tested dosage of
medicines prescribed by a
specialist without referring
the patient back to him for
opinion.
c. Accountability for damages Para 1 (c ): Accountability for
or deterioration of condition Damages: No unethical practice
or loss of life caused by is allowed as per ECHS rules
such unauthorized medical and suitable action will be taken
practice by an MBBS doctor for any aberration. However, it
merely on Orders of MD, may be appreciated that a doctor
ECHS. proceeds with the treatment of
an aliment for betterment of the
patient. Apprehension of the
patient to reflect fear of damage
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from the treatment being
provided by a qualified doctor is
thus misplaced.
d. When the GOI orders of Para 1 (d): Denial of ECHS
30.12.2002 categorically Facilities:
order ECHS to ensure that 1. The Govt Order No. 22
no ESM pensioner is (1)/01/US(WE)/D(Res) dated 30th
denied ECHS facilities for Dec 02 sanctioning the ECHS
ANY REASON, authority scheme has made it voluntary to
under which the Station join the scheme for all those who
Commander, retired prior to the issue of the
Kannur/MD,ECHS has order.
formulated the present
strategy to deny this facility 2. The same order mentions the
fully to ESM hailing from location of all the ECHS
places far away from the Polyclinics. Before becoming a
Polyclinic. member, you could have
analysed in greater detail about
the effect of Kannur Polyclinic
being located far from your
residence.
3. No member is being denied
medical/ ECHS facilities.
e. Action taken report of Para 1(e):Action by MD, ECHS:
MD/ECHS on the As mentioned earlier, in this
Complaint on practice of particular case purely on request
unlawful and unethical of the individual and on
practice of Polyclinic humanitarian grounds,
resulting in denying of the permission was granted for any
facilities guaranteed by the authorized person to collect
Government of India. medicines on your behalf. In our
opinion the Polyclinic has not
undertaken any unlawful or
unethical practice by asking you
to collect medicines or present
your self before the doctor for
periodic review before
medication is prescribed/
reviewed.
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In the meantime, appellant had already moved a complaint before us for
failure to respond under File No. CIC/AT/A/2006/00472. This was duly heard
and the decision of the Commission dated 18.1.07 was as below :
“The matter was heard in the Commission where the appellant was
heard through his representative & respondents Brig. Nair and Brig.
Malik. A reply has been given to the appellant on dated
15.12.2008. The Commission has directed the representatives of
the appellant to collect the same from the respondents and pass it
on to the appellant. Should the appellant still need to present his
second appeal he may approach the Commission afresh for
hearing.”
The present case is, therefore, an appeal made directly to us in accordance
with the directions of this Commission against the information received in the
letter of 15.12.06 which has been quoted above. Appellant’s prayer before us is
as follows :
(a) That the respondent may kindly be ordered to provide
information requested.
(b) That this Hon’ble Commission may kindly consider
imposition of penalties stipulated in section 20 of the Act.
(c) To consider the necessity for recommending for an enquiry
under Section 18 (2) of the RTI Act for framing false report in
judicial proceedings.
(d) For recommending any other action as deemed necessary in
such an arbitrary defiance of the Right to Information Act by
Defense Service Officers.”
The appeal was heard by Video-Conference on 6.8.08. Appellant Col.
Kurup, when contacted over telephone No. 0490-2320590, opted not to be
present. The following were present in NIC Studio, Delhi :
RESPONDENTS
Brig P. R. Sangam, SM, DDG, RTI & CPIO of INQ of MoD (Army).
Col Binay, Dir, ECHS.
Maj M. Gahlot, GSO-1 (Legal), RTI Cell.
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Maj. Manisha Gahlot GSO-1 Legal submitted the following chronology in
processing the application of Col. Kurup :
(a) “19 Sep 06: Application dated 30th Aug 2006 was received from
Dir HRC.
(b) 20 Sep 06: The application was processed. Sir HRC was
informed by this office that application was not received earlier.
(c) 28 Sept 06: Central Organisation ECHS forwarded their reply to
the applicant vide their letter No. B/49806-MoD/Ag/ECHS dated
12 Sept 2006, provisioning requested information.
(d) 12 Oct 06: Applicant forwarded his appeal to the CIC.
(e) 28 Nov 06: Hearing Notice received from the CIC.
(f) 15 Dec 06: reply forwarded to the applicant.
(g) 26 Dec 06: Dir Media clarified our stand vide letter No.
A/810027/RTI/164/M/PI relating to processing of the case at
IHQ of MoD (Army).
(h) 16 Jan 07: The applicant asked for additional information
pertaining to a ‘Photocopy of an intimation letter received by
CPIO from HE. The President of India in response to an e-mail
from the applicant dated 16 July 2006’.
(i) 18 Jan 07: the Hon’ble CIC issued orders closing the matter
after directing the representative of the appellant to collect the
reply forwarded by the respondents on 15 Dec 06.
(j) 09 Feb 07: Addl information sought by the applicant vide his
application dated 16 Jan 07 was provided to the applicant.
(k) 27 Feb 07: Addl inputs asked as fresh request.
(l) 03 Apr 07: Addl information as sought in 27 Feb 07 application
was provided.”
She also submitted as follows :
“It is also brought to your kind notice that a meeting on the case
was held on 9th Jan 2007 at the CIC before Mr. A. Tiwari. Brig
Satish Malik, Deputy Managing Director ECHS along with Brig
Satish Nari, DDG PI attended the meeting. The case was
presented before the CIC. Legal counsel of the applicant, Mr.
Agrawal was also present who wanted a fresh date which was
declined by the Hon’ble Information Commissioner stating that a
copy of the reply given to the applicant should be provided to the
Counsel and in case, the applicant is not satisfied, he may
represent again for ‘fresh date’.”
Brig. P.R. Sangam, S.M., DDG RTI submitted that the earlier application of
11.7.06 was received in the ECHS but was not treated as an RTI application and
only as a complaint to which a response was sent on 12.9.06. After the
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complaint was received from the Director HRC on 19.9.06, the matter was
processed further and the letter of 28th Sept., 06 sent to applicant. It is admitted,
however, that the complete information was only provided on 15.12.06 in
response to the first appeal. Brig. Sangam also submitted that basically the
application of 11.7.06 from Col. Kurup was a grievance on not receiving
medicine. Col. Binay, Director, ECHS who is also present in the hearing
submitted that exceptions were made from established procedure to see that Col.
Kurup received the medicine sought .
DECISION NOTICE
This appeal has been heard on the basis of an earlier decision by this
Commission of 18.1.07 reproduced above, and, therefore, addresses only the
question of the response provided on 15.12.06 to the questions asked by
appellant Col. Kurup. From the questions and answers quoted above, it will be
clear that each of the questions stands answered. However, from a reading of
the appeal, we find that appellant Col. Kurup is dissatisfied with the functioning
of ECHS, the processes adopted by it and the perceived lacunae in addressing
the medical requirements of elderly and retired personnel, particularly, those
located at a distance from the ECHS Units. Col. Binay submitted that the ECHS
is about 5 years old and is still in the process of evolution. Its processes are in
fact at present under review. It is, therefore, recommended to ECHS that the
suggestions and apprehensions of appellant Col. Kurup may be taken into
consideration in redesigning the functioning of ECHS.
On the question of delay in response to the initial application of 11.7.06,
Brig. Sangam has submitted that ECHS does not have a CPIO of its own. RTI
applications addressed to ECHS are serviced by CPIO-Army, Ministry of
Defence. The ECHS, therefore, had received the application from Col. Kurup as
a complaint and not as a request for information, hence the reply of 12.9.06 in
which each question had not sought to be answered. This is an unacceptable
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explanation. Under the RTI Act every Unit is to have at the very least an APIO.
Even if there was no such authority the matter should have been referred
immediately to the CPIO Army since it clearly states the sections with sub-
sections of the RTI Act under which the questions had been raised. However,
since there was no CPIO designated for the purpose, we cannot hold any
authority liable for the delay and, therefore, consider imposing penalty. Ministry
of Defence will, however, review this system within one week of the date of issue
of this Decision Notice and take steps to ensure that such a fault does not recur
to ensure that an RTI application addressed to any Unit of the Ministry of
Defence is addressed immediately on receipt.
This appeal is disposed of accordingly. Announced in the hearing. Notice
of this decision be given free of cost to the parties.
(Wajahat Habibullah)
Chief Information Commissioner
6.8.2008
Authenticated true copy. Additional copies of orders shall be supplied against
application and payment of the charges, prescribed under the Act, to the CPIO
of this Commission.
(Pankaj Shreyaskar)
Joint Registrar
6.8.2008
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