Saving ECHS from Fiscal Pedantry
In this blogpost I want to draw reader's attention to sever damage being caused to ECHS by fiscal pedantry in clearance of bills by functionaries of MoD. It is a well known fact that direct interface between the government official and citizen has been major cause of corruption in the country. As an antidote the CVC in its paper on National Anti Corruption Strategy stresses on need to employ Information and Communication Technology (ICT) to put maximum services on line. The Government of India, especially since May 2014, has taken multiple steps to revolutionise the delivery of subsidies and MNREGA through DBT by levaraging ICT.
Use of ICT removes corruption by, depersonalising decision-making, standradising procedures, ensures service on first come - first served basis and makes whole transaction transparent.
In the field of health care, CGHS pioneered online payment of hospital bills by establishing Bill Clearance Authority (BCA). The government of India formed an entity called UTI-ITSL to act as BCA. This entity consists of requisite medical and financial experts who scrutinise bills submitted by Empanelled Hospitals and release payment. So good has been the performance of UTI-ITSL as BCA that today Memorandum of Agreement (MOA) between CGHS and Empanelled Hospital includes a guarantee of 70 Percent of bill being paid within five days. No wonder that today best of the hospitals across the country have joined the CGHS.
The ECHS came into being in the year 2002. It has been benchmarking its services to the older CGHS. Thus it came as no surprise that in the year 2012 the ECHS followed the lead of CGHS, and appointed UTI-ITSL as Bill payment Authority ( BPA) albeit with one crucial difference that it imposed a layer of Competent Financial Authorities (CFA) between BPA and Empanelled Hospital. This modification effectively converted the Bill Payment Authority into a Bill Payment Adviser to the CFAs (Director Regional Centre, Deputy MD, MD ECHS and MoD). In keeping with provisions of FR, the CFAs were given the right to 'cross-check' the bills cleared for payment by BPA and release payment to the empanelled hospital only when they, meaning CFA, were satisfied. In other words direct human interface between the government official, that is, CFA and the service provider, that is, hospital got reestablished which resulted in emergence of all the old ailments like, subjectivity in decision-making due to difference in personalities of CFAs, disrupted procedure leading to violation of principle of first come - first served and dilution of responsibility with regard to any wrong payments, for example in this system both BPA and CFA are refusing to accept responsibility for audit objections raised by C&AG. The CFA relied on the medical staff officer in his office to 'cross-checking the bills. This led to delayed payments resulting in loss of discount which government could have gained if bills were passed within stipulated 10 days. In the Para 2.6.2.3 of Performance Audit of ECHS No. 51 of 2015 the C&AG has calculated loss of discount at Rs. 34.10 for FY 13-14. Most alarmingly some corrupt CFAs and their medical staff officers, instead of raising queries with BPA, started misusing their power to 'cross-check the bills. They hold the gun of 'arbitrary cuts to bills cleared by BPA' to the head of Empanelled Hospitals. Net result of this illegal and counterproductive step is that reputed hospitals are slowly withdrawing from ECHS.
May I request to make online bill payment system of ECHS absolutely similar to CGHS. As introduction of CFAs has not resulted in any substantial gains. Rather layering of staff and reestablishment of human interface between CFA and Empaneled Hospitals is leading to 'fiscal pedantry' which has potential to destroy the scheme.
Use of ICT removes corruption by, depersonalising decision-making, standradising procedures, ensures service on first come - first served basis and makes whole transaction transparent.
In the field of health care, CGHS pioneered online payment of hospital bills by establishing Bill Clearance Authority (BCA). The government of India formed an entity called UTI-ITSL to act as BCA. This entity consists of requisite medical and financial experts who scrutinise bills submitted by Empanelled Hospitals and release payment. So good has been the performance of UTI-ITSL as BCA that today Memorandum of Agreement (MOA) between CGHS and Empanelled Hospital includes a guarantee of 70 Percent of bill being paid within five days. No wonder that today best of the hospitals across the country have joined the CGHS.
The ECHS came into being in the year 2002. It has been benchmarking its services to the older CGHS. Thus it came as no surprise that in the year 2012 the ECHS followed the lead of CGHS, and appointed UTI-ITSL as Bill payment Authority ( BPA) albeit with one crucial difference that it imposed a layer of Competent Financial Authorities (CFA) between BPA and Empanelled Hospital. This modification effectively converted the Bill Payment Authority into a Bill Payment Adviser to the CFAs (Director Regional Centre, Deputy MD, MD ECHS and MoD). In keeping with provisions of FR, the CFAs were given the right to 'cross-check' the bills cleared for payment by BPA and release payment to the empanelled hospital only when they, meaning CFA, were satisfied. In other words direct human interface between the government official, that is, CFA and the service provider, that is, hospital got reestablished which resulted in emergence of all the old ailments like, subjectivity in decision-making due to difference in personalities of CFAs, disrupted procedure leading to violation of principle of first come - first served and dilution of responsibility with regard to any wrong payments, for example in this system both BPA and CFA are refusing to accept responsibility for audit objections raised by C&AG. The CFA relied on the medical staff officer in his office to 'cross-checking the bills. This led to delayed payments resulting in loss of discount which government could have gained if bills were passed within stipulated 10 days. In the Para 2.6.2.3 of Performance Audit of ECHS No. 51 of 2015 the C&AG has calculated loss of discount at Rs. 34.10 for FY 13-14. Most alarmingly some corrupt CFAs and their medical staff officers, instead of raising queries with BPA, started misusing their power to 'cross-check the bills. They hold the gun of 'arbitrary cuts to bills cleared by BPA' to the head of Empanelled Hospitals. Net result of this illegal and counterproductive step is that reputed hospitals are slowly withdrawing from ECHS.
May I request to make online bill payment system of ECHS absolutely similar to CGHS. As introduction of CFAs has not resulted in any substantial gains. Rather layering of staff and reestablishment of human interface between CFA and Empaneled Hospitals is leading to 'fiscal pedantry' which has potential to destroy the scheme.
I also take this opportunity to exhort the government to fulfill the promise your election promise of establishing 'Veterans Commission' manned by veterans and the serving who are quite competent to take care of themselves far better than those presently sitting in DESW.
posted by Yogi at 4:30 AM
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