Central Government Health Scheme

Central Government Health Scheme (CGHS) was established on 1 July 1954.^[4] It was initially introduced in Delhi as the Contributory Health Service Scheme (CHSS) under the administrative control of the Directorate General of Health Services.^[5][6] Initially there were 16 Dispensaries catering to 53,000 Government Employees and a total of 2,23,000 beneficiaries.^[6] Prior to CGHS, employees had to claim reimbursement of medical expenditure under Central Services (Medical Attendance) Rules. CGHS was introduced to provide a more comprehensive healthcare to the Central Government Employees and to make the system more efficient. The scheme was later extended to several other categories of officials, such as members of parliament, supreme court judges, etc.

Over the years, CGHS wellness centres were expanded to cover more and more cities throughout India.^[7]

Central government employees, serving as well as retired, and their family members are eligible for CGHS benefits. The serving employees should be residing in a CGHS covered city to be eligible to subscribe to CGHS scheme. For pensioners, this is not necessary. At the time of retirement, the pensioner can choose to avail either CGHS benefits or the Fixed Medical Allowance (FMA).^[8][9]

CGHS also have several other categories of beneficiaries, which were added over the years, such as Members of Parliament, Judges of Supreme Court and High Courts, employees of certain autonomous organisations covered under the scheme, Railway Board employees, etc.^[10][11]

A subscription amount is deducted from the Pay of the Central Government Employee every month for coverage under CGHS scheme. For Pensioners, either monthly payment or a one-time lifetime payment of subscription can be chosen at the time of retirement.^[12]

Currently CGHS wellness centres are functioning in 80 cities all over India.^[13]

The Wellness Centres are headed by Chief Medical Officer (CMO) in-charge and functions from Monday to Saturday 7:30 AM to 2:00 PM. The staff pattern is as per Staff Inspection Unit (SIU) norms based on workload, and a Medical Officer is expected to attend to 75 patients in 6 hours.^[18][19]

Through the wellness centres located at several cities across India, the beneficiaries can avail medical consultations and are provided medicines free of cost. Total number of beneficiaries are 47.44 lakhs.^[16] The beneficiaries requiring expert evaluation and hospitalisation are referred to hospitals known as Healthcare Organizations (HCOs) empaneled under CGHS. A total of 2486 private hospitals and diagnostic centres are empanelled under CGHS.^[16] In addition to Modern Medicine, the beneficiaries can also avail healthcare under Indian Systems of Medicine, such as Ayurveda, Unani, Sidha, Yoga and also Homeopathy.^[20][21][22]

Serving employees of the Ministry of Health and Family Welfare, Pensioners, Members of Parliament, etc., are eligible for cashless treatment at the empaneled hospitals.^[10]

The Department-Related Parliamentary Standing Committee on Health and Family Welfare noted in its report that a significant number of posts are vacant in CGHS Organisation to the tune of 2,023 positions (28.81% of sanctioned strength) and may lead to an undesirable doctor to beneficiaries ratio, increased patient waiting time and reduced quality of care.^[16] The Committee also noted that around 26% of the Wellness Centres are located in Delhi NCR region and the uneven distribution of these wellness centres in the nation restricts the accessibility of the beneficiaries to CGHS Services.

• Central Health Service
• Ministry of Health and Family Welfare