Central Information Commission
Col. N. R. Kurup vs Army Headquarters, Ministry Of Defence ... on 6 August, 2008
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.1
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 2 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 3 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 4 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.5
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.6
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 7 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 8 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 9