By about 1.30pm, there is a palpable sense of urgency at the Central Government Health Scheme (CGHS) Wellness Centre at Gandhi Nagar in Kochi.
Over 70 people, inside and outside the centre, glance at their watches and phones before looking up at the token display. With 2pm approaching, the chances of seeing a doctor look grim for many.
When the centre closes, several elderly beneficiaries walk out disappointed and frustrated. Some have waited since early morning.
Others have travelled from places like Palakkad to consult a doctor, get a referral or collect medicines. For many, the visit will have to be repeated the next day.
For a scheme meant to provide medical support to serving and retired central government employees and their families, accessing even basic services has become an uphill task for many beneficiaries in and around Ernakulam district.
A day lost for one signature
Retired CISF officer Vishwanathan N travelled from Idukki by bus, reaching Kochi around 7.30am. The Gandhi Nagar CGHS facility is the nearest one for him.
“My wife underwent a bone marrow transplant in 2001 and has had to deal with multiple medical issues since then,” he says.
“I am here to get a doctor’s signature to procure a medicine for her. Since it is a Schedule H1 drug, it cannot be dispensed without the required paperwork. To avail myself of the benefits of CGHS, I have to go through this long process.”
The wait is not his only worry. “If I cannot get it done today, I will have to stay back, find a room nearby and try again tomorrow. I have no relatives or friends here who can accommodate me,” he adds.
Like him, those who suffer the most are senior citizens. Especially those whose children live away. With no one else to depend on, they must make the long journey themselves, often more than once, for something as routine as a signature or a medical refill.
The frustration is hard to miss. During TNIE’s visit on Tuesday, a group of beneficiaries gathers to draft a written petition on the centre’s functioning. “Submitting complaints is a regular affair. Nothing is going to change,” grumbles one of them.
The staff, too, acknowledge the strain, pointing to shortages, mounting workloads and administrative restrictions.
Opened in 2020, the centre has been overwhelmed ever since. “Doctors are usually expected to see a maximum of around 75 patients a day, but here the number crosses 100,” says an official.
“They attend to patients continuously through the six-hour OPD, from 8am to 2pm, with little room for breaks. The official CGHS portal shuts at 2pm, making it difficult to accommodate those still in the queue on humanitarian grounds.”
Jaya V Nathan, a retired Income Tax department employee from Edachira, is back for a second consecutive day after missing the doctor earlier.
“This centre alone has around 22,000 beneficiaries registered. There are just two doctors,” she says. “A single centre is supposed to handle only up to 6,000.”
Abdul Salam, a former Naval Physical & Oceanographic Laboratory (NPOL) employee from Kakkanad, says he reached the centre by about 8am.
“I had to wait beyond 2pm to get some referral papers signed,” he says.
For Salim T A, a retired BSF officer accompanying his wife, the experience stings. “I was in service for over two decades and even served in Kashmir. But this is what I have come back to at home,” he says.
A larger problem
S Ananthanarayanan, former NPOL director and president of the Central Government Officers’ Association, says the infrastructure is “inadequate for both the number of beneficiaries and the area served”.
“This is the only CGHS Wellness Centre in the region. People travel from nearby districts to access the facility,” he says. “It is high time more centres were opened.”
The demand is not new. R B S Mony, president of the Association for Welfare of Air India Retired Employees, says it has been raised for years.
“There has been little progress. A new centre for Ernakulam has already been sanctioned, but no steps have been taken to make it operational,” he alleges.
“Thiruvananthapuram already has three, and Kollam recently got one.”
The pressure on the Gandhi Nagar centre is evident in the queues that form well before the centre opens. “Some beneficiaries arrive as early as 4am to secure a token,” he says.
Mony adds that he has pursued the issue with T K Damodaran, president of the CGHS Beneficiaries Welfare Association of India.
“We have been writing to and meeting MPs for quite a few years, but to almost no avail,” he shrugs. “What is missing is a sense of urgency in alleviating the difficulties faced by senior citizens.”
Limited choice of hospitals
The rush is not the only issue, says Ananthanarayanan.
“Wellness Centres handle consultations, referrals and medicines. For specialist care, investigations and in-patient treatment, we have to depend on empanelled hospitals,” he explains.
“Choice is limited. One reason is the CGHS reimbursement rates, which may not match the actual cost of treatment at large hospitals. Another issue is delayed government reimbursements that discourage hospitals from being part of the scheme.”
A stroke patient himself, Ananthanarayanan says the current system is exhausting. “I can avoid CGHS facilities. I do that whenever things get too cumbersome. But what option do people who do not have that privilege do?” he asks.
Introduced in 1954, CGHS was designed to give serving and retired central government employees and their eligible dependents comprehensive healthcare.
Its network of wellness centres, government facilities and empanelled private hospitals was meant to ensure continuity of care, particularly after retirement.
Here, however, the gap between that promise and the everyday experience of beneficiaries is hard to ignore.
“We were once part of nation-building,” says a former Prasar Bharati employee as he leaves the centre. “Today, we are treated like third-class citizens. That hurts the most.”