WBHS and Consumer Protection Act

I have recently got feedback from one Jt. Secy., Law Cell, Finance Dept. that the general notion that there is arbitrary discrimination in the admissibility of class of accommodation in hospitals/ medical institutions on the basis of pay of employees despite equal monthly contribution from all under WBHS,2008 is wrong. WBHS is not an isolated scheme rather, it’s derived from WB Service (Medical Attendance) Rules,1964. It’s intended to provide medical facilities IN ADDITION TO to those admissible under WB Service (Medical Attendance) Rules,1964. This is OPTIONAL and NON-CONTRIBUTORY. Whoever wishes to enroll his name & names of dependent family members including spouse under WBHS is required to FORGO the monthly medical allowance otherwise admissible to him should he not opt for this scheme. The term “forgo” does not have same implication as that of the term “contribute”. Therefore, there is no point of justification to assume that an employee who avails of additional medical facilities under WBHS by forgoing fixed medical allowance (@ 300/-) is paying monthly contribution @ 300/- to the State Govt. either directly or indirectly in lieu of fixed medical allowance. He is sensu stricto contributing nothing under the scheme. Moreover, the important point is that the entitlement to different classes of accommodation for different categories of employees is not a new concept that has been adopted for the first time. In fact, admissibility of pay-based accommodation for in-patient treatment has been still there in WBS (MA) Rules,1964 effective from year 1977 vide Notifications No. Est. 7328/ 2M-9/77 dated the 20.07.1977.
Government of West Bengal
Department of Health, Family Planning.
No. Est. 7328/ 2 M-9/77. Dated : Calcutta, the 20th July, 1977
N O T I F I C A T I O N
In pursuance of sub clause (V) of clause (i) of rule 2 of the West Bengal Services (Medical Attendance) Rules, 1964, published with this Department Notification No. Estt/2850/2M-36/64, dated the 22nd. June, 1964, at pages 1933-1939 of Part I of the Calcutta Gazette, Extraordinary, of the 25th. June, 1964 and in supersession of this Department Notification No. Estt/3538/2M-36/64(iv) dated the 13th. July, 1964, published at page 2159 of Part I of the Calcutta Gazette, Extraordinary, dated the 13th. July, 1964, the Governor is pleased hereby to notify, for the purposes of the said rules, the class of accommodation specified in the entries in column 1 of the table below, as being suitable for the category of Government servant specified in the corresponding entries in column 2 of that table, including the members of their families, namely:-
TABLE
Class of accommodation admissible………………………….Category of Government servants
(1)…………………………………………………………….(2)
1) Accommodation in Cabin……………………………………Gazetted Officers
2) Accommodation in paying beds……………………………..Non-gazetted employees of both Class III and Class IV Service
By order of the Governor,
Sd/- S. S. Chatterjee.
Deputy Secretary to the Government of West Bengal.

However, in sharp contrast to the provisions of WBHS the Central Govt. Health Scheme (CGHS) is MANDATORY for an employee and CONTRIBUTORY in nature. CGHS benefits are presently available in only 27 cities in India. The C.G. employees receive medical treatment under the Central Services (Medical Attendance) Rules, 1944 in those areas where CGHS are not operative. There is no monthly medical allowance payable to the C.G. employees as part of salary under the existing provisions of CS (MA) Rules, 1944. C.G. employees residing in areas covered by CGHS are liable to contribute for the scheme at prescribed rates depending upon their pay and, entitled to different classes of accommodation in enlisted hospitals/nursing homes. Even if he/she does not wish to avail of the facilities under CGHS and does not apply for medical card, it’s binding on the office to deduct an amount equal to his contribution from monthly salary if it is known to his office that the employee resides in an area where CGHS facilities are available.

Dear brother som,
Pls let me take this opportunity to have further discussion on this issue as such appeal was made by adil85 through his post dated 29.07.2012 for the sake of better understanding of the WBHS.
aidl85, in his post dated 01.10.2012, arrived at the conclusion that the C. P. Act has no manner of application in this case. So, there is no contradiction in this particular aspect. But, it is very much evident from some previous posts that the it is invariably considered that the phrase “forgo the regular medical allowance ” in Clause 4(1) of WBHS as having the same meaning as making payment of “medical allowances as a premium for the membership to get the benefit of the scheme and, which as policy matter is deducted automatically from his salary each month.”
Dear som, adding much to your agony, I feel sorry to say that there is a MISTAKE in the application of term “subscription” or “premium” in relation to the availability of benefits under WBHS. When an employee forgoes medical allowance to avail of the benefits of WBHS he is not deemed to be subscribing or paying premium by an amount equal to the amount otherwise admissible to him had he not opted for the scheme. The employee is not a “subscriber” at all in this case. There is no question of becoming a ” subscriber” of the WBHS as the employee is not required to pay any subscription as per the existing policy of the govt. The act of relinquishment of medical allowance does not invoke a sense of payment of subscription in a direct or indirect way whatsoever. Nor does it amount to payment of any premium. There is no words like “contribution”, “contributor”, “subscription” , “subscriber” or “premium” etc. used in the WBHS,2008 to bring out the sense of payment of premium/ contribution/ subscription. Pls see sub-clause (1) of clause (4) and, also the declaration given by an employee in Application form for enrolment under WBHS (Form-A) which is as follows:
“I do hereby declare that upon enrolment under the above scheme I shall forgo the regular medical allowance drawn by me as part of salary.
I further declare that I shall abide by the provisions of the West Bengal Health Scheme, 2008, as may be in force from time to time.
Signature of the Applicant”.
I repeat that WBHS,2008 is an additional version of original WBS (MA) Rules, 1964, which is meant to provide better facilities. This is clarified in it’s Notification No. 7287–F dated 19-09-2008.
I reiterate that pay-based entitlement to accommodation in hospitals/ medical institutions is not a newly introduced policy. It was there in the original WBS (MA) Rules,1964 vide Notification No. Est. 7328 2 M-9/77. Dated : Calcutta, the 20th July, 1977, as already referred to in my previous post.
I can’t help saying that I have strong objection to your comment that “Now you are diverting this topic towards its authenticity.”
I request you to go through the post made by adil85 on 01.10.2012 and 10.10.2012 again and again, wherein deep concern was expressed on the authenticity / legality / propriety of WBHS and, the fate of the scheme, if challenged in the Court, was guaranteed as uncertain and gloomy:-
“…… then the terms and conditions of the facilities of the scheme are based on arbitrariness which is violative of Article 14 of the Constitution of India. If some one approaches the Court of Law then either the benefits will become the same for every one or the rules of WBHS 2008 will be quashed.” “ In WBHS 2008 scheme it is seen that the entire rule is based upon discrimination and violation of Article 14 of the Constitution. If some one (participant or beneficiary) moves to the Court of law the scheme will be quashed ab-initio……….In fact such rules are framed by the fresher law graduates who join WB legal Service or by the ill educated big wigs of the Government who give it to frame to their section officers instead of doing their selves. …….”
Frankly speaking, as a member of this forum I took part in the discussion and, only tried to justify the authenticity of the scheme in response to the general request made by adil85, which goes as “ Members should also discuss the issue raised by me with their bosses as an academic discussion and post their views on this forum so that an awareness may be created in the employees.”
Yes, everybody can move the Court for legal justice if he considers himself deprived of a govt. policy. No problem. I always support you. This forum is for discussion on govt. policies and, looking into the effects/ consequences of govt. actions/ move from all possible angles.
The expenses borne initially by an employee for medical treatment of self and other beneficiaries are reimbursable as per admissibility under rules. What’s the problem with it! What’s your objection to it – not clear to me! The same is true for C.G. employees who get benefits of either CS (MA) Rules or CGHS. I have no hesitation to say that WBHS is better than CGHS insofar as the matter relates to the monthly subscription which is practically NIL for state govt. employees in contrast to the C.G. employees who do not get any monthly medical allowance from the Centre under ordinary CS (MA) Rules. On the other hand, the employees MUST contribute if they reside in a CGHS covered area, irrespective of the fact that whether they are enrolled under this scheme or not! The contribution should compulsorily be deducted from their salaries for CGHS even if they do not opt for this scheme! They are not left with any choice but, a state employee has every liberty to select or disselect the WBHS – to retain or relinquish the regular medical allowance.
With regards.

Thanks for the appeal dear 10moy da but one thing I would like to inform you that we always welcome debates as the same is helpful to extract the actual fact. The size of the reply depends upon many things but we should always try to avoid the unnecessary portion and repetition to make it concise. Please dont take it otherwise, its just a request to all.

I think we all are going off topic. Please let me know whether the employees who opt to come under the scheme can claim themselves protected under the Consumer protection Act? I think this is the heart of this topic.

Thanks for the discussion initiated by Mr. Adil85. Matter is surely and should be under consumer protection law. The WBHS members ought to be the consumers. But what I have seen for many members is that, they or their dependents are getting hospitalised, paying the treatment bills and after submitting the bill claim, their claims are being curtailed or partially cut by the authority, citing no reasons, whose fault it is for the over billing (if any). Is the incumbent (member) responsible for the so called reason of over billing? Why that extra money is to be paid from the incumbents pocket? In such cases whom should the employee file grievence, the nursing home or govt, (whose fault was that for over charges if any) but who will tie the bell around the cat’s neck and get targetted by authority for getting the benifit. Moreover the processing of claims are also getting delayed in the writers. Delayed justice is denied justice. Discussion sought