Medical Attendance and Treatment Rules
601. 1. The authorised medical officer means the Railway Medical Officer within whose jurisdiction the Railway employee is headquartered or one who is specifically nominated for the purpose.
(Railway Board?s letter No.89/H/6-1/dated 10-7-1989)
Note: (1) The authorised medical officer may as per the requirement of a particular case, refer the case to any other medical officer of the required speciality.
(2) The jurisdiction of a Railway Medical Officer will be taken to cover the railway employees and their beneficiaries residing within a radius of 2.5 km. of the hospital/Health Unit/Station of the Railway.
2. ?Medical attendance? means:--
(a) Attendance on a railway employee, a member of his family or dependent relatives at the consultation room maintained by the authorised medical officer or any Railway hospital/Health unit.
(b) If there is no such consultation room/health unit/hospital, then attendance in any railway hospital/health unit/dispensary to which the railway employee or a member of his family or dependent relatives, is referred to by the authorized medical officer.
(c) Attendance on a railway employee at his residence.
(d) Such pathological, bacteriological, other tests etc. or other methods of examination for the purpose of diagnosis and treatment as are available in any Railway Hospital and are considered necessary by the authorised medical officer.
Note: When such facilities are not available in the Railway hospital, then such examination may be conducted in any Government or recognized hospitals (Government hospitals include hospitals run by local bodies), at the instance of the authorised medical officer. State Governments where agreeable, should debit the cost of treatment to the Railway administration concerned, preferring bills or raising debits in such cases. Otherwise reimbursement to railway employees concerned, would be permissible as per rules. Reimbursement of claims on account of such investigations even at non?recognised institutions may be decided by the General Manager in consultation with FA & CAO, provided these were done at the instance of the authorised medical officer and the amount involved does not exceed Rs.1000/- per case.
(e) Such consultation with a specialist or other medical officer in the service of Government, stationed at places served by the Railway administration as the authorized medical officer with the approval of Chief Medical Director, certifies to be necessary to such extent and only in such measure as the specialist or the Medical officer may, in consultation with the authorised medical officer determine.
Note : A patient should not be referred to ?
(i) a specialist or a medical officer not in service of Government.
(ii) a specialist or medical officer in the service of Government but posted outside the place served by the Railway.
(f) Consultation with specialists or other medical officer means taking advice on the line of treatment and management but not treatment by the Consultant.
(g) If the authorised medical officer feels that the patients condition is of a serious nature as to require medical attendance by some person other than himself, with the approval of the Chief Medical Director of the Railway (which shall be obtained before hand) unless the delay entails serious danger to the health of the patient:
(i) send the patient to the nearest specialist or medical officer by whom, in his opinion medical attendance is considered necessary for the patient, or
(ii) if the patient is too ill, request such specialist or medical officer to attend the patient.
(h) A specialist or medical officer summoned as above, on production of a certificate by the authorised medical officer on this behalf, will be entitled to travelling allowance as admissible to him under the rules applicable to him.
(i) Honorary specialists attached to Government hospitals or recognised hospitals, may be considered as Government specialists for the purpose of this sub-para, subject to the condition that such consultation will be permissible only in places where Government specialists are not available and is only on the advice of the authorised medical officer with prior approval of the CMD. The fees paid to Honorary consultants for consultation at their private consulting rooms will be reimbursed to the railway employees in accordance with the rates prescribed for Government specialists. Consultation with honorary specialists at their consultation room will be permissible only in emergent cases.
3. A. Treatment means?
(a) Use of all medical and surgical facilities available at railway hospitals/health units or consultation room of the authorized medical officer.
(b) The employment of such pathological, bacteriological, radiological and other investigations as are considered necessary by the authorised medical officer.
(c) Supply of such medicines, vaccines, sera, as are ordinarily stocked in the hospital.
(d) The supply of such medicines, sera etc. not ordinarily stocked which the authorised medical officer may certify in writing to be essential for the recovery or for the prevention of serious deterioration, in the condition of the patient.
(e) Such accommodation as is ordinarily provided in the hospital, suited to the status of the railway employee concerned. If accommodation suited to the status is not available, accommodation of a higher class may be allowed provided it can be certified by the medical officer incharge of the Government recognized hospital that:--
(i) that accommodation of the appropriate class was not available at the time of admission of the patient, or if subsequently available , the condition of the patient did not permit shifting; and
(ii) that the admission of the patient into the hospital could not be delayed due to the nature of illness until accommodation of the appropriate class became available.
(f) such nursing as is ordinarily provided to in-patients by the Hospital (engagement of special nurses will be allowed to the extent indicated in sub-section 3 of Section 3 of this Chapter).
(g) the specialist consultation as described above.
(h) confinement in the case of a female railway employee or a dependent female member of a railway employee?s family.
(i) pre-natal and post-natal treatment received before and after child birth for physiological or other disability attributable to child bearing or child birth.
(j) sterilization irrespective of the fact whether it is intended to serve as a measure of family limitation.
----reimbursement of medical expenses for sterility per-se.
(Railway Board?s letter No. 86/H/6-4/58 dated 21-12-88)
----re-canalisation in case of loss of child.
(k) termination of pregnancy under the Medical Termination of Pregnancy Act 1971 and Medical Termination of Pregnancy Rules 1972.
(l) Anti-rabic treatment.
(m) Shifting of the patient for treatment, or for examination from residence to a hospital, or from one hospital to another hospital, in an ambulance belonging to the Railway or Government or a local authority etc.
Note: (1) If an ambulance cannot be pressed into service to attend on an exceptionally emergent cases, alternative arrangement of taxi or other suitable and available transport vehicle should be made to ensure prompt transport. The payments that may be involved in such case can be made out of contingencies. These powers may be delegated to ADMOs. However, where public transport facilities are hired, , these should be reviewed by the comptent higher authority .
(2) In exceptional cases when the patients are not fit to resume duty but are discharged from Hospital as amputation, convalescent cases recommended sick leave, Fracture cases with application of plaster of paris etc. with the specific approval in writing of the medical officer, in- charge of the hospital, the facility of transporting patients to their residence in an ambulance may also be allowed free of cost.
(n) Blood transfusion charges paid to a Government institution or any other local organisation recognised by the State Government for the supply of blood to patients in hospital.
Note: (i) There is no objection to the purchase of blood plasma from a chemist or to obtain blood from a private donor, provided the authorised medical officer certifies in writing that it was not available in Government /recognised institution and the price paid for the blood was reasonable. In such cases reimbursement of the charges will be admissible.
(o) Free diet to the extent indicated in sub-section 2 of Section ?C? of this chapter.
B. It does not include:
(a) Dental treatment or the supply of artificial denture except to the extent indicated in para 608 of this chapter.
(b) Massage treatment except that in the case of poliomyelitis, which may be allowed as part of the general treatment.
(c) Testing of eye-site for glasses except at Railway Hospital where facilities exist for the same.
Note: (1) If local conditions warrant, railways may have their own arrangement for manufacturing and supplying glasses to Railway employees and their families and dependents on ?no profit? , ?no loss? basis. The scheme is to be financed from staff Benefit Fund. In the case of Group ?D? staff, only 50% of the cost of spectacles may be borne by the SBF.
(2) Reimbursement of charges incurred by a patient by a private oculist is not admissible in any circumstance.
(d) Taxi, tonga or other conveyance charges incurred, to convey a patient from his residence to the hospital or vice versa, except as provided in Para 601 III A(M) above.
(e) Cottage booking fee, admission fee, dhobi charges and charges for Attendants/ayah at the Hospital.
(f) Special articles of diet not ordinarily provided by the hospital to its in-patients.
(g) Charges incurred on account of treatment for immunising or prophylactic purpose except at Railway Hospital at the discretion of the authorised medical officer.
Note: Cost of vaccines, inoculations and injections for prophylactic and immunising purposes taken before the commencement of international travel by Railway employees and members of their families and dependent relatives in order to procure health certificates required under international travel regulations, may be reimbursed to them from railway revenues provided they are travelling on duty or are on authorised leave in circumstances in which they are entitled to fares at railway expense.
4. Railway Employees? for the rules contained in this Manual mean persons who are members of a service, or who hold posts under the administrative control of the Ministry of Railways, excepting such of the employees of the Ministry of Railways as are covered by the medical attendance and treatment rules issued from time to time by the Ministry of Health and Family Welfare.
5. ?Family members? and Dependent relatives for the purpose of these rules, will include all such persons as are eligible for passes under the Pass Rule.
6. ?Patient? means a person to whom the rules in this chapter apply, and who has fallen ill.
(Rules 102(7), 102(13), 107(7), 901, 902, 903, 904(ii), Ministry of Railways decision below Rule 908, Note and Ministry of Railways decision below Rule 909(i), Note 2 under Rule 916, 920 of the Indian Railway Establishment Code Volume I, and the notes thereunder, and Paras 1432, 1433, 1435-A, 1437 1441 to 1443, 1445, 1446, 1454, 1455, 1457 (iii), 1502(iii) and 1502(iv) of the Indian Railway Establishment Manual and Ministry of Railways letter No. E52 ME3/19/3 dated 29th December, 1952, No. MH 59ME1/30/Medical dated 14th May, 1960, No. 61/M & H/7/69 dated 23rd June,1961 No. 62/H/7/52 dt. 22nd October, 1962, No.63/H/1/4 dated 7th August, 1962, No. 65/H/1/51 dated 23rd May, 1966, No. 66/H/1/49 dt.7th March, 1967, No. 67/H/1/50 dated 31st January, 1968, No.66/H/1/33 dated 9th December, 1968, No.69/H/1/17 dated 19th August, 1969, No.70/H/13/29 dated 23rd July, 1971 and 13th December, 1971, No.72H/6-1/27 dated 11th January, 1973, No.F(X) I-64-PW4/dated 16th July, 1975, No.E(W)74/PSS-1/11 dated 8th September, 1976, F(X)I-64-PW4/8 dated 16th July, 1975, No.79/H/6-1/31 dated 5th April, 1980 and 87/H/6-1/3 dated 26-6-1987).
602. Section B: Extent of Application
RAILWAY SERVANTS EMPLOYED IN THE OFFICE OF THE RAILWAY BOARD
THE RESEARCH, DESIGNS AND STANDARDS ORGANISATION AND OFFICE OF THE RAILWAY LIAISON OFFICER, AT NEW DELHI AND THEIR FAMILIES
All railway servants employed in the offices of the Railway Board, the Research, Designs and Standards Organisation and the Railway Liaison Office whose headquarters are at New Delhi and their families, shall be entitled Medical Attendance and Treatment in accordance with such rules as may be issued from time to time by the Ministry of Health and Family Welfare for medical attendance and treatment of Central Government servants having their headquarters at Delhi and New Delhi.
Note 1: - Railway servants of the Research Designs and Standards Organisation and their families while employed at the Chittaranjan Locomotive Works and at Tatanagar will lbe governed by lthe Railway Medical Attendance Rules contained in Part II and will be attached the Chittaranjan Locomotive Works and the Eastern Railway respectively.
Note 2: - Railway servants of Groups A & B who are governed by the rules in Sub sec.2 may, on appointment in the offices mentioned in this rule, may be allowed to exercise an option to be governed by the rules in Sub sec.1 or to continue to be governed by the rules in Sub sec.2. A similar option may be allowed in the case of groups C & D employees governed by the rules in Part II who come to the Railway Board?s office from railways on deputation for limited period. Those electing the rules in Sub sec. 2 will be regarded as attached to the Northern Railway for this purpose.
Sub-section 2 : Railway employees
Medical attendance and treatment facilities shall be available, free of charge, to all ?Railway employees? and their ?family members and dependent relatives, irrespective of whether they are in Group A, Group B, Group C, Group D, whether they are permanent or temporary, in accordance with the detailed rules as given in Section ?C? of this chapter.
Note:--Railway staff employed in the offices mentioned below shall be regarded as attached to Railway Administration.
1. Advance Permanent Way Training School, Pune .
2. Railway Staff College, Vadodara.
3. Director Railway Movement, Kolkata.
4. RRB Chairman where located.
5. Chief Mining Engineer (Dy. Coal Commissioner Production) .
6. RDSO, Lucknow.
7. Dy. Director Railway Stores, Kolkata.
8. DLW, Varanasi.
9. CLW, Chittaranjan.
10. DCW, Patiala.
11. Wheel & Axle Plant, Bangalore.
12. Railway Rates Tribunal, Chennai .
13. Chairman & Vice Chairman of Railway Claims Tribunal at places where located.
14. Chairman, Vice-Chairman & Members, Indian Railway School of Signal and Telecommunication Engineering, Secunderabad.
15. Tank Wagon Controller, Bombay.
16. MTP, Kolkata, Mumbai, Chennai, Delhi.
17. ICF, Perambur.
18. DCW, Patiala.
(Rule 916(i) under Rule 916 & 918-RI, Paras 1403(b), 1405 & 2306 of Indian Railway Establishment Manual and Ministry of Railway?s letter No. 69/H/1/38 dated 6th October, 1969, No. 71/H/1-1/35 dated 5th November, 1971 and No. 80/H/6-1/3 dated 22nd February, 1980 and No. 89/H/10/1 dated 30-11-1989).
Sub-section 3 : Railway employees on leave/leave preparatory to retirement/post retirement leave
A railway employee on leave including LPR is eligible for medical attendance and treatment.
(Rule 913 R.I. & Para 1410 of IREM)
Sub-section 4 : Retired Railway employee on re-employment
Retired railway employees on re-employment in the Railways are entitled to free medical attendance and treatment facilities free of charge as per details given in Section ?C? of this chapter.
(Ministry of Railway?s letter No. E51ME1/3/3 dated 26-2-1951).
Sub-section 5 : Officers and staff of the Commissioner of Railway Safety
The staff and officers attached to this establishment are entitled for free medical attendance and treatment for self and family members in accordance with the detailed rules as given in Section ?C? of this Chapter, irrespective of whether they were transferred from the Railways or recruited directly by the Ministry of Tourism and Civil Aviation.
(Ministry of Railways letter No. 66/H/16/3 dated 16-2-1966)
Sub-section 6 : Audit staff
Medical attendance and treatment to the extent available to the Railway employees of corresponding status will be available free of charge to the Railway Audit staff and family members in accordance with the detailed rules as given in Section ?C? of this Chapter.
Audit staff attached to Railways should exercise option if they want Railway medical facilities for treatment under Railway or may continue their treatment under the Central Health Services.
(Ministry of Railway?s letter No. E46 ME39/3 dated 24-6-1946 and 64/H/6/158 dated 9-11-64.)
Sub-section 7 : Railway employees on deputation to RITES/IRCON
Railway employees on deputation to the above organisations may be permitted to continue to avail the medical facilities in accordance with the detailed rules as given in section ?C? of this Chapter. However, RITES/IRCON should pay annual contribution on the basis of per capita expenditure on a Railway employee on All India Railway Basis, multiplied by the number of Railway employees on deputation, who have opted for these rules.
(Ministry of Railway?s letter No. 79/H/6-3/8 dated 18-7-1980)
Sub-section 8 : Free Medical facilities to whole time employees and officers employed by AIRF/NFIR
1. Whole time employees of Zonal recognized Unions Federations are entitled to free medical treatment for self only.
2. Family members of whole time employees of aforesaid federation/Unions in the hospitals and Health Units is limited to outdoor treatment only.
(Railway Board letter No. 90/H/6-7/13 dated 22-6-1995)
Sub-section 9 : Quasi Railway Organisation
I. Free medical attendance and treatment facilities are available to the staff themselves of the
(i) Consumer Cooperative Societies
(i) Staff Benefit Fund Committees
(ii) Railway Institutes
(iii) Railway Officer?s Club
(iv) Station Committees
The family members of these employees will be given free OPD treatment.
II. The family members of the staff of Consumer Co-operative Societies may be given medical attendance and treatment on per capita basis, the charge being calculated on the basis of total expenditure on medical services on All India basis excluding the cost of health service.
III. Medical attendance and treatment facilities are available to the staff and their families of the Co-operative Credit Societies and Bank on per capita basis as stated above.
Note:--The staff of the canteens on Railways run by cooperative Societies specially formed for the purpose and in the Ministry of Railway?s office may be extended free medical treatment in OPDs only. For any investigation charges are leviable.
(MOR?s decision No. 2 deal rule 902 R. T. paras 1403 (a), 2922 & 2940 (vi) of Indian Railway Establishment Manual, MOR?s letter No. 64/H/7/116 , dated 31-8-1965, 71/H/1-1/18 dated 14th September, 1971 and 73/H/6-1/24, dated 1-10-1973).
Sub-section 10 : Apprentice
Free medical attendance and treatment facilities will be admissible to all apprentices other than those governed by the Apprentice Act, 1961 but not to their family members, on the same scale as available to Railway employees but confined only to the extent facilities are available in Health Units and Railway hospitals. For the purpose of medical attendance and treatment facilities, they may be classified according to the categories for which they are apprentices. For the purpose of recovery of diet charges, the stipend drawn by them should be considered as pay. No reimbursement facilities are available in non-railway institutions, T.B. institutions where beds have been reserved, for railway employees.
(i) Trade Apprentices who are governed by the Apprentices Act 1961, but come otherwise within the definition of the phrase ?Family members or dependent relatives? of a railway employee, will be eligible for medical attendance and treatment facilities, according to the status of the railway employee under the normal rules.
(i) Free medical treatment may be offered to apprentices including those governed by the Apprentice Act 1961, when personal injuries are caused to them by accident arising out of and in the course of training as an apprentice.
(MOR?s decision (i) below Rule 902 are RI, paras 1401, 2401 and 2409 of IREM and MOR?s letter No. MH58ME1/24 Medical, dated 12-1-60 and No. E(TRJ)1/67/TRI/15 , dated 8-2-1968)
Sub-section 11 : Railway employees enrolled/commissioned in the territorial army
A Railway employees enrolled/commissioned in the territorial army will be entitled to military medical services during the period of training and embodiment. The family members and dependent relatives of the employees will be governed by the railway medical attendance and treatment rules during the above period.
(Para 4 II of the IREM)
Sub-section 12 : Private servants
A private servant of a railway employee (i.e. a person employed on whole time basis on a salary in the personal services of the railway employee), who is eligible for passes, is also eligible for medical attendance and treatment as out-door patient and also, to the extent accommodation is available as in-door patient, at all railway hospitals and health units. In case of in-door treatment, charges at 40% of the schedule of charges laid down for out-siders may be levied for the specialized and indoor treatment and for radiological examination.
NOTE.?The out-patient treatment should be confined to short routine illnesses and not diseases requiring prolonged management of cases.
(Rule 932 RI and Railway Board?s letter No. 65/H/7/189 dated 3-2-1967 and 10-11-1967 and No 71/H/1-1/16 dated 29-3-1972)
Sub-section 13 : Casual labour
1. Casual labour project as well as non-project, may be given medical facilities for self only in the out-patients Department. The service cards of the employees may be utilised as the identification cards for this purpose.
2. There should be no artificial break in the service of casual labours.
Note: 1. When they develop post-vasectomy complications and require indoor treatment, free, diet is also admissible.
2. Casual labourers with more than three months service will become entitled to the same rights and privileges as admissible to regular railway employees.
(Railway Board?s letter No.66/H(EP)/6/74 dated 11-6-1973, No. E(NG)II 77CL-12 dated3-5-78)
Sub-section 14 : Contractors, their staff and labourers
Staff of contractors engaged by Railway administration are not entitled to free medical attendance and treatment facilities. They and their family members may be treated in railway hospitals and health units in places where there is no other hospitals are available provided the contractor pays the cost of diet, medicines and dressings.
(Para 1409 of IREM)
Sub-section 15 : Commissioned vendors
1. Free medical facilities in OPD are available to Commissioned vendors/bearers engaged in departmental catering as out door patients for self only. As in-door patient it will be available when they are injured during the course of the duties.
2. The patients treatment should be confined to short routine illness and not disease requiring prolonged management of cases.
(Railway Board?s letter No. 62/H/1/70 dated 16-2-63 and 61/H/70 pt.a dated 17-3-64 and 71/H/1-1/16 dated 16-6-1971)
Sub-section 16: Central Government employees governed by C.S.(M.A.) Rules 1944
Central Government employees governed by these rules subject to availability of accommodation can avail of medical attendance and treatment as admissible to outsiders in railway hospitals on payment of charges prescribed for outsiders. Preference would, however be given to these employees amongst outsiders.
(Railway Board?s letter No.74/H/6-3/14 dated 4-8-75)
Sub-section 17 : Families of railway employees on secondment of foreign service.
The families of railway employees on secondment abroad on foreign service terms left behind in India may be treated at par with the families of retired railway employees governed by the Retired Railway Employees Contributory Health Scheme.
(Railway Board?s letter No. 78?H/6-1/27 dated 21-9-1978)
Sub-section (24) : Identity cards necessary for availing of facilities in railway hospitals
1. If a railway beneficiary does not produce a medical identity card no medical treatment should be afforded to the railway beneficiary, except emergency first-aid.
2. Licensed Porters, Commissioned vendors, etc. who are not regular railway employees may be issued identity cards with additional endorsement indicating the category to which they belong.
3. For casual labours, their service book will serve as the medical identity card.
4. In emergencies, however, a patient, even in the absence of identification papers has to be attended first, including administration of such medicines and use of such appliances as may be necessary. With welfare inspectors, efforts should be made to establish the patient?s identity. In case of patient is found to be a non-railway beneficiary, he should be treated as an out-sider, charged accordingly or transferred to a non-railway hospital as soon as the patients? condition stabilises and the expenditure written off with the concurrence of the competent authority.
(Railway Board?s letter Nos 79/H/6-1/24 dated 30-7-79, 76/H/6-1/10 dated 25-5-1978 and 79/H/6-1/22 dated 26-7-79.)
A Government employee transferred temporarily or permanently to a post under the Ministry of Railways shall be entitled to opt for medical attendance and treatment facilities in the course of the detailed rules as given in Section ?C? of this chapter.
(Rule 912 RI)
Sub-section 19 : Railway employees on deputation in India/abroad posted abroad
1. Railway employees on deputation in India-Railway employees sent on deputation to other Government Departments/Corporations/Undertakings may be governed by the medical attendance rules of the borrowing Departments/Corporations/Undertakings. The borrowing Departments/ Corporations/ Undertaking may, however, allow the Railway employee, at his option, to enjoy Railway medical facilities provided a contribution to Railway revenues is made by the borrowing Departments/Corporations/Undertaking or by the Railway employee concerned, as may be mutually agreed upon between them, at the rates of recovery prescribed from time to time for government employees of his status under the Central Government Health Scheme.
(Note under Rule 911-R.I.)
2. Railway employees on deputation abroad and India-based Railway employees posted abroad.?(i) Railway employees working in posts outside India and /or sent abroad on deputation may be divided into the following three categories for the purpose of grant of medical facilities, viz.
(a) those who are sent on ?short-term? deputation abroad, i.e. when the period of continued stay abroad does not exceed six months;
(b) those who are sent on ?long-term? deputation abroad; i.e. for a period in excess of six months; and
(c) India based Railway employees posted abroad.
(ii) Railway employees falling under category 1(a) above will be governed by the orders issued by the Ministry of External Affairs from time to time, whereas those falling under i(b) and i(c) above will be entitled to medical facilities as are admissible under the Assisted Medical Attendance Scheme as published by the Ministry of External Affairs and as corrected from time to time.
(ii) Subject to the provisions the Assisted Medical Attendance Scheme, the concessions admissible thereunder are also applicable to wives, children and step-children residing with and wholly dependent on the employees falling under i(b) and i(c) above.
(Min. of External Affairs Memorandum No. 1(i) 19/MP-55 dated 13th September, 1955).
3. Families in India of employees posted abroad?(a) Free medical attendance and treatment will also be admissible to families in India of employees posted abroad, provided medical attendance and/or treatment is in accordance with the rules and orders in force in India.
(b) The employee concerned should arrange to collect from his family in India all the necessary certificates, bills, receipts, vouchers, etc. that are required to accompany and claim for refund under the relevant rules and orders. He should then submit his claim to his Accounts Officer through the Head of the Mission/Post in which he is serving. The claim should be made out in the salary bill form and supported by the prescribed application form, necessary bills, vouchers and certificates as required under the rules. When the payment is authorised by the Accounts Officer, it should be made payable in India to a person duly nominated by the employee to receive payment on his behalf. Refunds for expenditure incurred in India shall not be made in a foreign currency. The nomination shall generally accompany the claim so that after the claim has been passed by the Accounts Officer, that officer can issue a letter of authority to the nominee to receive the payment. The expenditure on such refunds should be debited to the Railways.
(Min. of External Affair?s Memorandum No. 1(i) 19/MP-55 dated 13th September, 1955).
4. The Controlling Officer?The ?Controlling Officer? in the case of medical claims of the Railway employees serving in Missions/Post abroad will be the Head of the Mission/Post concerned.
(Note below Rule 35 of Appendix V?R.I.)
603. Section ?C? ?Scope of medical attendance and treatment
Sub-section I : General
1. Medical attendance and treatment.?The Railway employees, their family members and dependent relatives are entitled free of charge medical attendance and treatment;
2. In such railway hospitals/health unit or consulting room maintained by the authorised medical officer, at or near the place where the patient falls ill, as can, in the opinion of the authorized medical attendant, provide necessary suitable facilities; or
3. If there is no such hospital, health unit or consulting room about, as mentioned above, any such government hospital/health centers or dispensaries are near the place, as can in the opinion of the authorised medical officer provide the necessary suitable facilities; or
4. If there is no such hospital, as mentioned in paras 2 and 3 above, or any other hospital with which arrangements have been made for the treatment of the railway employees at or near the place as can, in the opinion of the authorised medical officer, provide the necessary and suitable facilities.
I. Allotment of hospital accommodation in railway hospitals depends on the condition and seriousness of the disease and not on the status of the patients. However, in some government hospitals, accommodation in special wards is provided according to the status of the patient. As far as railway employees are concerned, those drawing basic pay of Rs.1600/- or above per month, would be considered eligible for special wards.
II. Family members may avail of medical facilities from a medical institution referred to in sub-paras 1, 2 and 3 above without the intermediary of the authorised medical officer.
(Rule 906 R.I., Railway Board?s letter No. 67/H/1/58 dated 23-5-68, 71/H/1-1/6, dated 9th October, 1971, 79/H/6-1/5 dated 3-2-1980 and 82/H/6-1/22 dated 25th May, 1987).
604. Attendance at Residence.?1. Attendance at residence is restricted to :
(a) a gazetted railway employee, when he falls sick, attendance is free,
(b) a non-gazetted railway employee, when he falls sick, and is as a result compelled to be confined at his residence, no charges to be levied.
(c ) a member of a gazetted/non-gazetted railway employee?s family or dependent relatives, when the authorised medical officer certifies in writing that removal of the patient to a hospital is dangerous or injurious to life. In all such cases, the employee concerned should pay the visiting fee as per schedule.
Note.?Railway employees are expected not to call the medical officer for minor ailments thereby wasting their time and depriving other patients of their service.
2. For visits at a residence of a railway employee, drawing Rs. 1200 and over per months, for attendance on their family members and dependent relatives, emergent or otherwise, the railway medical officer are entitled to receive fees. The payment of fees in such cases may be regulated by the visit.
605. The medical officer shall be entitled to charge the following fees as indicated below:
Employees drawing a pay of Rs. 1600/- (new scales) or more per month
Employees drawing pay less than Rs. 1600/- (new scale ) but not less than 1200/- per month
No fees for domiciliary visits shall be charged from employees drawing pay of less than Rs.1200 p.m.
(Railway Board?s letter No. 82/H/6-1/22, dated 25-5-1987).
(a) When more than one member of a railway employees family or dependent relative are to be examined at the residence, visiting fees may be charged for each separately.
(b) When a railway medical officer is called upon to render assistance to a railway employee or a member of his family or dependent relatives at an outstation, he may be granted traveling allowance as per rule when the medical service rendered is free. When, however, the medical officer is entitled to charge fees as provided above, he may claim travel allowance only if he deposits the fee received into the railway revenues. When preferring such claims for travel allowance, the medical officer should indicate the amount of fees received by him and also certify on the bill that the fee received have already to the railway revenues.
(c ) No extra fees to be charged for conveyance except for very great distances where the decision of the Chief Medical Director is final. No higher fees for night visit.
(d) No railway employee shall be compelled to adopt any of the foregoing system of payment for medical attendance or to employ any railway medical officer for this purpose.
(e) A railway employee may obtain services of a medical officer of a lower grade than that of the medical officer to whose services he is entitled, on payment of the scale of contract fees or fees by the visits fixed for the medical officer he chooses.
(Rule 330, 903(3), 921-929 and 931 RI, note below no.1453 of the IREM and Railway Board?s letter No.62/H/1/20 dated 6-5-64 and 65/H/7/44 dated 7-10-66).
606. Special provisions regarding female and children beneficiaries.?At places where there are no railway hospitals or government hospitals, female beneficiaries and children of railway employees upto 12 years of age, may directly obtain medical attendance and treatment without the intermediary of the authorized medical officer from the nearest Govt./Private Hospital.
(Rule 919 R.I. and Ministry of Railway?s decision no.1 thereunder, paras 1446 (v) and (vi) of the IREM and Railway Board?s Letter Nos. 64/H/154 dated 11-12-1964, 6/H/11/9 dated 20-3-1967, 76/H/11/11 dated 17-4-1970 and 80/H/6-4/15 dated 21-8-1980.)
607. Supply of artificial limbs and appliances.?A railway employee, a member of his family or dependent relatives whether injured on duty or not, requiring artificial limbs and appliances, would be entitled to reimbursement of both hospitalisation charges and full cost of artificial limbs and appliances, as also cost of repairs, renewals and adjustments thereof from time to time payable from railway revenues subject to the following conditions:-
(a) Production of a certificate from a specialist in the concerned speciality in the railway hospital that the above was essential.
(b) Apparatus repairs renewals or adjustments being done at the Rehabilitation department of a Medical College, Artificial Limb Centre of Pune or other organisations and centres recognised for the purpose by the Central/State Government concerned.
(c ) The cost of repairs or adjustment of a limb appliances should not exceed the cost of replacement of that limb appliances.
Note.?The above para does not apply to the supply or replacement of heart pace makers and heart valves.
(Railway Board?s letter No. 80/H/6-4/33 dated 5-12-80 and Feb. 1981).
608. Provision of dental treatment:--1. Free treatment be given to railway employees and beneficiaries incurred to following ailments in all railway dental clinics and at all places where railway dental attention facilities have been provided.
(ii) Scaling and gum treatment
(iii) Root canal treatment
(iv) Filling of teeth
2. In addition, free dental treatment of a major type is also admissible in cases where it is considered as a part of any general or consequential ailment and when the teeth are the source of disturbance. Treatment of such conditions may include treatment of any condition involving the operations on gums, for extraction of growths, surgical operations needed for the removal of Odon tomes and impacted wisdom teeth.
(1) Arrangements may be made to hire the services of a local dentist to work part time in a railway hospital. In such cases no charges should be levied for normal cases like extraction, scaling etc. but for other items like filling of cavities etc., a schedule of charges may be prescribed and recoveries made from such staff .
(2) The supply of artificial dentures is excluded from the scope of dental treatment.
(Para 1440 of the IREM and Railway Board?s letter No. E57MES/85/Medical dated 9/10 March 1961 and 62/H/7/31 dated 30-4-1962)
609. Donation of blood.?1. No prior permission of the Government is required for donating blood in Blood Banks attached to railway hospitals or government hospitals or if called upon in emergencies to donate blood in any Blood Bank.
2. No prior permission is necessary for acceptance of an amount on account of donation of blood, since it is considered that receipts from the sale of blood does not attract the provisions of Rule RII 2035 and 2216.
3. When a railway employee or a member of his family donates blood to a railway hospital or a government hospital, he may receive payment at the rate of Rs.50/- (Rupees fifty only) per donor per bottle or blood i.e. 300 c.c. However, no incentive money should be paid to voluntary blood donors against their wishes and every effort should be made to encourage the voluntary free Blood donors.
The Railway may consider issue of cards to voluntary blood donors with the offer of free replacement if the donor needs blood transfusion for self within a period of 12 months.
(Authority: Railway Board?s letter No. 84H/6-1/17 dated 4-6-85 and 90/H/68/3 dated 15-3-91.)
4. Railway employee who donates blood to a railway hospital on a working day may be granted special Casual Leave, for that day.
5. A railway employee who comes from out-station to donate blood to a railway hospital may be granted a complementary pass of the same class as admissible to him under the normal rules to cover the journey. He may be allowed a minimum journey time apart from one day special casual leave.
6. As blood is a therapeutic substance used in treatment of patients, expenditure incurred for obtaining blood shall be debited to ordinary railway revenues and allocated under the head ?medicines?.
(a) As far as possible, railway employees should be encouraged to donate blood voluntarily and not with any mercenary motive.
(b) Hence there should be no occasion to force a person to accept the permissible payments.
(c ) Blood collected for use in Non-Railway hospitals should not qualify for payment from Railway revenues, even if the collection has been done in Railway premises.
(Railway Board?s letter No. 65/H/7/248 dated 5-2-1966.)