The 185th ESIC Board meeting, held in Rishikesh on September 10, has decided to include unorganised sector workers into its network.

The meeting also discussed ways to include the 50 crore unorganised sector workers and their family members into the ambit of the scheme. At present, 3.41 crore workers are insured under the scheme.

But the process may take years as just 68 of the 736 districts in the country have dispensary-cum-branch offices (DCBO) – a basic healthcare amenity provided for insured persons.

Yet to be enforced

A document of the Labour Ministry, circulated to the members of the board, says the ESIC is yet to be implemented in 153 districts. In May, 2018, the ESIC had decided to open DCBOs in each of the covered districts. But even after three years, there is not much progress as per the document presented before the board.

Also read: Unorganised workers to be brought under ESIC net

“Even after six decades of being in presence till 2015, the ESI scheme has a presence in 393 districts, of which, only 30 districts were fully notified. As on July 1, the Act has been notified in 583 districts, 399 of them fully, 184 partially implemented it. The scheme is yet to be implemented in 153 districts,” said the document.

The Ministry blamed the State governments for the delay. “Under ESI scheme, the State government concerned makes provision for medical care for the potential insured persons and their dependent families before notification of the Act. Expansion of the ESI Scheme thus depended on arrangement for delivery of medical care by the State concerned, resulting in slow pace of implementation of the Act,” the board was told.

Inadequate dispensaries

A minimum of 3,000 insured persons are required for opening a dispensary under ESIC norms.

“ESIC requires 10,000 dispensaries for providing primary care to over three crore IPs, but only 1,469 dispensaries have been established,” said the Ministry. DCBOs’ functions include providing primary medical care, streamlining referrals for secondary medical care, expediting scrutiny of bills of secondary care referrals, and ensuring distribution of drugs to Modified Employer Utilisation Dispensary.

The note also said that after approval for opening of DCBOs in every implemented districts in 174th meeting of ESIC, initially 314 DCBOS were approved in various States, and just 29 DCBOS were made functional from September-October 2018.

A trade union representative in the board told BusinessLine: “The Code on Social Security will take away even the little social security coverage the workers of this country enjoy. We told the Labour Ministry to come with a clearer vision before promising more to people from the existing ESIC network.”

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