The Comptroller and Auditor General of India (CAG) has raised serious concerns about the functioning of the Ex-Servicemen Contributory Health Scheme (ECHS)—India’s largest healthcare scheme for military veterans. The findings reveal deep-rooted administrative, financial, and structural failures that are directly impacting the health and dignity of lakhs of retired soldiers and their families. In its Audit Report No. 27 of 2025, tabled in both Houses of Parliament, the CAG reviewed the performance of ECHS from 2018–19 to 2022–23. The conclusion is clear and worrying:
👉 ECHS, though well-intentioned, is struggling badly at the ground level.
For elderly veterans, war widows, and disabled pensioners, these failures are not merely technical issues—they are matters of survival.
What Is ECHS and Why Does It Matter So Much?
The Ex-Servicemen Contributory Health Scheme (ECHS) was launched in 2003 with a noble objective:
to provide lifetime, cashless medical care to ex-servicemen and their dependents.
Today, ECHS Covers:
- 32+ lakh Ex-Servicemen
- Around 65 lakh total beneficiaries
- Hundreds of polyclinics across India
- Treatment through:
- ECHS polyclinics (OPD care)
- Armed Forces hospitals
- Government hospitals
- Empanelled private hospitals
Most ECHS beneficiaries are senior citizens suffering from chronic conditions such as:
- Diabetes
- Heart disease
- Hypertension
- Arthritis
- Cancer
For them, ECHS is not a benefit—it is a lifeline. Any disruption directly affects their health, finances, and self-respect.
Major Finding #1: Empanelled Hospitals Are Unevenly Distributed
One of the most serious issues highlighted in the CAG audit on ECHS is the poor availability of empanelled hospitals, especially outside major cities.
What the Audit Found:
- Some cities have too many empanelled hospitals
- Nearby towns and rural areas have none
- Veterans are forced to travel long distances for:
- Specialist consultations
- Diagnostic tests
- Surgeries
Who Suffers the Most?
- Elderly veterans
- Disabled pensioners
- War widows
- Veterans living in remote or semi-urban areas
Although the Ministry of Defence claims it is simplifying empanelment procedures, the audit confirms that actual improvement on the ground remains limited.
Major Finding #2: Acute Shortage of Doctors and Medical Staff
Shockingly, the manpower structure of ECHS has not been revised since 2003, despite a massive increase in the number of beneficiaries.
Consequences:
- Overworked doctors
- Extremely long waiting times
- Short consultation durations
- Decline in quality of medical care
The CAG noted that staffing levels at:
- ECHS headquarters
- Regional centres
- Polyclinics
have remained almost unchanged for over two decades.
📌 While the government approved 1,357 additional staff positions in November 2024, veteran bodies argue that this step is far from sufficient.
Major Finding #3: Medicine Shortages and Unsafe Ambulances
Another disturbing revelation in the Ex-Servicemen Contributory Health Scheme audit report 2025 is the frequent shortage of essential medicines.
Because of this:
- Veterans are forced to buy medicines from private pharmacies
- Many skip treatment due to high costs
- Out-of-pocket expenses increase sharply
Ambulance Crisis:
- Several ECHS ambulances are officially marked “Beyond Economic Repair”
- Yet, they are still being used
- This poses serious safety risks during emergencies
The Ministry has promised:
- Bulk procurement of medicines for six months instead of three
- Replacement of old ambulances
But the audit stresses the need for urgent and sustained action, not temporary fixes.
Major Finding #4: Funds Available, But Poorly Utilised
One of the most surprising findings is that ECHS infrastructure funds were under-utilised.
Key Observations:
- Land is available for permanent polyclinic buildings
- Construction has not started in many locations
- Temporary buildings continue to function despite approvals
Although the government has sanctioned 48 permanent ECHS polyclinic buildings, the CAG has warned that: Delays must be fixed, and accountability must be enforced.
👉Occasion for wearing of medals/miniature medals on civil attire by Ex-Servicemen
Major Finding #5: Delayed Payments Harming Veterans
Perhaps the most painful issue for veterans is delay in payments.
The Audit Reveals:
- Delays in payments to empanelled private hospitals
- Delays in reimbursements to veterans
- Shortage of funds under Medical Treatment Related Expenditure (MTRE)
Impact on Veterans:
- Hospitals refuse to admit ECHS patients
- Veterans are forced to pay upfront
- Financial stress increases after retirement
The government has admitted this issue and proposed one-time additional funding, but the audit questions the sustainability of such measures.
Major Finding #6: Weak Monitoring and Oversight
The CAG also highlighted weak supervision and monitoring mechanisms, including:
- Poor scrutiny of emergency admissions
- Ineffective use of ECHS hospital kiosks
- Inactive vigilance teams
This lack of oversight increases the risk of:
- Errors
- Delays
- Misuse of the system —ultimately harming genuine beneficiaries.
👉How to change registered mobile number in ECHS online
What Does the CAG Recommend?
The CAG audit on ECHS provides clear, actionable recommendations:
- Allocate sufficient funds in one go
- Increase doctors and paramedical staff
- Revise polyclinic capacity based on patient load
- Speed up construction of permanent buildings
- Expand hospital empanelment in remote areas
- Replace obsolete ambulances immediately
- Strengthen vigilance and monitoring teams
👉 Controversy on 8th Pay Commission for pensioners
The Way Forward: Respect Beyond Retirement
This CAG report is a serious wake-up call. Ex-Servicemen Contributory Health Scheme remains a well-designed scheme on paper, but without urgent reforms in staffing, funding, infrastructure, and execution, it risks failing the very people it was created for.
For ex-servicemen:
- Delayed treatment can be life-threatening
- Medical uncertainty destroys post-retirement security
Now that Parliament has taken note, the real test lies in swift, transparent implementation of these recommendations.
A nation’s respect for its soldiers must not end at retirement. It must continue through strong systems that care for them when they need it most.
👉ECHS websites: explore health benefits, smart cards, & claims for ESM
Q1. What did the CAG audit find about ECHS?
The CAG audit found staff shortages, hospital access issues, delayed payments, medicine shortages, poor infrastructure utilization, and weak monitoring in ECHS.
Q2. Which period does the ECHS audit cover?
The audit covers the period from 2018–19 to 2022–23.
Q3. How many beneficiaries are covered under ECHS?
ECHS covers over 32 lakh ex-servicemen and around 65 lakh total beneficiaries, including dependents.
Q4. Why are ECHS payment delays a serious issue?
Delayed payments force hospitals to deny treatment and compel veterans to pay from their own pockets, increasing financial stress after retirement.
Q5. Has the government taken any corrective steps?
Yes, steps like additional staff approval, ambulance replacement, and bulk medicine procurement have been proposed, but the CAG stresses that faster and sustained implementation is required.
Thanks for your information sir,
The CAG’s Audit Report on ECHS draws attention towards misuse of the system- ultimately harming genuine beneficiaries & recommends strengthening vigilance and monitoring.
The Vigilance Department of the ECHS should place checks in the system to ensure that service veterans enjoy the benefits of only one Govt. or Govt. supported health care scheme. Suppose, a veteran is discharged/released/retired from the defence forces with ECHS in place for him/her and his/her dependents. Subsequently, he/she joins on the civil side. Here also he/she is covered by Govt. or Govt. supported health care scheme. There is every likelihood that he/she may be enjoying both the health care schemes- ECHS and another extended by the Central/State Govt./Public Sector Units/Quasi Govt. Organisations etc. It is suggested that when an armed forces veteran joins/re-employed on the civil side,the re-employing organisation should be required to forward his/her details to the Central Organisation of ECHS.The veteran may be required to opt for a more beneficial health care scheme-ECHS or that extended by the re-employing organisation.The Central Organisation of ECHS should take up this matter with the State Governments through the Department of Ex-servicemen Welfare, Ministry of Defence, Govt. Of India.
Such this is big problem among veterans.
Our Service HQs are equally to be blamed. When DG AFMS down to SEMO can take care of the Serving Soldiers, why can’t they look after their own Ex-Servicemen.
DGAFMS is functioning and accountable to Ministry of Defence.
If all the three Services Chiefs down to GOCs of Division/ Sub Area don’t forget that they have got this Rank and Appointment by standing on these Ex-Servicemen shoulders only, thus ows them the due respect and ensure their welfare, all the problems would be resolved.
My personal views.
Oic polyclinic are not working properly. I have a case to mention here.i had consulted a SurgGastroenterologist for STAPLER Surgery for hemorrhoids but to my surprise, he demanded Rs.30,000/- since he says it is not covered in ECHS.Ireported to oic polyclinic, who took no action and was trying to convince me that stapler surgery may be not included in ECHS.I escalated the matter and then things were done… OIC POLYCLINICS are not going an extra mile to do good to ESM and simply they are avoiding.
Ayushman Card is better than the ECHS card
Empanelled hospital list is outdated/wrong. Hospitals are reluctant to help ECHS BENEFICIARIEs because of delay in payments/ formalities etc
To avail echs facilities fm khandwa to indore it’s big harassment withholding arthritis low backaches knee pain and also for spose backaches jt pain BP problem
Going around bus stop to echs changing city buses a list expansive is 100 to 150 ₹ total of khandwa mp to indore 1000# and if needed to stay night for further investigation/ consultant reviews more expansive
In views of above the out station beneficiary shall be
Paid with consultant of echo ##