HCFI Dr KK Aggarwal Research Fund

12^th June, 2021, 11am-12pm

Key points from discussion

• The government has initiated several compensation schemes such as Pradhan Mantri Garib Kalyan Yojana (into which the insurance scheme for HCWs was also included), the Pradhan Mantri Garib Kalyan Anna Yojana (under which about 80 Cr people will get free ration), Family Pension Scheme (for the dependents of Covid victims under the ESI scheme) and the PM Care for Children Scheme (under which a corpus of Rs 10 lakh will be created for each child till the age of 18 years. Then the child would get monthly financial support and on reaching the age of 23 years, he/she will get the corpus amount as one lump sum for personal and professional use).
• A presentation on “Compensation schemes for healthcare workers and children affected by COVID-19” was given by Ms Ira Gupta, Advocate, Partner, Privy Law Firm and Legal Advisor, HCFI.
• The exact number of doctors who have died is not easily available. This data is under reported.
• Pradhan Mantri Garib Kalyan Package was announced by the central government in March 2020 and it covers loss of life due to COVID-19 and accidental death on account of COVID-19-related duty. Under this scheme, Rs 50 lakh is provided to the family of the HCW who died due to Covid. It covers Safai karamcharis, ward boys, nurses, ASHA workers, paramedics, technicians, doctors and specialists and other HCWs in Government Hospitals, Health Care centres, wellness centres and hospitals of Centre and State. The scheme also covers private hospital staff / retired / volunteer / local urban bodies / contract / daily wage / ad-hoc / outsourced staff requisitioned by States / Central Hospitals / autonomous hospitals of Central/ State / UTs, AIIMS & INIs/hospitals of Central Ministries specifically drafted for care of COVID-19 patients. From 24^th April this year, this scheme has been revived for another 180 days.
• There are two pension schemes: Employees Deposit-Linked Insurance (EDLI) and Employee State Insurance Corporation (ESIC). The maximum insurance benefit is Rs 7 lakh and the minimum insurance benefit is Rs 2.5 lakh and is available till March 2022.
• There are many shortcomings in the scheme: it does not include single doctor clinics; also does not specify if death due to physical assault or any other reason such as bursting of oxygen cylinder or post-Covid patients who die after recovering from the infection is covered under this scheme. Many documents are required to be filled up, the death certificate does no mention Covid as a cause of death (claims have been dismissed). The patient’s family has to approach to make the claim; instead hospitals should help the family. Also, there is lack of awareness among the public about the scheme.
• The Supreme Court of India has taken cognizance of children who have lost their parents. The National Commission for Protection of Child Rights (NCPCR) has filed an affidavit before the Supreme Court on 7.6.20, wherein they have stated that between April 2020 and 5th June 2021, 30,071 children were abandoned or lost one or both parents. 
• The number of children affected is highest (11,815) between 8-13 years of age.
• Maharashtra has the highest number of children affected (7084). However, the data is under reported. 
• Under the Juvenile Justice (Care and Protection of Children) Act, 2015, children without parents or care givers are defined as children in need of care and protection. This act mandates institutional and non- institutional care for these children and prescribes the SOPs for rehabilitation of such children.
• PM Cares for Children scheme provides fixed deposit in the name of the child: Rs 10 lakh. The child is a beneficiary under Ayushman Bharat Scheme (PM-JAY) with a health insurance cover of Rs. 5 lakhs.
• The Ministry of Women and Child Development have a scheme called the Integrated Child Protection Scheme. It provides a sum of Rs 10 lakh per district for non-institutional care of Covid orphans 
• Contact details of Child Welfare Committee members, designated Child Care Institutions and Child helpline number 1098 should be displayed in every hospital.
• Hospitals should collect details of trustworthy persons known to the patients in the admission form, who can be contacted to take care of children in case of any eventuality. They should also provide support for Child Psychological care and counselling by SAMVAD (Support, Advocacy & Mental health interventions for children in Vulnerable circumstances and distress).
• The district magistrate is required to create a district-level multi-departmental task force to map the needs. He has to also ensure that the children are rehabilitated in order of preference as prescribed under the Juvenile Justice Act, 2015.
• Panchayati Raj institutions and urban local bodies also have a responsibility towards children.
• The National Commission for Protection of Child Rights (NCPCR), has devised an online tracking portal “Bal Swaraj (COVID-Care link)” for child in need of care and protection to track and monitor children who need care and protection in real-time, digitally and also to track children who have lost both their parents during COVID-19. All district officers across States/UTs have been asked by the Supreme Court to fill data on the Commission’s portal in the link provided.
• CARA, under the Ministry of Women and Child Development, is the nodal body for adoption of Indian children (orphaned, abandoned or surrendered children) is mandated to monitor and regulate in-country and inter-country adoptions.
• However, there are problems in availing benefits from these schemes such as sponsorship programs mandated under the Juvenile Justice Act are lying dormant, child trafficking in the garb of adoption process, children do not have bank accounts. All schemes require joint account. But no bank account was opening due to lockdown. Private schools have not been asked to waive off fees of such children.
• Total deaths so far in India are 3,63,379 which includes 30,071 children. Of these, 26,000 children have lost one parent and 3621 children have lost both parents.
• As per the Indian Medical Association (IMA), 864 doctors have died in the second wave. This number was 750 in the first wave.
• There are some instances where doctors were asked to do Covid duties, but have not been able to get the remuneration promised to them. One of the reasons cited for this is that the benefits are for government appointed doctors only and not private doctors. Compensation schemes should include all doctors, including private practitioners, single doctor clinics etc.
• The Association of Medical Consultants in Mumbai has topped up the insurance cover of every member by 7 lakh over and above the existing health insurance. This covers PPE kits, masks etc. and other ancillary services including domiciliary treatment. There is also a corona raksha kavach of one lakh rupees for all workers (doctor/nurse/safai karamchari etc.) in a clinic who become RT PCR positive.
• AHPI in collaboration with IMA and Federation of Healthcare Organizations Karnataka has worked to get the compensation claims to the next of kin of HCWs who have died due to Covid-19. As leaders we have to follow up on this and ensure that compensations are given. We should also help those who do not have any support. A strategy towards this end can be collectively worked out. For this, we should start state wise.
• IMA has asked all state branches to contact the next of kin/relatives of all private doctors across India who lost their life due to Covid and complete the registry. IMA has started a Corona warrior Fund, which will provide Rs 10 lakh to the family. So far, IMA has disbursed the amount to families of 14 members.
• Doctors who are not part of the IMA also need support. There should be a helpline for families of doctors/HCWs who have died due to Covid. Everybody should get help and everybody should get benefit.
• Stand-alone practitioners need to be documented. We have to make a list of those involved in Covid care.
• Covid is under reported as the death certificate often lists the cause of death as for e.g. cardiorespiratory and not Covid. A Covid death surveillance response is needed.
• Allied HCWs like dental professionals should also be taken care of and compensated as even they were treating patients and some of them died. Even Ayush doctors should be covered.
• Organizations like IMA, AHPI can play a big role in helping to avail benefits from the government schemes to the victims/sufferers.
• Compensation has to be non-discriminatory; it has to be equal for everybody.

Participants

Dr Mahesh Verma

Dr Suneela Garg

Prof Bejon Misra

Dr Ashok Gupta

Dr KK Kalra

Dr DR Rai

Dr Alex Thomas

Dr Anil Kumar

Ms Ira Gupta

Mrs Upasana Arora

Mr Saurabh Aggarwal

Dr S Sharma