CENTRAL SERVICES (MEDICAL

ATTENDANCE) RULES, 1944

PREAMBLE

In exercise of the powers conferred by sub-section (2) of section 241, read with
sub-section (3) of section 313 of the Government of India Act, 1935, the Governor
General in Council is pleased to make the following Rules, namely:

Rule 1 SHORT TITLE AND EXTENT OF APPLICATION

Rule 1 (1). These rules may be called the Central Services (Medical Attendance)
Rules, 1944.

Rule 1 (2). They shall apply to all Government servants other than (i) those in railway
service and (ii) those of non-Gazetted rank stationed in or passing through
Calcutta, whose conditions of service are prescribed by Rules made or
deemed to be made by the Central Government, when they are on duty,
leave or Foreign Service in India or when under suspension

Rule 2. DEFINITIONS

In these Rules, unless there is anything repugnant in the subject or context:-

Rule 2 (a) Authorised Medical Attendant means
(i) in respect of a Government servant who belongs to a Central
Service, Class I, or whose pay is not less than Rs.500 per mensem,
the Principal Medical Officer of the district appointed by the
Government to attend its officers in the district;

(ii) in respect of Government servant not belonging to a Central

Service Class I, whose pay is less than Rs.500 but more than 150
per mensem, an assistant surgeon grade I (Medical Graduate), or
other medical officer appointed by the Government to attend its
officers in the station.;

(iii) in respect of any other government servant an Assistant Surgeon

Grade II (Medical Licentiate), or other Medical Officer, similarly
appointed.

Rule 2 (b) Districts means the district in which the Government servant falls ill.

Rule 2(c) The Government means

 (i) in respect of a Part A or Part B state, the State Government;
and

(ii) in respect of a Part C State, the Lieutenant Governor or the Chief

Commissioner, as the case may be.

Rule 2 (d) Government Hospital includes a Military Hospital, subject to the

provisions of Appendix 32 to the Regulations for Medical Services of the
Army in India, 1937, a hospital maintained by a local authority and any
other hospital with which arrangements have been made by the
Government for the treatment of government servants.

Rule 2 (e). Medical Attendance means-

(i) in respect of a government servant specified in sub-clause(a),

attendance in hospital or at the residence of government servant,
including such pathological, bacteriological, radiological or other
methods of examination for the purpose of diagnosis as are
available in any government hospital in the district and are
considered necessary by the authorised medical attendant and such
consultation with specialist or other medical officer in the services
of the Government stationed in the state as the authorised medical
attendant certifies to be necessary, to such extent and in such
manner as the specialist of medical attendant determine;
(ii) in respect of any other government servant but excluding a
member of the central service class IV, attendance at a hospital or
in the case of illness which compels the patient to be confined to
his residence, at the residence of the government servant, including
such methods of examination for purposes of diagnosis as are
available in the nearest government hospital and such consultation
with a specialist or other medical officer of the government
stationed in the district as the authorised medical attendant certifies
to be necessary to such extent and in such manner as the specialist
for medical officer may, in consultation with the authorised
medical attendant, determine;
(iii) in respect of a member of the central service, class IV, attendance
at a hospital including such methods of examination for purposes
of diagnosis as are available in the nearest government hospital and
such consultation with a specialist or other medical officer of the
government stationed in the district as the authorised medical
attendant certifies to be necessary to such extent and in such
manner as the specialist or medical officer may, in consultation
with the authorised medical attendant, determine.

Rule 2 (f) Patients means a government servant to whom these Rules apply and
who has fallen ill;
Rule 2 (g) State means the State in which a patient has fallen ill;

Rule 2 (h) Treatment means the use of all medical and surgical facilities available
at the Government hospital in which the Govt. servant is treated and
includes-
(i) the employment of such pathological, bacteriological, radiological,
or other methods as are considered necessary by the authorised
medical attendant;
(ii) the supply of such medicines, vaccines, sera or other therapeutic
substances as are ordinarily available in the hospital;

(iii) the supply of such medicines, vaccine, sera or other therapeutic

substances not ordinarily so available as the authorised medical
attendant may certify in writing to be essential for the recovery or
for the prevention of serious deterioration in the condition of the
Government servant;
(iv) such accommodation as is ordinarily provided in the hospital and is
suited to his status; accommodation in general or free wards in the
hospital being regarded as suitable for a member of the Central
Services, Class IV;
(v) such nursing as is ordinarily provided to in-patients by the
hospitals; and
(vi) the specialist consultation described in clause (e) but does not
include diet or provision at the request of the Govt. servant or
accommodation superior to that described in sub-clause (iv).

Rule 3 MEDICAL ATTENDANCE

Rule 3 (i)- A Government servant shall be entitled, free of charge to medical

attendance by the authorised medical attendant;
Rule 3 (ii)- Where a Government servant is entitled under sub-rule (i), free of charge,
to receive medical attendance, any amount paid by him on account of such
medical attendance shall, on production of a certificate in writing by the
authorised medical attendant in this behalf be reimbursed to him by the
Central Government.

Rule 4 TREVELLING ALLOWANCE FOR MEDICAL ATTENDANCE

JOURNEYS

Rule 4 (i)- When the place at which a patient falls ill is more than five miles by the
shortest route from the consulting room of the authorised medical
attendant-
(a) the patient shall be entitled to traveling allowance for the journey to and
from such consulting room, or
 (b) if the patient is too ill to travel the authorised medical attendant shall be
entitled to traveling allowance for the journey to and from the place where
the patients.
Rule 4(ii)- Application for traveling allowance under sub-rule (i) shall be
accompanied by a certificate in writing by the authorised medical
attendant stating that medical attendance was necessary and if the
application is under clause (b) of that sub-rule that the patient was too ill
to travel.

Rule 5 CONSULTATION WITH SPECIALIST

Rule 5 (1)- If the authorised medical attendant is of opinion that the case of a patient
is of such a serious or special nature as to require medical attendance by
some person other than himself, he may, with the approval of the Chief
Administrative Medical Officer of the State (which shall be obtained
beforehand unless the delay involved entails danger to the health of the
patient)-
(a) send the patient to the nearest specialist or other medical officer as
provided in clause (e) of Rule 2, by whom, in his opinion, medical
attendance is required for the patient; or
(b) if the patient is too ill to travel, summon such specialist or other medical
officer to attend upon the patient.
Rule 5(2)- A patient sent under clause (a) of sub-rule (1) shall on production of a
certificate in writing by the authorised medical journeys to and from the
headquarters of the specialist or other medical officer.
Rule 5(3)- A specialist or other medical officer summoned under clause (b) of sub-
rule (1) shall, on production of a certificate in writing by the authorised
medical attendant in this behalf be entitled to travelling allowance for the
journey to and from the place where the patient is.

Rule 6 MEDICAL TREATMENT

Rule 6 (1)- A Government servant shall be entitled, free of charge, to treatment-

(a) in such Government hospital at or near the place where he falls ill as can
in the opinion of the authorised medical attendant provide the necessary
and suitable treatment; or
(b) if there is no such hospital as is referred to in sub-clause (a) in such
hospital other than a Government hospital at or near the place as can in the
opinion of the authorised medical attendant, provide the necessary and
suitable treatment;
Rule 6(2)- Where a Government servant is entitled under sub-rule (1), free of charge,
to treatment in a hospital, any amount paid by him on account of such
treatment shall, on production of a certificate in writing by the authorised
medical attendant in this behalf, be reimbursed to him by the Central
Government.
Rule 7 TREATMENT AT RESIDENCE

Rule 7 (1)- If the authorised medical attendant is of opinion that owing to the absence
or remoteness of a suitable hospital or to the severity of the illness, a Govt.
servant cannot be given treatment as provided in clause (a) of sub-rule (1)
of Rule 6, the Government servant may receive treatment at his residence.
Rule 7(2)- A Government servant receiving treatment at his residence under sub-rule
(1) shall be entitled to receive towards the cost of such treatment incurred
b him a sum equivalent of the cost of such treatment as he would have
been entitled, free of charge, to receive under these rules if he had not
been treated at his residence.
Rule 7(3)- Claims for sums admissible under sub-rule (2) shall be accompanied by a
certificate in writing by he authorised medical attendant stating-
(a) his reasons for the opinion referred to in sub-rule (1); and
(b) the cost of similar treatment referred to in sub-rule (2).

Rule 8 OTHER MEDICAL FACILITIES

Rule 8 (1)- Charges for services rendered in connection with but not included in
medical attendance on, or treatment of, a patient entitled, free of charge, to
medical attendance or treatment under these Rules, shall be determined by
the authorised medical attendant and paid by the patient.
Rule 8(2)- If any question arises as to whether any service is included in medical
attendance or treatment it shall be referred to the Government and the
decision of the Government shall be final.

Rule 9- COUNTERSIGNATURE OF CERTIFICATES

The Controlling Officer of a patient may require that any certificate required
by these Rules to be given by the authorised medical attendant for
traveling allowance purposes shall be countersigned-
(a) in the case of a certificate given by the principal medical officer of a
district, by the Chief Administrative Medical Officer of the State; and
(b) in the case of a certificate given by any other medical officer, by the
principal medical officer of the district.

Rule10- TRANSFER TO FOREIGN SERVICE

No Government servant shall be transferred to foreign service unless the

foreign employer undertakes to afford to him so far as may be privileges
not inferior to those which he would have enjoyed under these Rules if he
had been employed in the service of the Government of India.

Rule11- TREATMENT OUTSIDE INDIA

Rule 11 (1)- A Government Servant shall be eligible to obtain medical treatment
outside India or, as the case may be, to claim reimbursement of the cost of
 medical treatment obtained inside or outside India in accordance with the
provisions of this rule.

Rule 11 (2)- A Government Servant desirous of availing of medical treatment outside

India may make an application through the Department/Ministry to which
the Government servant is attached to the Standing Committee established
under this rule in the form specified by the Standing Committee.

Rule 11 (3)- A Government servant desiring to avail of medical treatment outside India
for himself or for a member of his family for any treatment specified in the
Table below shall, subject to the other provisions of this rule, be eligible
for medical treatment outside India.

Table

(1) Complex/high risk Cardio Vascular Surgery cases for treatment at

Centres with extensive experience;
(2) Bone marrow Transplant;
(3) Complex Medical and Oncological Disorders, such as leukaemia and
Neo-plastic conditions;
(4) Complex high risk cases in Micro Vascular and Neuro Surgery for
treatment at Centres with extensive experience;
(5) Treatment of extremely complex ailments other than those mentioned
above which in the opinion of Standing Committee can only be treated
abroad and fall in the high risk category.

Rule 11 (4)- It shall be competent for the Central Government to review from time to
time the list of treatment facilities as specified in the Table to sub-rule (3)
and make such additions or deletions as it may deem fit by notification in
the Official Gazette.

Rule 11 (5)- The Central Government may for purposes of this rule, constitute a
Standing Committee consisting of :-

(a) the Director-General of Health Services in the Ministry of Health in

the Central Government,
(b) the Director-General of Armed Forces Medical Services.
(c) the Director-General of the Indian Council of Medical Research, and
(d) the Joint Secretary in the Ministry of Health and Family Welfare
(Convener), for purposes of considering and recommending to the
Central Government cases for medical treatment outside India.

Rule 11 (6)- On receipt of an application for medical treatment outside India, the
Standing Committee may, it after due consideration, satisfied that the
ailment or treatment can be treated only outside India, issue a certificate to
the concerned Department or Ministry to which the applicant Government
 servant is attached conveying its approval of the application and the
concerned Department or Ministry shall, on the strength of that certificate
incur necessary expenditure in getting the Government servant concerned
or the member of his family treated outside India in accordance with the
procedure laid down by the Standing Committee.

Rule 11 (7)- It shall be competent for the Central Government to authorize

reimbursement of expenditure on medical treatment obtained outside
India, if it is satisfied that the prior approval could not be obtained by the
Central Government servant due to circumstances beyond control;

Provided that the Government servant fulfils all other conditions

relating to medical treatment outside India under this rule.

Rule 11 (8)- The Standing Committee may, if it is satisfied that in the interest of the
Government servant or the member of his family obtaining treatment
abroad it is essential so to do, recommend one attendant to accompany the
Government servant or the member of his family, as the case may be, and
the expenditure so incurred shall also be eligible for reimbursement.

Rule 11 (9)- Where the Standing Committee, on receipt of an application for medical
treatment outside India consider that adequate facility for treatment of the
ailment sought to be treatment is available in any medical institution
within India, it shall record such a finding and authorize treatment of such
ailment in such medical institution within India whereupon the cost of
such treatment shall be reimbursed.

Rule 11 (10)- For purposes of sub-rule(9), the Ministry of Health in consultation with
the Standing Committee shall, from time to time, notify the names of such
institutions along with the ailments and the types of treatment available in
such institutions.

Rule 11 (11)- The scale of expenditure and the eligibility for treatment for which a
Government servant or a member of his family shall be entitled, shall be
identical to the scale of expenditure and the eligibility of an official of the
Indian Foreign Service of the corresponding grade in the Ministry of
external Affairs under any Assisted Medical Attendance Scheme for the
time being in force.