Page 0141

REGIONAL INITIATIVES

140 CANCER CONTROL 2014

‰ If accompanied by an attendant, the concession was

reduced to 50% for both the patient and the attendant -

issued as a combined ticket.

‰ The concession was offered to cancer patients travelling

for admission to hospitals or institutes or after discharge

from these institutions.

‰ In 1961, the concession was extended to outward and

return journeys i.e., the outward journey for admission to

the cancer hospital or institute or in connection with reexaminations

or periodical check-ups and the return

journey after discharge.

Since its inception the concession for cancer patients has

evolved in the following manner:

Year Concession

1969 A 75% concession was allowed on second

class mail and express trains.

1981 The same concession was extended to

both first class and second class.

1986 After the introduction of sleeper class, the

same concession was allowed for this.

2003 The same concession was extended to

3AC and AC CC and 50% concessions

were offered for 2A and 1A classes.

Present policy

At present cancer patients are eligible for 100% concession in

AC 3 tier/sleeper; a 75% concession on second class, AC Chair

Car; and a 50% concession in AC 2 tier and AC first class.

These are allowed on the basic fares of mail and express trains.

The escorts of cancer patients are also eligible for a 75%

concession in second class, sleeper, AC Chair Car, AC-3-tier

and a 50% concession AC 2 tier and AC first class. They are

allowed only on basic fares for mail and express trains.

The procedure for obtaining cancer patient concessions

Concessional tickets are issued on production of a certificate

from the head of a cancer hospital or institute where the

patient is being treated. Outward journey concessions are

issued from the station where the patient boards to the

hospital where they are being treated. The return journey

concessions are issued from the treatment/checkup/discharge

centre to the patient's place of residence.

A large number of cancer patients have been using this

facility. During 2012-13 approximately 1.5 million passengers

have used the concession; of which 900,000 passengers have

reserved tickets and nearly 600,000 passengers used unreserved

tickets. The total monetary value of concessions

given to cancer patients in 2012-13 was approximately US$

5.88 million (Rs 375 million).

Facilitating travel with reserved seating

Apart from the support given in the form of fare concessions,

Indian Railways also facilitates the travel of cancer patients by

providing a special quota of reserved seats. Such quota is

earmarked on approximately 150 mail and express trains

covering the major metros where the hospitals and institutes

for specialized treatment are located. In addition, cancer

patients who use the concessions are also given limited direct

access and preference in the allotment of an emergency quota

of seats which helps travel at very short notice. Therefore, to

some extent, cancer patients are given adequate priority over

the other categories of traveller including those travelling on

duty, senior officials, etc.

The figures cited above are impressive and encourage

further research. It would be interesting to know how many

other countries (high, middle or low income) are operating

similar concessionary fare programmes for cancer patients

and their carers. Even more importantly, what evidence there

is that providing cheaper or free travel for patients leads to

any or all of the following outcomes: downstaging at the point

of diagnosis; increased attendance and adherence to

treatment protocols; improved availability for follow-up and

improved survival rates? Cancer Control would be interested in

receiving summaries of these data from major treatment

hospitals in India whose patients are known to have benefited

from these concessionary fares. l

Sh Rajender Kataria is an officer with India's Administrative

Service. He has served in various capacities in State and Union

Governments including as Assistant Commissioner and SubDivisional Magistrate,

Joint Commissioner of Commercial Taxes,

Chief Executive Officer, Zila Parishad, and Deputy Commissionercum-District Magistrate.

He has also served as the Administrator

of two famous Temples - Mata Mansa Devi, Panchkula and Shri

Mata Sheetla Devi, Gurgaon, as well as Chief Administrator of

Haryana Urban Development Authority, Private Secretary and

Chief Staff Officer to Union Ministers of Labour and Employment,

Railways and Social Justice and Empowerment.

Mark Lodge became involved in evidence-based research as a

young member of the General Practice Research Group at the

Department of Public Health and Primary Care, University of

Oxford. In 1993 he joined the embryonic Cochrane

Collaboration, working as the Trials Register Co-ordinator. Mark

joined the INCTR as its Director for Programme Development

and is now the Executive Director of the UK Office with

responsibility for the Network's Evidence Base Programme. Mark

Lodge is an Associate Fellow, Particle Therapy Research Institute,

University of Oxford.

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