The dispensary is the backbone of the CGHS Scheme. Instructions on various matters and inter-related aspects are issued from time to time for the guidance of the Medical Officers and the Specialists and updating them with the latest issues pertaining to healthcare and its comprehensive management. With continuous and rapid expansion of this healthcare scheme, the situation has drastically improved especially related to the health issues concerning Governmental Employees included under this scheme. But, at the same time, a number of problems have arisen on account of it. On account of the rapidly expanding staff and manpower, various practices, procedures and instructions to be implemented in regard to the duties and responsibilities of hospital employees are not adhered to in a stringent manner. As a result, there is some laxity in the entire process and deficiency in the healthcare services under the CGHS. Various instructions and orders issued from time to time serve as a Compendium for the guidance of the CGHS staff.