Ailing hospitals to be overtaxed?

Saturday 15th October, 2022

Health Minister Keheliya Rambukwella is reported to have said that more paying wards will be set up at the state-run hospitals. Such a scheme will not only enable cost recovery but also benefit the public as the cost of private healthcare provision could be brought down to affordable levels, he has said, claiming that the state sector healthcare institutions can provide a much better service than private hospitals. It is not clear from the media reports on the proposed scheme whether a feasibility study thereon has been carried out. The government ought to ascertain if the project is feasible and consult all stakeholders before making a final decision. The fact that some paying wards are already available at the National Hospital, Colombo, does not mean that the feasibility of the proposed project could be taken for granted.

The need to make private healthcare provision more competitive cannot be overemphasised. Private hospitals do not scruple to fleece the sick. They have become a law unto themselves with the connivance of corrupt governments and venal health officials. The health sector trade unions have alleged that politicians and bureaucrats do not sort out problems at the state-run hospitals so that they could outsource laboratory tests and thereby enable the private sector to make a killing.

Private hospitals have earned notoriety for overcharging patients, who have to grin and bear it. A private hospital in Colombo has reportedly started the practice of selling bottled water to inpatients, who must be given unrestricted access to clean drinking water free of charge. The Health Ministry does precious little to regulate these crooked healthcare providers.There is no gainsaying that the public sector healthcare institutions have the potential to compete with private hospitals, but the question is whether corrupt governments will allow them to do so at the expense of the private sector.

The government is apparently trying to bite off more than it can chew. It has failed to ensure that the public receives a satisfactory service at the state-run hospitals. Shouldn’t it take steps to develop the state sector health institutions to improve the existing services before trying to set up paying wards? Most government hospitals lack space and even their corridors are strewn with patients. They are also experiencing various shortages including that of human resources. They must not be overtaxed.

The Government Medical Officers’ Association (GMOA) was quoted by this newspaper on Thursday as saying that more than 500 doctors had already migrated, and 800 others were planning to do so. If the government decision to retire medical personnel at the age of 60 is implemented, the public health sector will lose about 800 doctors including 300 specialists, the GMOA has said. A similar situation is bound to arise in respect of other categories of health workers as well. The GMOA has said some provincial hospitals are facing the threat of closure due to a shortage of doctors. The Mullaitivu and Kilinochchi hospitals are almost crippled, it has said. How does the government propose to tackle this issue?

Meanwhile, the government has undertaken to divest even profitable state-owned enterprises such as Sri Lanka Insurance. No aid or bailout packages come without stringent conditions. Free healthcare is anathema to most donors, who advocate divestiture. One can only hope that the proposed paying ward scheme is not part of a strategy to make the free healthcare system wither on the wine in keeping with aid conditions.Health Minister Rambukwella says he has not yet submitted a proposal about the aforesaid scheme to the Cabinet. But now that he has sent a trial balloon, it will be interesting to see the reaction of the health sector trade unions, etc., to his proposal.