Opinion
Centenary of Sri Lanka Medical Council: To evolve or to revolve?
The Sri Lanka Medical Council, as the sole regulator of medical professionals in Sri Lanka, has played a vital role in shaping the nature, quality, and character of medical professionals and the medical profession for a century.
The speech made by Justice Yasantha Kodagoda on 5 July 2025 at the Centenary Celebrations of the SLMC, deserves praise and our sincere thanks for its forthrightness. The speech presents to the medical community at large, an invitation and opportunity to look more inwards than outward in its regulatory role for the future. His Lordship’s speech was aptly titled “Strategies for Addressing Malpractices in Healthcare Systems”. This is also the very point that was reiterated by the current registrar of the SLMC who stated, “With a vision for continuous improvements and adaptation, the SLMC is poised to navigate the future of healthcare with the same dedication that has defined its first century.”
We have been told for at least the past decade that there is a new Medical Bill which is with the Ministry of Health which will address the issues raised by the medical professions and health professionals which will enable the dedicated men and women of future SLMCs to perform the duty of the SLMC. In summary, it is to protect the citizens of Sri Lanka from the medical professionals (‘The SLMC is a statutory body established for the purpose of protecting health care seekers by ensuring the maintenance of academic and professional standards, discipline and ethical practice by health professionals who are registered with it’)
As pointed out by Justice Kodagoda, issues pertaining to medical ethics by practicing medical professionals, and the manner in which the SLMC has handled such issues in the recent past in particular, has led to increasing public concern about the SLMC. His Lordship went further and even proposed a mechanism/s to overcome such public concern with a particular reference to ethical issues resulting from the practice of medicine. He quite correctly used words such as ‘neutrality’ and ‘representation’ to a ‘Complaints Secretariat’, which he proposed to be instituted to handle issues on complaints against medical professionals. He even suggested that non-medical professionals should be allowed to serve on such disciplinary panels.
As of now the composition of SLMC Council is exclusively limited to doctors as far as the medical profession is concerned. Thus, whatever process is suggested within this fundamental framework, it will, as of now, ultimately result in Self-regulation of Doctors by Doctors. This is the real question which needs addressing and one hopes that the new Medical Bill, decades in the making, will address the fundamental question of ‘Can the medical profession self-regulate itself or does the composition of the SLMC need fundamental reform to include non-medical personnel on its council to unbiasedly perform its statutory duty of protecting the Sri Lankan citizen from the Sri Lankan medical profession?
The institution on which the SLMC was modeled on, over a century ago is the General Medical Council (GMC) of the United Kingdom which was established in the year1858. Initially its members were elected by the members of the profession and enjoyed widespread confidence from the profession. The 167-year-old GMC has undergone many reforms to serve the public and profession in a more transparent, accountable and responsible manner over the years. With regards to public concern that the GMC was self-regulating itself to the detriment of public trust in it, was addressed in 2013. The General Medical Council (GMC) in the UK was reduced to 12 members from 24 members on January 1, 2013. The Council has 12 members, include 6 medical professionals (registrant members) and 6 non-medical individuals (lay members). The GMC also has an Executive Board that handles daily operations and over 1,000 associates who support its work.
An interesting article appeared in the comments section of the British Medical Journal of 12th November 2022. That opinion piece was titled The GMC (General Medical Council) has been failing for 30 years. The opinion of the authors, Martin Mckee and Scott L. Greer, dealt with matters of transparency pertaining to the regulatory role of the GMC within the profession in the United Kingdom. This opinion piece was brought to the notice of the SLMC by way of an e-mail and regular post on 17th November 2022. The point of discussion which was requested from the SLMC was ‘is the current composition of the Council of the SLMC unbiasedly capable of ‘self-regulation’ of the profession at large?’ and ‘Has/Is the Sri Lanka Medical Council acted/acting in the best interest of the citizens of Sri Lanka or Is it acting in the self-interest of the profession, or more specifically the self-interest of an elected/selected segment of the medical profession?’
With regards to the composition of the SLMC Council, and the Medical Bill of a wider outlook which has been proposed, the SLMC called for submission of proposals by way of a newspaper advertisement on 5th October 2018. The Sri Lanka Medical Association (SLMA) Council at the time submitted a set of proposal to be included in the new Medical Bill to the SLMC on 22nd October 2018 (the deadline for submission was 28th October 2018).
As the SLMC is celebrating its Centenary and has stated its desire ‘for continuous improvements and adaptation, to navigate the future of healthcare with the same dedication that has defined its first century’ we reproduce below a few submissions made for the consideration of the SLMC back in 2018 with a particular reference to the Council of the SLMC and the process of appointment to the Council of the SLMC
(A). The composition and the term of office of the SLMC
1. The SLMC shall consist of a total of fifteen (15) members appointed by the Constitutional Council of Sri Lanka.
i. Ten (10) members shall be reputed medical/dental practitioners, who have been registered with the SLMC for a minimum period of 20 years.
ii. Two (02) members shall be Deans from the Faculties of Medicine, who have been registered with the SLMC for a minimum period of 20 years.
iii. Three (03) shall be leading professionals of high repute from education, law, finance or management professions, from the private or public sector, with a minimum period of service of 20 years after obtaining the first professional qualification or degree.
2. The President of the SLMC should be elected by the members of the SLMC at its first meeting.
3. The term of office of the Council shall be three (03) years.
4. Any person can serve in the Council only for a maximum of six years in toto.
(B). The process of appointment to the Council of the SLMC
1. The Registrar of the SLMC shall call for applications from eligible members of the Medical/Dental profession and members of the education, legal, finance or management professions, at least three (03) months before the expiry of the term of office of the SLMC.
2. All applications received shall be forwarded to the Constitutional Council through the Executive President of Democratic Socialist Republic of Sri Lanka.
3. The Constitutional Council shall appoint the members within a period of six (06) weeks from the date of submission of the names to the Constitutional Council by His Excellency the President of Sri Lanka.
4. The Constitutional Council shall ensure that the appointees can discharge their duties free from the influence of politicians and trade unions and can perform their functions without fear or favour.
These are a set of submissions among many the SLMC would have received during the period it sought public opinion for the new Medical Bill. We hope that the SLMC in its centenary year will revisit these proposals carefully and seriously address the issue of self-regulation of the doctors by doctors, and introduce more transparency in guiding the medical profession in Sri Lanka in to the future, keeping in mind its statuary role of ‘protecting health care seekers by ensuring the maintenance of academic and professional standards, discipline and ethical practice by health professionals who are registered with it’
As the SLMC enters its 2nd century, the powers that be at the SLMC and medical profession itself, must reflect objectively on the core statutory function of the SLMC. The outcome of this reflection ought to be finding the most suitable answer to the question (perhaps not the ideal answer) How can the SLMC as a statutory body protect the health seekers by ensuring the maintenance of academic and professional
standards, discipline and ethical practice by health professionals who are registered with it?
In doing so the SLMC must not revolve around what it thinks it is doing well but revolve around selected core issues and evolve in manner to serve the interest of the Sri Lankan public which is it’s statutory bound to do.
By Dr Ruvaiz Haniffa
Past President, Sri Lanka Medical Association (2018)
Opinion
The shadow of a Truman moment in the Iran war
Wars often produce moments when leaders feel compelled to seek a decisive stroke that will end the conflict once and for all. History shows that such moments can generate choices that would have seemed unthinkable only months earlier. When Harry S. Truman authorised the atomic bombings of Hiroshima and Nagasaki in 1945, the decision emerged from precisely such wartime pressures. As the conflict involving the United States, Israel and Iran intensifies today, the world must ensure that a similar moment of desperate calculation does not arise again.
The lesson of that moment in history is not that such weapons can end wars, but that once the logic of escalation begins to dominate wartime decision-making, even the most unthinkable options can enter the realm of strategic calculation. The mere possibility that such debates could arise is reason enough for policymakers everywhere to approach the present conflict with extreme caution.
As the war drags on, both Donald Trump and Benjamin Netanyahu will face mounting pressure to produce decisive results. Wars rarely remain confined to their original scope once expectations of rapid victory begin to fade. Political leaders must demonstrate progress, military planners search for breakthroughs, and public narratives increasingly revolve around the need for a conclusive outcome. In this environment, media speculation about “exit strategies” or “off-ramps” for Washington can unintentionally increase pressure on decision-makers. Even well-intentioned commentary can shape the climate in which leaders make decisions, potentially nudging them toward harder, more dramatic actions.
Neither the United States nor Israel lacks the technological capability associated with advanced nuclear arsenals. The nuclear arsenals of advanced powers today are far more sophisticated than the devices used in 1945. While their existence is intended primarily as deterrence, prolonged wars have historically forced strategic communities to examine every available option. Even the discussion of such possibilities is deeply unsettling, yet ignoring the pressures that produce such debates can be dangerous.
For that reason, policymakers and societies on all sides must recognise the full range of choices that prolonged wars can place before leaders. For Iran’s leadership and its wider strategic community, absorbing this reality may be essential if catastrophic escalation is to be avoided. From Tehran’s perspective, the conflict may well be seen as existential. Yet history also shows that wars framed as existential struggles can generate the most dangerous strategic decisions.
The intellectual climate in Washington has also evolved. A number of influential voices in Washington now argue that the United States has become excessively risk-averse and that restoring global credibility requires a more assertive posture. Such arguments reflect a broader shift toward the language of renewed deterrence and strategic competition. Yet this very logic can make it politically harder for leaders to conclude conflicts without visible demonstrations of strength.
The outcome of this conflict will also be watched closely by other major powers. In 1945, the atomic decision was shaped not only by the desire to end a brutal war but also by the strategic message it sent to rival states observing the emergence of a new geopolitical era. Today, other significant powers will similarly draw lessons from how the United States manages both the conduct and the conclusion of this conflict.
This is why cool judgment is essential at this stage of the war. Whether the original decision to go to war was wise or ill-advised is now largely beside the point. Once a conflict has begun, the overriding priority must be to prevent escalation into something far more dangerous.
In such moments, the international system can benefit from the quiet diplomacy of actors that retain a degree of strategic autonomy. Among emerging nations, India stands out as a major emerging power in this regard. Despite its energy dependence on the Gulf and deep economic engagement with the United States, India has consistently demonstrated a capacity to maintain independent channels of communication across geopolitical divides.
This unique positioning may allow New Delhi to explore, discreetly and without public fanfare, avenues for de-escalation with Washington, Tel Aviv and Tehran alike. At moments of heightened tension in international politics, the world sometimes requires what might be called an “adult in the room”: a state capable of engaging all sides while remaining aligned exclusively with none.
If the present conflict continues to intensify, the value of such diplomacy may soon become evident. The most important lesson from 1945 is not only the destructive power of nuclear weapons but the pressures that can drive leaders toward choices that later generations struggle to comprehend. History shows that when wars reach their most desperate phases, restraint remains the only safeguard against catastrophe.

(Milinda Moragoda is a former Cabinet Minister and diplomat from Sri Lanka and founder of the Pathfinder Foundation, a strategic affairs think tank, can be contacted via email@milinda. This was published ndtv.com on 2026.03.1
by Milinda Moragoda
Opinion
Practicality of a trilingual reality in Sri Lanka
Dr. B.J.C. Perera (Dr. BJCP) in his article ‘Language: The symbolic expression of thought’ (The island 10.03.2026) delves deeper into an area that he has been exploring recently – childhood learning. In this article he writes of ‘a trilingual Sri Lanka’, reminding me of an incident I witnessed some years ago.
Two teenagers, in their mid to late teens, of Muslim ethnicity were admitted to the hospital late at night, following a road traffic accident. They had sustained multiple injuries, a few needing surgical intervention. One boy had sustained an injury (among others) that needed relatively urgent attention, but in itself was not too serious. The other had also sustained a few injuries among which one particular injury was serious and needed sorting out, but not urgently.
After the preliminary stabilisation of their injuries, I had a detailed discussion with them as to what needed to be done. Neither of them spoke Sinhala to any extent, but their English was excellent. They were attending a well-known international school in Colombo since early childhood and had no difficulty in understanding my explanation – in English. The boys were living in Colombo, while their father would travel regularly to the East (of Sri Lanka) on business. The following morning, I met the father to explain the prevailing situation; what needs to be done, urgency vs. importance, a timeline, prioritisation of treatment, possible costs, etc.
Doctor’s dilemma
The father did not speak any English and in conversation informed me that he had put both his boys into an International School (from kindergarten onwards) in order to give them an English education. The issue was that the father’s grasp of Sinhala was somewhat rudimentary and therefore I found that I could not explain the differences in seriousness vs, urgency and prioritisation issues adequately within the possible budget restrictions. This being the case and as the children understood exactly what was needed, I then asked the sons to ‘educate’ the father on the issues that were at hand. The boys spoke to their father and it was then that I realised that their grasp of Tamil was the same as their father’s grasp of Sinhala!
In the end I had to get down a translator, which in this case was a junior doctor who spoke Tamil fluently; explained to him what was needed a few times as he was not that fluent in English, certainly less than the boys, and then getting him to explain the situation to the father.
What was disturbing was having related this episode at the time to be informed that this was not in fact not an isolated occurrence. That there is a growing number of children that converse well in English, but are not so fluent in their mother tongue. Is English ‘the mother tongue’ of this ‘new generation’ of children? The sad truth is no and tragically this generation is getting deprived of ‘learning’ in its most fundamental form. For unfortunately, correct grammar and syntax accompanied with fluency do not equal to learning (through a language). It is the natural process of learning two/three languages (0 to 5 years) that Dr. BJCP refers to as being bilingual/trilingual and is the underlying concept, which is the title of Dr. BJCP’s article ‘Language: The symbolic expression of thought’.
“Introduction into society”
It is critical to understand at a very deep level the extent and process of what learning in a mother tongue entails. The mother’s voice is arguably the first voice that a newborn hears. Generally speaking, from that point onwards till the child is ‘introduced into society’ that is the voice he /she hears most. In our culture this is the Dhorata wedime mangalyaya. Till then the infant gets exposed to only the voices of the immediate /close family.
Once the infant gets exposed to ‘society’ he /she is metaphorically swimming in an ocean of language. Take for example a market. Vendors selling their wares, shouting, customers bargaining, selecting goods, asking about the quality, freshness, other families talking among themselves etc. The infant is literally learning/conceptualizing something new all the time. This learning process happens continuously starting from home, at friends/relatives’ houses, get-to-gathers, festivals, temples etc. This societal exposure plays a dominant role as the child/infant gets older. Their language skills and vocabulary increase in leaps and bounds and by around three years of age they have reached the so-called ‘language explosion’ stage. This entire process of learning that the child undergoes, happens ‘naturally and effortlessly’. This degree of exposure/ learning can only happen in Sinhala or Tamil in this country.
Second language in chilhood
Learning a second language in childhood as pointed out by Dr BJCP is a cognitive gift. In fact, what it actually does is, deepens the understanding of the first language. So, this-learning of a second language- is in no way to be discouraged. However, it is critical to be cognisant of the fact that this learning of the second language also takes place within a natural environment. In other words, the child is picking up the language on his own. As readily illustrated in Dr. BJCP’s article, the home environment where the parents and grandparents speak different languages. He or she is not being ‘forcefully taught’ a language that has no relevance outside the ‘environment in which the second language is taught’. The time period we (myself and Dr. BJCP) are discussing is the 0 to 5-year-old.
It does not matter whether it is two or three languages during this period; provided that it happens naturally. For as Dr. BJCP states in his article ‘By age five, they typically catch up in all languages…’ To express this in a different way, if the child is naturally exposed to a second /third language during this 0 to 5-year-old period, he /she will naturally pick it up. It is unavoidable. He /she will not need any help in order for this to happen. Once the child starts attending school at the age of 5 or later, then being taught a second language formally is a very different concept to what happens before the age of 5.
The tragedy is parents, not understanding this undisputed significance of ‘learning in/a mother tongue’, during the critical years of childhood-0 to 5; with all good and noble intentions forcefully introduce their child to a foreign tongue (English) that is not spoken universally (around them) i. e., It is only spoken in the kindergarten; not at home and certainly nowhere, where the parents take their children.
Attending school
Once the child starts attending school in the English medium, there is no further (or minimal) exposure to his /her mother tongue -be it Sinhala or Tamil. This results in the child losing the ability to converse in his/her original mother tongue, as was seen earlier on. In the above incident that I described at the start of this article, when I finally asked the father did he comprehend what was happening; his eyes filled with tears and I did wonder was this because of his sons’ injuries or was it because his decisions had culminated in a father and a son/s who could no longer communicate with each other in a meaningful way.
Dr BJCP goes on to state that in his opinion ‘a trilingual Sri Lanka will go a long way towards the goals and display of racial harmony, respect for different ethnic groups…’ and ‘Then it would become a utopian heaven, where all people, as just Sri Lankans can live in admirable concordant synchrony, rather than as a splintered clusters divided by ethnicity, language and culture’. Firstly, it must be admitted from the aspect of the child’s learning perspective (0 to 5 years); an environment where all three languages are spoken freely and the child will naturally pick up all three languages (a trilingual reality) does not actually exist in Sri Lanka.
However, the pleasant practical reality is that, there is absolutely no need for a trilingual Sri Lanka for this utopian heaven to be achieved. What is needed is in fact not even a bilingual Sri Lanka, but a Sri Lanka, where all the Sinhalese are taught Tamil and vice versa. Simply stated it is complete lunacy– that two ethnic communities that speak their own language, need to learn another language that is not the mother tongue of either community in order to understand one another! It is the fact that having been ruled by the British for over a hundred years, English has been so close to us, that we are unable to see this for what it is. Imagine a country like Canada that has areas where French is spoken; what happens in order to foster better harmony between the English and French speaking communities? The ‘English’, learn to speak French and the ‘French’ learn to speak English. According to the ‘bridging language theory of Sri Lanka’, this will not work and what needs to happen is both communities need to learn a third language, for example German, in order to communicate with one another!
Learning best done in mother tongue
eiterating what I said in my previous article – ‘Educational reforms: A Perspective (The Island 27.02.2026) Learning is best done in one’s mother tongue. This is a fact, not an opinion. The critical thing parents should understand and appreciate is that the best thing they can do for their child is to allow/encourage learning in his/her mother tongue.
This period from 0 to 5 years is critically important. If your child is exposed naturally to another language during this period, he /she will automatically pick it up. There is no need to ‘forcefully teach’ him /her. Orchestrating your child to learn another language, -English in this instance- between the ages of 0 to 5 at the expense of learning in his /her mother tongue is a disservice to that child.
by Dr. Sumedha S. Amarasekara
Opinion
Tribute to Vijitha Senevirathna
APPRECIATION
On Friday, the 20th of March, Vijitha Senevirathna would have celebrated his 85th birthday if not for his sad passing away nearly a year ago.
The passing of Vijitha was a moment of great sorrow to all who knew him.
He was my classmate from Montessori to pre-university at Maris Stella College, Negombo. As a Maristonian, Vijitha excelled in his academic studies.
Eventually, he entered the Law College and practised as an Attorney-at-Law and Notary Public for over 50 years.
As an Attorney-at-Law, Vijitha earned the respect of the judiciary and a wide circle of clients. He upheld the highest and most cherished values of the legal profession and earned the trust of all who knew him. His 50th anniversary in the noble profession of law was celebrated with much pageantry, amidst a distinguished gathering of friends, relations, clerics, and the rich and famous of Sri Lanka.
Vijitha dearly loved his proud wife Nirmali and his six children, who are in the highest professions in Sri Lanka. He inculcated among his children professional efficiency, diligence, and honesty.
We who associated closely with Vijitha miss his warm friendship, sense of humor, and animated conversation. He was a raconteur, and people gathered around him and listened to his narrations and tales of yore, especially at the many celebrations at his residence in Dehiwala, where the waters of Scotland flowed generously.
I have personally admired Vijitha’s patience, grit, and lifetime achievements, despite a physical dysfunctionality he suffered over his lifetime.
For Vijitha, the song has ended, but the melody lingers on, in the words of the popular composer Irving Berlin.
Merrick Gooneratne
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