Government creating animosity between doctors and others

By Saman Indrajith

The Sri Lankan healthcare system has been allowed to atrophy since 1977 due to a lack of funding, National People’s Power (NPP) stalwart and former MP, Dr. Nalinda Jayatissa said.

He said that the country’s hospital system was established by the British as a necessity for its colonial economy, and by 1948, Sri Lanka had a robust healthcare system. And, until 1977, successive governments were investing about five percent of the GDP in health.

“Things changed dramatically after 1977. Since 1977, governments have washed their hands off of state-funded healthcare, and by 2020, out-of-pocket expenses on healthcare by people was about 60 percent.

“Then the economic crisis happened, and now we see a significant increase in people coming into government hospitals. The government hospitals can’t deal with this influx. There are no medicines, the quality of medicine available is suspect, healthcare professionals are leaving the country, and the equipment is broken.”

Dr. Jayatissa said politicians and bureaucrats are keen on buying expensive machinery but are less interested in maintaining the equipment.

“Most of these machines need to be operated in controlled environments. There should be trained staff, and the machines should be periodically repaired. None of this happens, and the machines break down. This is a serious situation, and the Health Ministry is virtually headless,” he said.

The NPP stalwart added that the government is also deliberately causing friction. It gave the doctors a 35,000 DAT increase, and other unions are up in arms about this.

“We are very concerned about the impact of union action on healthcare. At the end of the day, these strikes affect people. The government is also harassing people on a daily basis. However, the demands of the unions are just.”

He said that health staff are under tremendous stress and they deserve a salary hike, like everyone else in the country.

“We must also wonder if the government wanted to create problems between various staff categories. Now the animosity between doctors and other staffers is at an all-time high. There have been fisticuffs between doctors and other staffers. Unions must also understand the politics behind some maneuvers. We must try to win our demands with minimal impact on people.”

Dr. Jayatissa said that during the economic crisis, many nations offered to help the Sri Lankan healthcare system. Politicians and some senior officials used these opportunities to enrich themselves. What is happening in the health system is the best example of why the country needs a change in political leadership.

“About four years ago, Japan offered to develop angiogram units in five locations after identifying that about 45 percent of people die due to stroke and heart attacks. This was a 28 billion-rupee project, with 27 billion from Japan, to expand angiogram units in Kandy, Kurunegala and Anuradhapura hospitals and establish new units in Badulla, and Trincomalee. The Health Ministry recruited new people, and discussions were ongoing. The Japanese government then unilaterally cancelled the deal because there were allegations that one Minister solicited bribes from a Japanese company. The Minister was not penalized, but the project was halted. How many people were affected by this? Corruption is a main reason why we are not getting help,” he said.

Dr. Jayatissa said there is also a mechanism to predict the amount of medicine the country needs per year. There are also some in-built mechanisms to reduce corruption.

“We have the NMRA, SPC and medical supplies unit. We have three separate units as a way to keep tabs on each other. However, politicians have paralyzed these institutions to help them embezzle. The health ministry purchased a counterfeit human immunoglobulin consignment and paid a corrupt company a billion rupees. We have paid a billion rupees for coloured water. Imagine the level of corruption?” he said.

The former MP added that the Ministry of Health has an institution that was established to regulate private healthcare providers. However, the institution has done very little to ensure private healthcare producers provide a quality service.

“90 percent of resident patients are in government hospitals. However, 50 percent of OPD patients go to the private sector. An NPP government will regulate the private sector and strengthen government hospitals. Then people will choose where they want to go,” he said.