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Is Sri Lanka Medical Council fit for purpose?

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By Dr Upul Wijayawardhana

Quite a number of my distinguished colleagues have written about the Sri Lanka Medical Council (SLMC) or held press conferences lately, but all of them addressed only one issue; the removal, by the Minister of Health, of the president and four members of the council appointed by her predecessor. Whilst my colleagues are questioning the legality of this action, the Minister contends that she has the authority to do so and justifies her action on the basis of the findings of the five-member committee she appointed. As we, doctors, as well as politicians, being equally unaware of the finer points of law, perhaps, it is best left for the judiciary to decide on the legality or otherwise of this decision. However, if the courts decide that the Minister of Health acted illegally, surely, she should resign, not only because of this but also because of her erratic behaviour during the grave health emergency we are going through. We do not seem to be very lucky with our Ministers of Health; one with the infamy of a bogus ‘crocodile’ press conference being replaced by another who pollutes rivers with pots of a concoction devised by a faith healer and then, adding insult to injury, by promoting an untested remedy invented by a Kali Amma inspired kapuwa to get rid Covid-19!

After going through the website of the SLMC and making comparisons with the only other regulatory body I am familiar with, the General Medical Council of UK (GMC), I have a greater concern; whether the SLMC, as constituted at present and the way it seems to be functioning, is fit for purpose. Not being sufficiently distinguished, I have not had the pleasure of serving on either of these august bodies but have had dealings with both, after being reported by my colleagues.

I still remember the day my good friend Dr S. J. Stephen came rushing to my humble abode in the Summit Flats the moment he learned that I had been reported to the SLMC by a close colleague of mine. He was so concerned he offered to retain a top lawyer for me. I was reported for advertising myself by doing programmes on radio and television! Nowadays many doctors seem to be doing these but at that time I happened to be the pioneer in TV health education programmes. I remember Sanath Liyanage, who produced the very popular educational programme “Neth Sera” for Rupavahini, telling me that the medical programmes were widely watched even in Jaffna though my discussions with a panel of experts was in Sinhala.

When SLMC requested my comments regarding the complaint all I did was to point out that I did these programmes on behalf of the Sri Lanka Medical Association (SLMA), in keeping with its policy of public education and with the approval of the SLMA council. The matter did not progress further, but many infuriated colleagues of mine urged me to report the person concerned for his unethical action, malicious reporting, etc., but I did not want to descend to his level.

In addition to being the Consultant Cardiologist, for a time I was the Clinical Director of Medicine at Grantham Hospital in the UK. A doctor of Indian origin, whose name incidentally was Vaidya (Physician in Sanskrit), whom I appointed as a Staff Grade Physician (a position just below a Consultant) was behaving erratically and in spite of numerous representations by me, no action was taken by the hospital administration. He was once caught trying to put a nail under one of the tyres of my car! His ire got worse when post-graduate trainees from Sri Lanka who worked with me started winning the hearts and minds of the staff and patients with their ability as well as attitude. I must say I am very proud of the 10 trainees I had who have excelled themselves in Sri Lanka. Dr Vaidya reported me to the GMC on many counts including ‘import of illegal Sri Lankan labour’! After detailed written submissions the GMC decided that there was no case against me for further investigation. I must admit that I had few sleepless nights fearing a GMC investigation, which is a harrowing experience.

After it was proved that Dr Vaidya forged a letter from the Post-graduate Dean the hospital was forced to suspend him though they did not find him guilty of racism in spite of his circulating a letter condemning Sri Lankan doctors and the medical education system in Sri Lanka! Fortunately, the GMC took a different view when he was reported. I was the key witness at the GMC inquiry against him and one of the trainees who had returned to Sri Lanka was also present as a witness at the GMC expense. Dr Vaidya was found guilty of racism and forgery, as well as a number of other offences and his name was erased from the medical register.

In the UK, it is very easy for anyone, even a patient, to find out whether a doctor is registered and is in the specialist register as the GMC maintains an excellent website. Also, there are clear instructions in the website how to make a complaint against a doctor. All complaints are investigated by the Medical Practitioners Tribunal Service (MPTS) and all decisions of the MPTS are available on their website for public perusal. A quick glance shows at least three doctors receiving warnings each month and a few more getting undertakings/suspensions. Thus, there is an active process for patient protection.

I was aghast when I went through the SLMC website, not only for its primitive nature but for the paucity of information. The only detailed part in the website is the history of the CMC/SLMC, perhaps, reflecting our national weakness of harking on past grandiosity! Though it claims that the SLMC “is a statutory body established for the purpose of protecting health care seekers” there is not a word on the website how disappointed ‘seekers’ could raise concerns! There is no way of finding out whether any strictures were passed on any doctor or whether they are registered. As a test, I entered the names of some my trainees to find out the registration status but only a recurring message ‘no matches found’ appeared. As it is rumoured that there are many fraudulent practitioners, surely, this facility should be available.

According to the SLMC website, its President still is Prof. Carlo Fonseka! Carlo must be conducting affairs from heaven! But that is not possible because Carlo did not believe in an afterlife, a topic we discussed when I met him last, a few months prior to his death. In spite of the claim “it is a body corporate having perpetual succession and a common seal”, the last available annual report is for 2010!

I can go on pointing out many deficiencies on the website. I am surprised that many distinguished members of the profession who sat on the council did not realise the importance of an up-to-date website which, in this era of electronic communication, is the face of any organisation.

The most damning aspect, of course, is the constitution of the SLMC where there is a total disregard for the principle of ‘conflict of interest’. No office-bearer of a trade union should sit on the council of a regulator as it may compromise decisions. Justice becomes a mockery if the same counsel appears for both the prosecution and the defence! Any office-bearer of a trade union, even if not barred from contesting, should be mandated to give up such positions if they decide to sit on the council of the SLMC, as they cannot have it both ways. I am surprised that ex-officio members like the Deans of the faculties of Medicine and the Director General of Health Services did not take a principled stand on this issue. Had they declined to sit with those on whose part there was a conflict of interest, the government would have had no choice but to amend legislation. Or, is it that no government can defeat the rice-mafia or doctors’ mafia?

Not only the website but also the SLMC itself needs an overhaul but it should not go the way the GMC did. Many doctors in the UK are taking early retirement or exploring other avenues as they perceive that the GMC has become a body that harasses doctors, after it was revamped following public pressure. I am sure with the vast potential of talent available in Sri Lanka a middle way could be found and the SLMC can become a regulatory body fit for purpose.

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Features

Govt.’s choice is dialogue over confrontation

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By Jehan Perera

Preparing for the forthcoming UN Human Rights Council cannot be easy for a government elected on a nationalist platform that was very critical of international intervention. When the government declared its intention to withdraw from Sri Lanka’s co-sponsorship of the October 2015 resolution No. 30/1 last February, it may have been hoping that this would be the end of the matter. However, this is not to be. The UN Human Rights High Commissioner’s report that will be taken up at the forthcoming UNHRC session in March contains a slate of proposals that are severely punitive in nature and will need to be mitigated. These include targeted economic sanctions, travel bans and even the involvement of the International Criminal Court.

Since UN Secretary General Ban Ki-Moon’s visit in May 2009 just a few days after the three-decade long war came to its bloody termination, Sri Lanka has been a regular part of the UNHRC’s formal discussion and sometimes even taking the centre stage. Three resolutions were passed on Sri Lanka under acrimonious circumstances, with Sri Lanka winning the very first one, but losing the next two. As the country became internationally known for its opposition to revisiting the past, sanctions and hostile propaganda against it began to mount. It was only after the then Sri Lankan government in 2015 agreed to co-sponsor a fresh resolution did the clouds begin to dispel.

Clearly in preparation for the forthcoming UNHRC session in Geneva in March, the government has finally delivered on a promise it made a year ago at the same venue. In February 2020 Foreign Minister Dinesh Gunawardena sought to prepare the ground for Sri Lanka’s withdrawal from co-sponsorship of UN Human Rights Council resolution No 30/1 of 2015. His speech in Geneva highlighted two important issues. The first, and most important to Sri Lanka’s future, was that the government did not wish to break its relationships with the UN system and its mechanisms. He said, “Sri Lanka will continue to remain engaged with, and seek as required, the assistance of the UN and its agencies including the regular human rights mandates/bodies and mechanisms in capacity building and technical assistance, in keeping with domestic priorities and policies.”

Second, the Foreign Minister concluding his speech at the UNHRC session in Geneva saying “No one has the well-being of the multi-ethnic, multi-lingual, multi-religious and multi-cultural people of Sri Lanka closer to their heart, than the Government of Sri Lanka. It is this motivation that guides our commitment and resolve to move towards comprehensive reconciliation and an era of stable peace and prosperity for our people.” On that occasion the government pledged to set up a commission of inquiry to inquire into the findings of previous commissions of inquiry. The government’s action of appointing a sitting Supreme Court judge as the chairperson of a three-member presidential commission of inquiry into the findings and recommendations of earlier commissions and official bodies can be seen as the start point of its response to the UNHRC.

 

 

NEGATIVE RESPONSE

 

The government’s setting up of a Commission of Inquiry has yet to find a positive response from the international and national human rights community and may not find it at all. The national legal commentator Kishali Pinto Jayawardene has written that “the tasks encompassed within its mandate have already been performed by the Lessons Learnt and Reconciliation Commission (LLRC, 2011) under the term of this President’s brother, himself the country’s Executive President at the time, Mahinda Rajapaksa.” Amnesty International has stated that “Sri Lanka has a litany of such failed COIs that Amnesty International has extensively documented.” It goes on to quote from the UN High Commissioner for Human Rights that “Domestic processes have consistently failed to deliver accountability in the past and I am not convinced the appointment of yet another Commission of Inquiry will advance this agenda. As a result, victims remain denied justice and Sri Lankans from all communities have no guarantee that past patterns of human rights violations will not recur.”

It appears that the government intends its appointment of the COI to meet the demand for accountability in regard to past human rights violations. Its mandate includes to “Find out whether preceding Commissions of Inquiry and Committees which have been appointed to investigate into human rights violations, have revealed any human rights violations, serious violations of the international humanitarian law and other such serious offences.” In the past the government has not been prepared to accept that such violations took place in a way that is deserving of so much of international scrutiny. Time and again the point has been made in Sri Lanka that there are no clean wars fought anywhere in the world.

International organisations that stands for the principles of international human rights will necessarily be acting according to their mandates. These include seeking the intervention of international judicial mechanisms or seeking to promote hybrid international and national joint mechanisms within countries in which the legal structures have not been successful in ensuring justice. The latter was on the cards in regard to Resolution 30/1 from which the government withdrew its co-sponsorship. The previous government leaders who agreed to this resolution had to publicly deny any such intention in view of overwhelming political and public opposition to such a hybrid mechanism. The present government has made it clear that it will not accept international or hybrid mechanisms.

 

 

SEQUENTIAL IMPLEMENATION

 

In the preamble to the establishment of the COI the government has made some very constructive statements that open up the space for dialogue on issues of accountability, human rights and reconciliation. It states that “the policy of the Government of Sri Lanka is to continue to work with the United Nations and its Agencies to achieve accountability and human resource development for achieving sustainable peace and reconciliation, even though Sri Lanka withdrew from the co-sponsorship of the aforesaid resolutions” and further goes on to say that “the Government of Sri Lanka is committed to ensure that, other issues remain to be resolved through democratic and legal processes and to make institutional reforms where necessary to ensure justice and reconciliation.”

As the representative of a sovereign state, the government cannot be compelled to either accept international mechanisms or to prosecute those it does not wish to prosecute. At the same time its willingness to discuss the issues of accountability, justice and reconciliation as outlined in the preamble can be considered positively. The concept of transitional justice on which Resolution No 30/1 was built consists of the four pillars of truth, accountability, reparations and institutional reform. There is international debate on whether these four pillars should be implemented simultaneously or whether it is acceptable that they be implemented sequentially depending on the country context.

The government has already commenced the reparations process by establishing the Office for Reparations and to allocate a monthly sum of Rs 6000 to all those who have obtained Certificates of Absence (of their relatives) from the Office of Missing Persons. This process of compensation can be speeded up, widened and improved. It is also reported that the government is willing to consider the plight of suspected members of the LTTE who have been in detention without trial, and in some cases without even being indicted, for more than 10 years. The sooner action is taken the better. The government can also seek the assistance of the international community, and India in particular, to develop the war affected parts of the country on the lines of the Marshall Plan that the United States utilized to rebuild war destroyed parts of Europe. Member countries of the UNHRC need to be convinced that the government’s actions will take forward the national reconciliation process to vote to close the chapter on UNHRC resolution 30/1 in March 2021.

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Features

Album to celebrate 30 years

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Rajiv Sebastian had mega plans to celebrate 30 years, in showbiz, and the plans included concerts, both local and foreign. But, with the pandemic, the singer had to put everything on hold.

However, in order to remember this great occasion, the singer has done an album, made up of 12 songs, featuring several well known artistes, including Sunil of the Gypsies.

All the songs have been composed, very specially for this album.

Among the highlights will be a duet, featuring Rajiv and the Derena DreamStar winner, Andrea Fallen.

Andrea, I’m told, will also be featured, doing a solo spot, on the album.

Rajiv and his band The Clan handle the Friday night scene at The Cinnamon Grand Breeze Bar, from 07.30 pm, onwards.

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Features

LET’S DO IT … in the new normal

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The local showbiz scene is certainly brightening up – of course, in the ‘new normal’ format (and we hope so!)

Going back to the old format would be disastrous, especially as the country is experiencing a surge in Covid-19 cases, and the Western Province is said to be high on the list of new cases.

But…life has to go on, and with the necessary precautions taken, we can certainly enjoy what the ‘new normal’ has to offer us…by way of entertainment.

Bassist Benjy, who leads the band Aquarius, is happy that is hard work is finally bringing the band the desired results – where work is concerned.

Although new to the entertainment scene, Aquarius had lots of good things coming their way, but the pandemic ruined it all – not only for Aquarius but also for everyone connected with showbiz.

However, there are positive signs, on the horizon, and Benjy indicated to us that he is enthusiastically looking forward to making it a happening scene – wherever they perform.

And, this Friday night (January 29th), Aquarius will be doing their thing at The Show By O, Mount Lavinia – a beach front venue.

Benjy says he is planning out something extra special for this particular night.

“This is our very first outing, as a band, at The Show By O, so we want to make it memorable for all those who turn up this Friday.”

The legendary bassist, who lights up the stage, whenever he booms into action, is looking forward to seeing music lovers, and all those who missed out on being entertained for quite a while, at the Mount Lavinia venue, this Friday.

“I assure you, it will be a night to be remembered.”

Benjy and Aquarius will also be doing their thing, every Saturday evening, at the Darley rd. Pub & Restaurant, Colombo 10.

In fact, they were featured at this particular venue, late last year, but the second wave of Covid-19 ended their gigs.

Also new to the scene – very new, I would say – is Ishini and her band, The Branch.

Of course, Ishini is a singer of repute, having performed with Mirage, but as Ishini and The Branch, they are brand new!

Nevertheless, they were featured at certain five-star venues, during the past few weeks…of their existence.

 

 

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