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SLMC in crisis

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The recent release of the report of a panel of inquiry that probed the affairs of the Sri Lanka Medical Council (SLMC) and the subsequent removal of its President and four members by the Minister of Health has brought to the surface many problems concerning this important statutory body. It is well known that the inquiry was initiated by a complaint made by the office-bearers of a powerful trade union who happen to be members of the council.

Many deficiencies, shortcomings and irregularities in the report itself have been exposed. The impartiality of the inquiring panel has also come into question. It appears that the inquiry, meant to be of a fact-finding nature, had erroneously recommended punitive action.

The confusion in the minds of many regarding the difference between the Sri Lanka Medical Council (SLMC) and the Sri Lanka Medical Association (SLMA) should be clarified at the outset.

The SLMC is a statutory body established, in 1924, on the Medical Ordinance based on the same format as the General Medical Council (GMC) of Great Britain. It is tasked primarily with ensuring the safety of the general public seeking medical treatment from doctors registered by the council. It does so by maintaining the standards of medical education and by supervision and disciplinary control of medical practitioners of all categories. The public are encouraged to bring any complaints, supported by affidavits, regarding the actions of the practitioners to the SLMC. It is illegal to practise allopathic medicine in the country without first getting registered with the SLMC.

The SLMA, on the other hand, is an association of doctors of all categories dealing with academic matters, and bringing doctors updated with advances in medicine for Continued Professional Development (CPD). Its membership is voluntary, not compulsory, and is open to all graduate medical practitioners registered with the SLMC. It plays an advocacy role in various health issues affecting the people, as well as assisting the government in matters of health policy. At present, it is actively involved with the health authorities in attempts to control the Covid pandemic. It promotes ethical practice of medicine.

As already mentioned, the SLMC is based on a Medical Ordinance 96 years old. Naturally, much amendment is necessary to suit the current requirements. Such changes have been formulated and proposed to the Ministers of Health, the ultimate authority, by the SLMC at various times during the past two decades. Unfortunately, no action has been taken in implementing them. This has led to the various allegations levelled against the Council, often for no fault of theirs.

At present, the SLMC is composed of 25 members: the Director General of Health Services (ex-officio), the Deans or their representatives of the nine medical faculties in the country, eight graduate doctors registered in the main section 67 of the Ordinance, elected by vote, one representative each of the dental practitioners and registered medical practitioners and the President and four members nominated by the Minister of Health.

Many controversies have arisen due to this composition. Much criticism has been raised about the way the elections are conducted to select the eight graduate members. The trade unions like the GMOA with a large membership have a near monopoly of getting their members elected to fill these posts. They conduct their campaigns like in national elections, spending vast resources at their disposal, in bringing bus loads of doctors to Colombo for voting and even intimidating opposing contestants. At present, the GMOA President is an elected member of the SLMC along with three other office-bearers of his union. Being a vociferous trade union, the GMOA does its utmost to impose its will on council decisions. On several occasions, they have been reprimanded by the President of the SLMC for disrupting the council proceedings.

The current controversy concerns the five members, including the President nominated by the Minister of Health. Although the Minister is the nominating authority, the Ordinance does not allow her to remove them until five years have lapsed since their appointments. (This situation is similar to that which empowers the President of the country to appoint judges of the apex courts, but he has no authority to remove them.) The recent dismissal of the President and four members is therefore considered illegal.

Reasons given for such action based on an adverse report of the panel of inquiry referred to the above are worth further analysis. As mentioned already, allegations were brought in mainly by the GMOA:

1. Improper conduct of disciplinary inquiries. As a significant number of the accused naturally happen to be GMOA members purely because of their vast membership, there is a conflict of interest if GMOA members in the council are to sit on disciplinary committees. Thus, barring them from sitting on such committees has caused much dissatisfaction among the union members.

2. Delay in conducting the ERPM examination for foreign qualified doctors. This is an ongoing problem. The examination schedule has been disrupted this year due to the Covid related restrictions. Matters have been made worse over the years by different groups of candidates getting court injunctions preventing the holding of examinations for various reasons. The examination branch of the SLMC has been working round the clock, headed by a respected emeritus professor of the Colombo Medical Faculty, with long term experience in conducting medical examinations. The high rate of failure at this examination is due to many reasons. It cannot be blamed on the examination process. The format of the examination has been improved on several occasions over the years. No doubt an ever-increasing number of candidates and a paucity of available examiners cause several logistical problems. Unreasonable calls from the politicians and others to do away with the examination altogether have been resisted effectively so far. In one instance, when the Minister indicated that a crisis situation had arisen due to the high rate of failures, the SLMC pointed out that a graver crisis would arise if poorly trained doctors are allowed to practise medicine!

3. Inability to maintain minimum standards for entry into foreign medical colleges. It was realized way back in 2011 that some students had gone abroad for medical education without even passing the GCE advanced level examination. These students have returned with their medical degrees. The SLMC could not disqualify them from sitting the ERPM exam, as such retrospective action was deemed illegal. However, corrective action has been taken to establish minimum standards for entry to medical schools. Up to now the courts have rejected applying such criteria without being passed by an Act of Parliament. Various proposals for such action have been ignored or delayed by the political authorities. The provisions were at last passed by an Act of Parliament a few weeks ago. Thus, it is unjustifiable to blame the SLMC for such deficiencies and delays.

The political authorities, over the years, have attempted to interfere with the vital functions performed by the SLMC. Requests for lowering the pass marks at qualifying exams, register foreign medical specialists with substandard qualifications, and recognition of local and foreign private medical colleges with many deficiencies were successfully resisted by the SLMC. In one instance, the lady president was forced to resign when she did not comply, as there was no provision in the ordinance for her removal. So far, the SLMC has been able act honourably due to the non interference by those in authority, guaranteed by the Ordinance.

The present situation where the Minister single-handedly and illegally removed five members, including its President, is bound to have serious repercussions for the future. It is not a question of the suitability or otherwise of the personalities who were removed or those who replaced them. It is the illegal violation of the independence and autonomy of a statutory body. Hence it is essential that this decision is reversed and status quo restored.

Once that is done the amendments to the Medical Ordinance should be framed and implemented without any further delay. Changing the composition of the SLMC, the way the members are selected or elected, and the inclusion of respected non-medical professionals are among the priorities to enable the SLMC to discharge its duties to the general public at large. If the current situation prevails, the SLMC will be a toothless tiger serving the selfish interests of politicians. Ensuring that the medical profession is well regulated maintaining high ethical standards, thus safeguarding the interests of the general public will be the least of their concerns.

 

A Former Member of the SLMC



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Opinion

A paradox of history

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Shakespeare

There seems to be a striking similarity between ancient Greece and modern Britain. Both countries remain paradoxes of history. Greece was a small city state constantly at war with neighbouring countries. It did not have a big army, but it had considerable sea power. However, Greece was a leading state over the whole of the Mediterranean. In fact, Greece was once a super power in the Western world.

Britain was very powerful in the 19th century. British justice was administered in Africa, India and Ceylon. British factories flourished in many countries and schoolchildren started reading R.L. Stevenson’s ‘Treasure Island’ and the works of Rudyard Kipling. What Ralph Waldo Emerson said in the 1850s is still valid today. He said, “If there’s one test of national genius universally accepted, it is success; and if there be one successful country in the universe for the last millennium, that country is England. It is the best of actual nations.”

In World War I, Britain faced a crushing defeat. Eventually, the British Empire was reduced to a Commonwealth. World War II shattered the image of Britain further. Although Britain lost much of its power, it continued to be an influential country. Even after achieving independence, India retained English as an official language. The British parliament system is well established in many Commonwealth countries. Some people still wonder how England still exercises its influence over the minds of men and women.

Staying power

There are many powerful countries in the world today such as the United States, Russia and China. Although England is not a super power, she has staying power. According to Oliver Wendell Holmes, a good part of greatness is simply being there. For that matter, England has been there for many centuries. So far no other country has been able to defeat her. As a result, sometimes we wonder whether we can have a world without England.

England has had an unwritten Constitution for a very long time. Other countries have emulated her political institutions. The British people have an established church with complete religious freedom. Although there are social classes in Britain, there has been no major clash among them. Unlike in many other countries, there are only two leading political parties in England. When the Labour Party is in power, the government is not subservient to labour. Similarly, when the Conservative Party is in power, the government is not conservative.

Most British colonies in the East including India and Ceylon did not sever the cultural and emotional links with Britain and retain them even after achieving independence. India became independent in 1947, but she decided to retain English as an official language. By doing so, India produced a number of English writers such as R.K Narayan. However, Ceylon did not give English any official status and treated it as a link language. As a result, students paid less attention to learning English. They were made to understand that everything can be done by learning Sinhala and Tamil. We have failed to produce English writers in the calibre of J. Vijayatunga who wrote ‘Grass for my feet.’

Politically shrinking

The United Kingdom is politically shrinking. However, its influence vibrates throughout the world. English has brought many nations together. There is a common understanding among countries that share the English language and literature. William Shakespeare’s dramas are staged in countries such as China where English is not an official language. People have come to the conclusion that English has become a broker of ideas and institutions.

England is not an aggressive country. However, if provoked, it can deliver a mortal blow to its enemy. British Prime Minister Margaret Thatcher showed her mettle as the iron lady. Britain held the fort against the might of Napoleon Bonaparte who ruled France. The country can still boast of a heavy moral credit. The British stick to their international agreements. The power of England draws mainly from its language. British people say ‘It’s right’ when it is right’. When it is not right, they say, ‘It’s not right.’ Meanwhile English occupies a pre-eminent place in world languages. All the research work in many parts of the world is available in English. You can learn any subject easily through English.

Apart from the language, people respect British standards which are technical specifications and quality benchmarks developed by the British Standards Institution. The United Kingdom’s independent national standards body was established in 1901. It maintains over 37,000 standards covering industries such as construction, manufacturing and technology ensuring safety and reliability.

British English

Standard British English is the variety of English that has undergone codification to the point of being socially perceived as the standard language associated with formal schooling, language assessment and official print publications. For historical reasons dating back to the rise of London in the ninth century, the form of language spoken in London and the East Midlands became the Standard English used in schools, universities, literature and law.

British English functions as one of the two major foundational and standard varieties of the English language alongside American English. It serves as a primary reference point for spelling and grammar. It acts as a global standard, and international institutions are often defined by specific pronunciation.

Most Sri Lankan doctors primarily move to England for postgraduate training, higher specialisation and better career prospects. They are driven by superior training infrastructure, world-class facilities and globally recognised qualifications.

To sum up, when you think of learning an international language, there is no alternative to English. If you wish to read literature, you cannot ignore eminent English dramatists and poets such as William Shakespeare and John Milton. Many leading Sri Lankans like S.W.R.D. Bandaranaike were Oxford University products. Therefore, English deserves to be made an official language in Sri Lanka.

karunaratners@gmail.com

By R.S. Karunaratne

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Opinion

State Literary Awards only for the rich?

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The Department of Cultural Affairs has once again called authors, and publishers to lodge their entries for selection of the prestigious State Literary Awards 2026.The criteria and conditions required and notified in the public domain, makes it mandatory for the literary work to be printed and published prior to submission for consideration of the awards. There is absolutely no provision for writers to submit their work in Manuscript form.

Where does that leave the financially impoverished writers who are talented, creative and wish to submit a well edited typescript of their work as manuscript for consideration of the State Literary Awards? In a literary environment that encourages a proliferation of self-published books of all forms and features presented by vanity publishers who have their eye on the purse of the author than on literary merit and artistic excellence, it is easy to show that you are an ” established writer” by spending your cash abundantly towards glossy covered books which the printing industry and fawning publishers will lap up with greed.

Even the Gratiaen Prize in Sri Lanka, sponsored by world-renowned Michael Ondaatje allows for Manuscript entries together with published books. Significantly, the manuscript entries that win the prize are assisted to publish their work which is part of the winnings. Many a young, aspiring writer with little funds who won the Gratiaen Prize on merit, but had submitted their entry in manuscript form have been thereby encouraged to submit their work on merit basis only.

It is a fact that the Commonwealth Short Story Prize, a massive state-supported initiative across 56 nations accepts only unpublished short fiction. Further, several countries in the world have established national or state level literary prizes that specifically accept unpublished manuscripts to provide equity in discovering new talent and supporting national literature without bias or favour. In Australia, Jamaica, Philippines, major national awards organised by the State for literature, specifically accept unpublished manuscripts for consideration.

Let’s face the truth. The printing costs are escalating. There is little demand in Sri Lanka for literary work in the English Language in particular. Traditional Publishing where the literary work is reviewed and assessed for talent and creativity and thereafter published is seldom found. The reviews and critical analysis of literary works are rare. But publishers make a pile by pandering to the vanity of aspiring writers who have the financial clout to pay their way through to being featured in prestigious award ceremonies and accolades. Thereafter, their substandard works get a further fillip by bearing the label of “Won the State Literary Award for Literature”! It is a cycle of literary charlatans and their pimps in the publishing industry for whom the price that is paid for publishing and not Meritocracy is the sine-qua-non.

Is this the level playing field promised by the NPP Government and their Marxist protagonists? A government that was voted into power on the platform of affording fair opportunity and equality seems to discriminate in favour of the Haves against the Have- nots in the cultural department to say the least! Anil Fernando

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Opinion

Delivering on English

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English literature offers a rich heritage of wonderful ideas and thoughts. The reader can be intellectually uplifted. It brings refreshing new vistas and stimulating new ideas. However, this English literature has to be first introduced to the student in order to fire up his or her interest and be made aware of this rich source of culture. Students of basic English as a second language work hard and learn all the hum-drum mechanics of the language, for which they get tested and graded. But importantly, nae crucially, this should be followed up with intellectual rewards for the students’ efforts – which, of course, is the enjoyment of the works of literature of the many great writers in the English language. This is the great payoff, the great dividend for all their efforts but this, apparently goes missing.

One of the obvious reasons for the lack of “follow through” may be lack of time allocated in the curriculum – or, perhaps, more darkly, the teachers’ own lack of knowledge of the great range of good reading materials produced by the countless generations of literary geniuses who have gone before. Such writers have laid down for us a heritage of glorious literary works in books and essays, all of which are to be found in any good library. It is thought that much of this good literature ought to be introduced to all students of English, “full stop,” as part of developing a knowledgeable and cultured society. (Isn’t that what we want?) Reading English literature should bring an intellectual enrichment to all those willing to drink from this Bacchanalian horn of plenty.

It must be said finally, that it can be fairly expected that most young people, especially those learning English as a second language, are totally unaware of the many outstanding pieces of writing that propel English to stand tall amongst the rest. That is, students need to be first introduced to great writings and have a spark of interest ignited in these great works of literature.

For example, by being introduced to “Daffodils,” a short descriptive poem by William Wordsworth, the student can get some very pleasant ideas to think on.

Do not overlook Conan Doyle’s “Sherlock Holmes” detective stories, each one captivating the reader’s attention right to the end. It is by these short stories that the novice reader can first consolidate his power of reading.

For light reading Jerome K. Jerome’s book “Three Men in a Boat” is suggested. On one occasion he goes to the library suffering from a slight hay-fever (allergy) seeking a cure. He consults a book, “Lexicon of Pharmacology”, and recoils in horror as his symptoms fit most of those diseases described in the book! He concludes he cannot live much longer and staggers home to rest and recuperate! This is a well related tale in the book – although seemingly quite implausible!

Similarly, by having the poem meanings explained, e.g. “What is Life if Full of Care?” by William Henry Davis – how he regrets that we humans are always in a hurry, too busy to notice or see the delights of nature, and scenes of natural beauty, e.g., a young woman’s smile as she passes by; we have no time to make friends and even kiss her. Regrets! Explaining this to students would bring a certain intellectual insight.

John Keats’s poem, “Ode to Autumn” is another great work describing the ripening fruits of the autumn season and how nature as a living being, brings to fruition all the good things of a rural landscape quietly humming with warmth after a hot summer.

Again, it is likely necessary to explain to a young, Sri Lankan mind the meaning of the descriptive poetry found in this magnificent poem.

This is the real English to be tasted and then swigged at lustily in pleasure and satisfaction, not some writing airing historical grievances for children to study!

1970 British Cohort Study

It should be observed here that the ‘1970 British Cohort Study’ followed 70,000 people to examine various aspects of their lives. One result discovered was that if a young person reads a lot, it develops his/ her general intelligence no-matter his parents; it makes him smarter.

It was also noted that reading brings life-long benefits; it improves mood, it helps with social skills, increases empathy, reduces anxiety, protects against depression and slows brain decay, the study found.

But these days many young people never gain a great competence in reading English; the fear is that standards are falling. This is bringing poorer critical thinking, less depth of personality and less empathy for others which has the result of a more turbulent society.

People are urged to switch off their headphones and read more of what they like – try reading the newspapers!

Priyantha Hettige

 

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