Health Sector Heading For Catastrophe

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Like all other government and private sector employees, the stormy economic situation has affected the health services, driving health staff to look elsewhere for opportunities which may help salvage their personal economic situation. 

RTI Revelation

A request made under the Right to Information (RTI) Act, published in 4 September 2022 issue of Sunday Ceylon Today, revealed that over 2,200 medical practitioners had received the good standing certificate from the Sri Lanka Medical Council (SLMC). Doctors obtain the ‘Good Standing Certificate’ either for their higher education or work abroad. It was said that 2,206 medical practitioners had obtained the ‘Good Standing Certificate’ from Sri Lanka Medical Council (SLMC) till August this year. `

According to the SLMC a total 433 medical doctors obtained the ‘Good Standing Certificate’ in June this year while another 1,218 doctors had obtained it in 2019. Giving a breakdown the SLMC revealed at that time 1,081 had received the GSC in 2020. In 2021 a total 1,350 medical doctors had been given the certification.

On the other hand 533 new doctors registered with the SLMC in 2019 while 1,659 registered in 2020. Also, 1,623 doctors registered in 2021. But, only 328 doctors registered up to August this year.

According to SLMC, from 2019 to until August 4,143 doctors registered with SLMC while 5,855 doctors got the ‘GSC’ to go abroad.

Denial

   The Health Ministry and the doctors’ trade unions denied that, that a number of doctors who had received the GSC had left the country. MCPA President, Dr. Chamal Sanjeewa said that a few or 300 medical practitioners would have left the country having received job opportunities from 01 January to 31 August 2022. The GSC certifies that the particular doctor has no criminal charges against him.

One cannot assume that a medical practitioner had gone abroad just because he received the GSC, Media Committee Member of the Government Medical Officers’ Association (GMOA) Dr. Chamil Wijesinghe said. But a majority of doctors who leave the country go for Post graduate training with job opportunities, while there are also those who leave the country in order to accompany their spouses who have been enrolled in some educational programme and opt to stay on due to family commitments.

Dr. Wijesinghe lamented that the country’s economic debacle had led to a large number of medical practitioners weighing and preparing for the possibilities of seeking greener pastures by following various courses. They are amongst those who have taken the GSC. There are a large number of doctors following the International English Language Testing System (IELTS) course, Australian Medical Council certification exam and the United States Medical Licensing Examination, Prometric, in a bid to leave the country if the opportunity presents itself.

Nurses and Medical Laboratory Scientists   

The situation in the country is such that a majority of those qualified locally as nurses and medical laboratory scientists opt to move out of their league in order to fly overseas as care givers to elderly or sick persons. Repeated efforts made to contact the Sri Lanka Nursing Council (SLNC), failed. However, Secretary of the All Ceylon Nursing Union (ACNU), S.B. Mediwatte said that at least 1,000 nurses had had already left the shores for foreign employment. Most of them leave for Middle Eastern and Western countries for nursing and care giving jobs. Most of them who travel to the United Kingdom go as care givers. Currently there are 48,000 nurses employed in the Health service. Most of those who migrate for foreign employment are seniors in nursing who have experience working in hospital theatres and intensive care units.

It would definitely impair the services in Sri Lankan hospitals as a majority of them leave resigning from their jobs, he lamented.

Opportunities to serve abroad

GMOA Media Committee Member Dr. Wijesinghe said that the delay in approving the circular granting ‘Special Leave for Doctors travelling for foreign employment,’ only jeopardised the situation. The circular issued by the Ministry of Public Administration was amended and made service specific as the medial service was an All- Island service and ensured quality and equity.

Necessary requirements and criteria were introduced as a result. He said that the Minister of Labour and Foreign Employment, Manusha Nanayakkara too had pledged to support medical professionals by forming government to government agreements for medical professionals. Currently, doctors had to find foreign job opportunities for themselves.

Dr. Wijesinghe said, however, that to do anything the Health Secretary had to place his signature and it had to be implemented. It would not only stop medical practitioners from leaving the country all together, having resigned from their jobs, but would also help Sri Lanka to obtain the much needed dollars. They would also not lose their seniority as they would be given no-pay leave to work abroad for a certain period, Dr. Wijesinghe said.

However, informed sources from the Ministry noted that the delay was due to translation issue. The Circular should be issued in all three languages, they said. 

Health Ministry

Additional Secretary (Medical Services), Dr. Sunil de Alwis, when contacted, said that a mechanism had been worked out through which medical practitioners could avail themselves of this opportunity given to State service employees to work abroad. The service requirement within the country would be assessed while no-pay leave would be given to medical practitioners to serve for a certain period in a foreign country.

Dr. Alwis explained that the programme would be carried out without compromising the medical services in the country. Seniority and the service station of the medical practitioner would also be considered, he said.

Retirement

One wonders if the economic crisis has led the Sri Lankan Government into taking desperate measures and literally ‘juxtaposing’ policies in order to gain control of a situation gone bad.

The Ministry of Public Administration, issuing yet another circular following the Interim budget, created further dilemma with regard to the age of retirement with regard to special services, including those in the health sector. Hopefully, while trying to manage balance sheets, the Finance Ministry and the Government would not end up letting health staff leave the country while retaining the over 60s to manage the hospitals and the large patient population that seek the free health service.

(Pix courtesy NHSL)

By Dilanthi Jayamanne