Why this ‘private’ phobia

By Prof Wilfred Perera

(Lanka-e-News - 05.MArch.2017, 9.45PM) In this article I hope to convince the public of the glaring need for private Medical Colleges in this country to be worked out on a public-private partnership basis. This is perhaps the only country in the world that is against private medical colleges. I was the Professor at the first North Colombo Medical College, which was established 1981 by the College of General Practitioners and continued till 1995, when it was taken over by the Government and made into the Kelaniya Medical Faculty. Although, the CGP built a beautiful three storied building to house the professorial units and built many buildings to house the preclinical and para-clinical Departments and a large library, no compensation was given to the CGP by the Government.

This is one of the 16 countries in the world that has free education from the Grade 1 up to University. It is the taxpayers who pay for free education. Unfortunately what is given free is never appreciated, and that is why we see so many strikes by the IUSF and protest marches in the country, as they don’t have to pay for their education.

Throughout the world universities admit purely on merit. In our time we had to go for an interview before we were selected for the university.  In Sri Lanka, admission to the university is no more done on merit,  but by a peculiar system known as Z score, by which even the best students with 3 As do not get admission to the Medical Faculties, and the parents have to send their children abroad to various medical colleges and universities approved by the SLMC. It is a well-known fact that many of the doctors serving in the private and public sectors send their children abroad for higher qualifications in medicine and other fields. Many of them do not return to Sri Lanka. Thus according to Minister Kiriella, the country loses more than Rs. 15 billion every year due to the fact that we have no facilities in this country for private medical education.

Fortunately, the Inter-University Student Federation (IUSF) does not seem to make a fuss about the vast number of international schools in the country and the private universities and establishments that are continuing to give degrees in fields such as business management, accountancy, engineering, law and IT. None of the professionals in these fields go on strikes or protest marches in this country like medicos.

There are about 26,000 doctors registered with the SLMC — about 20,000 in Government Service. Around 15,000-16000 of Government doctors are members of the GMOA. The eight State Medical Faculties in Sri Lanka produce 1,200 doctors every year. And about another 300 Sri Lankan doctors qualified overseas enter the work force every year.  Thus only around 1,500 doctors enter the work force every year.

Sri Lanka has a population of 21 million and this goes up every year by more than 300,000.  The proportion of doctors to the population is around 1-1000. In Britain, it is 1-20. So will we ever be able to reach those figures even after couple of centuries at the rate we are going. The Government is hoping to open up two faculties in Wayamba and Sabaragamuwa.   Every year we will require 300 more doctors to match the annual increase in population.

The specialist Medical Officers in Curative (Hospital) Services 2016 is as follows;
Total Cadre required    3078
Total in position    1634
Total vacancies    1447

How long will it take to fill these vacancies? The cadre will increase every year with the increase in population.
The WHO requests the Government to reduce the doctor to patient ratio to 1 to 500. This means that we will require 40,000 doctors for a population of 20 million. Can the medical faculties in the country ever produce this number even after another 100 years? Thus it is quite obvious to any sane person to realise that we require urgently in this country private medical institutions under the PPP Programme. We require at least 20 more faculties to produce this number. I cannot understand why intelligent GMOA doctors cannot realise this. They too are carrying on protest marches and strikes in various parts of the country, putting the poor patients in to so much inconvenience and trouble. In my opinion all this is done with selfish motives. However, they do their private practice in the evening.

In our times, forty to fifty years ago, medical profession was highly respected. However, I feel ashamed, when I hear of what it has come to. It is no longer a profession or vocation but down right business. In the NCMC we taught our students not only medicine, but to treat the patients with TLC (Tender, Loving, Care). Unfortunately I don’t think that this is ever taught in our state medical faculties.  That is why the graduates who passed out from the NCMC are top consultants in this country and even abroad, because their approach to patients is quite different.
The GMOA and the medical students are protesting against the ruling given by the Appeal Court.

In my opinion, they should be charged with contempt of court. The SLMC has appealed to the Supreme Court for a final decision. We will have to wait and see what the outcome is.

By Prof Wilfred Perera

The writer was Prof of Obstetrics and Gynaecology at the North Colombo Medical College.

(First Published in Sunday Times)

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by     (2017-03-05 17:01:10)