There seems to be no cure for the ills of the Health Ministry. Not a single day passes without the news of a dispute there being reported. It looks as if health workers took turns to stage protests and harass the hapless public.
Yesterday, we reported another protest in the offing. Doctors have threatened to stop private practice, unless the Health Minister cancels the order that all private medical institutions be registered with the newly set up Private Medical Institutions Regulatory Council (PMIRC). The contention of the doctors is that those institutions are already registered with the Sri Lanka Medical Council (SLMC) and, therefore, the new scheme is without any basis. The Health Ministry insists that the new requirement is to regulate the government doctors` private practice and, as such, it must be fully complied with.
Sri Lanka, as we always make it a point to mention, is a peculiar country. State employees are debarred from engaging in private business. But, certain categories of workers are exempted from that rule. Doctors can engage in private practice even at their official residences. That has to be allowed, it is being argued, as the state cannot cope with the growing demand for healthcare on its own for want of funds. But for the life saving operations performed at private hospitals, we are told, thousands of people will die monthly while being on the waiting lists at government hospitals. However, at private hospitals a patient who survives a bypass operation may die of a heart attack on seeing the bill. So high are their charges. Complaints abound that bills are heavily bloated. But, we are yet to hear of any action taken against those hospitals.
Private practice is also considered a time tested antidote to the brain drain. For, doctors tend to leave for greener pastures, given the `opportunity cost` their stay in this country involves. In a country, where even morons sans basic school education are paid more than medical specialists, simply because they happen to be in politics, it may be argued, the good doctors deserve a better deal.
Thanks to private practice, the vast majority of doctors are living in clover. However, it is unfortunate that most of them have sold their soul to the devil. Their thirst for dosh has taken ascendancy over their sense of duty. Some of them are notorious for scooting away from their workplaces to practise at their own dispensaries or elsewhere. Some doctors are apparently blessed with super human skills; they are able to examine hundreds of patients a day at those private places!
Private practice has led to many rackets. It is now taken for granted that one who seeks specialised treatment at a state hospital first has to channel the specialist concerned at a private hospital. Else, one has to spend weeks, if not months, to enter hospital and by the time he finally gains admission, it might even be too late.
A mechanism to regulate private practice is a step in the right direction. The PMIRC doesn`t look so draconian a measure contrary to the claims of doctors. The fact that private health institutions are already registered with the SLMC doesn`t necessarily mean that registration with the PMIRC is redundant. If doctors can work at more than one place and get paid for that, there is no reason why they should oppose double registration of private dispensaries or hospitals.
The Ministry of Health mustn`t, on any grounds, treat the good doctors like terrorists. They need to be treated with utmost respect. Similarly, doctors shouldn`t deceive themselves into the belief that they are above the law. They, too, must obey the law and follow the rules just like any other category of workers. If they have nothing to hide, they should be able to tell the Health Minister to set up as many `councils` as possible for the registration of private health institutions. Their resistance only gives rise to serious doubts in the public mind as to their true intentions.
The Minister of Health ought to realise that he cannot revitalise the state health sector through regulations alone, however essential they may be. Yesterday, we reported that the Children`s Hospital was without surgical material to perform life saving operations. A similar situation was reported from the Karapitiya Teaching Hospital the other day. Such complaints are frequent. They are an indictment of the Minister. He should ensure uninterrupted supplies to hospitals.
The Minister shouldn`t take the doctors` threat lightly. All private hospitals, save one or two, don`t have their own medical staff. They are dependent on the government doctors. If doctors make the painful decision of foregoing a few days` extra earnings by suspending private practice, those hospitals will be paralysed. Most of the wayside dispensaries will also cease to function. In such an eventuality, the people will have to converge at the already congested state run hospitals for treatment. Can the Minister cope with the load? Does he have a contingency plan ready?
In dealing with the medical fraternity that has made him eat humble pie on many an occasion in the past, he has to tread cautiously. The people may appreciate his courage to try to force some bitter medicine down the throats of the good doctors, which is long overdue, but it will be good for the horizontally gifted Minister`s health to avoid a pratfall at this age.
Good luck to him!