Letters to the Editor

Show some commitment 

Therefore we call upon all candidates vying for Presidential office to give the lead by setting an example. We call upon them:-

- To declare that, if elected to office, they will solemnly undertake not to advocate and pursue policies that will lead to a further fragmentation of an already divided people.

- To declare that, if elected, they will do away with the present constitution and, through a Constituent Assembly, representative of all sections and strata of society, adopt one that will be truly indigenous and based on the national ethos of our people.

- To declare publicly, through the media and through a special gazette, well before the actual date of polling, their assets and liabilities, in Sri Lanka and abroad, whether held in their names or in the names of their spouses or unmarried children.

- To promise that they will not countenance, either on their own part or on the part of their representatives or agents, conduct which violates the laws relating to the conduct of the polls.

Shelton A. Wijesinghe, Chandra Meththananda, P.M. Wickramasuriya, W.B.A. Jayasekera, Stanley Gunaratne, Stanley Jayaweera, Dr. K.N.K. Wijewardena, Leela Isaac, Sepala Gunasekera, Daya Wijesinghe, D.P. Gunaratne and R.M.B. Senanayake

Free medical care; burden or bequest

The possibility of overcoming this situation by effectively employing these professionals to fulfil the overwhelming need for more doctors in the health sector, need not be over-emphasised. Sadly, some of us do not seem to have looked at the issue in this light. In a country where the population to doctor ratio is worse than 4000: 1, compared with the WHO recommended 800: 1, it is surprising that our health services are considered among the best in the Asian region. This honour is reaffirmed by the high praise it receives time and again. 

These plaudits speak volumes of the dedicated and selfless services afforded to the country by our overworked doctors and other health workers. It is unfair to take their never ending hard work and sacrifices for granted. 

Reducing the unreasonably heavy workload of doctors and providing employment opportunities in the government sector for the newly trained doctors are two related issues that can be taken as one. It is clear that the country cannot afford to fritter away scarce resources to train doctors nobody, much less the government, wants. We have increased the number of state medical faculties (the Eastern one being the most recent proposal) and the intake of each substantially. We are even thinking about private medical schools.

For what purpose are we producing so many doctors is a question that naturally arises. The answer is disarmingly simple. It must be because producing more doctors to look after the health of a rapidly growing population with better living standards must be one of the main concerns of the government. However, some of the public statements made recently do not bear out this concern. Some say there is no more room in the government sector for employing the new doctors. The recent batch of medical graduates who completed their internship are still without permanent employment. Some want the new doctors to seek employment in the private sector. Some thinking is apparently directed towards privatising the state medical service by handing over the present resources to the private sector.

All these ideas, plans and expedients seem to be in the melting pot at the present time, and nothing has so far precipitated. As a result the health service is stagnating and the future of newly passing out medical graduates is left on a limb.

A nation brought up since independence with free government health care, will treat as heretics those who preach privatisation of the state health service as a means of saving funds to invest in other forms of development. After all, for what purpose is development if a nation cannot look after the health of its citizens? What is the meaning of a privatised medical service if making use of it is going to cost an arm or a leg to the average wage earner, the farmer and the man in the street who comprise the majority of the Sri aLankan society? The access to free medical facilities is a veritable birthright given to the nation by our fathers who also gave us independence. Only the people themselves can decide if they are to continue with free medical care or not. No one has the right to take it away. At the same time no one will oppose the development of private hospitals for those who can afford it. 

The private sector will then remain an equally acceptable alternative to the state medical service, without being the predominant force. When the country forges ahead with economic development, the state medical facilities must also be developed as a matter of priority. A stagnant service as it is now, is not something a rapidly developing nation can be proud of. Besides, a deteriorating health service becomes a good excuse for experts to recommend privatisation. "Good health is the biggest wealth of a nation" is a truism we can always repeat.

The following are our suggestions to improve the health service and give employment to new doctors:

Health care areas found wanting

In Sri Lanka, cardio-thoracic treatment is available only in Colombo. Neuro-surgical treatment is limited to three centres. Burns and paraplegic care is offered at one paraplegic unit and one burn unit, both in Colombo. All these facilities fall far short of what the country requires and it is needless to say the staff working at these centres is overworked; because, the units are always over-crowded.

HeaIth care in rural areas

Good health care is limited to the urban areas of Sri Lanka. From Matara to Badulla on one side and from Matara to Ratnapura on the other, there is not a single hospital with surgical facilities. In any case there are no minor specialities at the Matara Hospital either. Similar drawbacks prevail in the Uva province, North Central province, major part of the North Western province, and Northern and Eastern provinces. 

Workload

In certain sectors of health care, doctors are overworked to such an extent that sometimes even their basic human rights are overlooked. When doctors are overworked there is a show of indifference towards patients.Such indifference is often found in intensive care units, emergency admission units and in outpatient departments. Doctors in fields like anaesthesia are called upon to work almost without rest in the outstations. There is an urgent need to employ more trained doctors to lessen the workload.

Parents' Union of the Medical Students
Kandy

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