doctors lose patience
Govt. says no money to meet GMOA's salary-hike demand
as patients's right to healthcare is buried in crippling strike
in the chronic tug-of-war between the Government Medical Officers
Association and the Ministry of Health are thousands of poor patients,
for whom free healthcare is a life and death matter.
Health Minister P. Dayaratne says there was very little he
could do and asks the doctors to postpone their strike until
the next cabinet meeting.
are with the doctors," he said last week adding, "but
we may have to wait till the Finance Ministry approves the
proposal of the cabinet sub committee because it's a large
sum. We are negotiating with them."
demand that doctors working in the North and East be continued
to be paid the inconvenience allowance, Minister Dayaratne
said the Government cannot pay this because there was no war
in the country.
circular states that the payment would be made until the end
of a war or for a maximum of two years.
we stopped payment in January 2002. If we continue this allowance,
then all public servants will demand a special payment even
in the absence of war.
GMOA suspended the four-day crippling strike on midnight Friday
as a mark of respect for the Poson Poya Day yesterday, many patients
fear that they will be once again pushed to difficulties if the
two sides fail to reach a compromise by tomorrow morning -- a deadline
the state doctors have set for the government.
The GMOA action committee would meet tomorrow morning to take a
decision based on the government's response to its demands.
services and children and maternity units were not affected by the
strike, the Out Patients' Departments were the worst hit in all
hospitals. In some hospitals, the OPD patients were turned away.
Other hospitals obtained the services of Registered and Assistant
Medical Officers to attend to the patients, who felt their right
to healthcare had been buried by both the doctors and the government.
One patient said that some patients might not seem to be serious,
but their cases could become serious as a result of the delay in
OPDs, regular clinics and routine surgeries were also affected by
the strike. Thousands of patients who came for the clinics from
3 in the morning were turned away by the hospital staff. Some left
the clinic, cursing the strike, the doctors and the government,
but a desperate few stayed back, hoping the strike would end any
moment and doctors would return to work.
Hospital, which generally carries out 75-80 surgeries a day had
confined operations to emergency cases only. On the positive side,
the National Hospital did not stop admitting new patients or patients
who were transferred from other hospitals, according to Director
Dr. Hector Weerasinghe.
compromise, says GMOA
The Government Medical Officers Association (GMOA), which
suspended its strike over the weekend in view of the Poson
Poya Day, says it has compromised enough and given all the
time the Health Ministry needed to sort out the issue.
1988, we pointed out the anomaly being created. But the authorities
did not heed our protests," Dr. Rohan Gunawardene, media
spokesman of the GMOA Interim Committee said.
the salary of a Grade II doctor and a Special Grade AMO/RMO
had a 12% difference before 1988. However, gradual increases
in the salaries of RMO/AMOs had placed an MBBS-qualified doctor's
salary 30 percent below the salary of an RMO/AMO.
gone through the tedious process of five years of university
education and a year of internship to earn an MBBS degree,
the state doctors feel that it is unfair to place the salary
of AMO/RMOs who follow a three year course on a higher scale.
salary, Dr. Gunawardene said, was vital in determining administrative
posts and responsibilities. For instance, the appointment
of an inquiring officer was determined according to the salary.
said the GMOA had come down in its demands by fifty percent
and have been lenient with the Ministry giving them sufficient
time to resolve the issue.
April 8 we came to a compromised solution proposed by the
Cabinet Sub Committee. In one such compromise the Sub Committee
said that although the anomaly would be rectified from 1993,
the arrears would be paid only from 1997.
agreed to a proposal that 50% of the arrears would be paid
in installments over six years starting from 2004," he
said. GMOA's interim President Dr. Kumar Weerasekera said
the trade union was forced to take action due to the government's
failure to sort the matter out on a priority basis.
Health Ministry Secretary Dr. Reggie Perera in a letter dated
May 7 assured the GMOA that the Cabinet Sub Committee would
present its recommendations at the "very next Cabinet
meeting", but no progress had been made although more
than a month had lapsed.
every discussion we are told that it will be taken up at the
next Cabinet meeting. Even during Wednesday's meeting with
Health Ministry officials, we were asked to call off the strike
as the issue would be taken up at the next cabinet meeting,"
said Dr. Weerasekera who also asked, "How many more Cabinet
meetings do they want us to wait if they couldn't do it all
chief said the strike would be called off only if they received
a concrete assurance that the anomaly would be rectified before
a definite date. While the rectification of the salary anomaly
is the main demand, the GMOA wants the inconvenience allowance
paid to docros working in the North and East to be continued.
claimed that the doctors were still living in harsh conditions
with poor accommodation and transport facilities in spite
of a ceasefire.
The Sunday Times
learns that the number of patients transferred from the strike-hit
provincial hospitals to the National Hospital had increased during
the four days of trade union action by doctors.
The trade union
action began on Tuesday but it was only confined to Teaching and
General hospitals. On Wednesday, doctors in Base hospitals joined
the strike while peripheral hospitals doctors expressed their support
the following day. It was only doctors at the Lady Ridgeway Children's
Hospital and the Cancer Institute at Maharagama who did not join
the strike for obvious reasons.
allegations that doctors hold patients to ransom to win their demands
and they now concentrate more on private practice, the GMOA went
ahead with an islandwide indefinite strike claiming that it had
been forced to take trade union action due to what it called the
Health Ministry's inaction.
say they will come back to work only if the Government gives a written
assurance that the salary anomaly would be rectified within a definite
timeframe. The doctors claim that there exists a big anomaly between
the salaries of doctors and RMO/AMOs from 1988. They say as a result
of the Health Ministry's myopic action, the crisis over the salary
anomaly aggravated in 1993 and by last year the disparity had widened,
in favour of RMO/AMOs.
Society of Registerd and Assistant Medical Officers (SRAMO) disputed
this claim saying that as a result of adjustments and increments
effected last year, the difference was only 7 percent.
Health Minister P. Dayaratne says he acknowledges that there exists
a problem of salary anomaly but he could do very little because
the Treasury has no money. The GMOA, scoffing at the Minister's
remarks, asks how the ministry got money when it wanted to rectify
the salary anomaly of RMOs last year.
A Cabinet Sub
Committee has estimated that Rs. 550 million would be required annually
to meet the the salary hike and more than one billion rupees for
the arrears demand of the 11,000 state doctors. Minister Dayaratne
claimed that he was pursuing the matter with Treasury officials
and was trying to get them to reconcile to the Sub Committee's recommendations.
Minister John Seneviratne told The Sunday Times that a request for
a salary hike for doctors was postponed pending the Devendra Commission
report. "The report was pending at the time and I promised
to consider an increase following the report. But, the new government
misinterpreted the report recommendation claiming it had suggested
the retrenchment of the people in service," Mr. Seneviratne
de Silva who succeeded him as health minister during the PA regime,
alleged gross mismanagement on the part of the Government. "The
government had created an anomaly without taking into consideration
the cumulative impact on other groups in the health sector."
of who created the anomaly, the problem remains unsolved and the
patients left with no choice get battered by the indifference the
doctors and the government show towards the patient's right to healthcare.
The GMOA asks the Ministry to resolve the issue at its earliest
while the Ministry in turn requests the doctors to be patient. In
either case, both say, "For the sake of patients!"
by doctors, says patients' group The National Association for the
Rights of Patients yesterday strongly condemned the latest strike
by doctors as an act of blatant, irresponsibility towards poor suffering
for NARP which includes several patients rights and civic action
groups said they would draw up a petition signed by thousands of
patients asking the government to ban strikes by doctors and nurses
and other health sector staff. He said the doctors might have a
legitimate grievance regarding salaries and the government should
work out a process of arbitration through the Commissioner of Labour
instead of allowing doctors to inject more agony into the plight
said the health minister had agreed that doctors would get an extra
salary which would cost about 550 million rupees in public funds
in addition to 1,000 million rupees for payment of arrears. With
so much being given from public funds the people had a right to
insist that they would no longer be subjected to the torture of
strikes by doctors and other health staff.
The Govt. Medical
Officers' Association which launched a strike last Tuesday suspended
the strike for the Poson weekend but warned of further action from
tomorrow if a circular was not issued on the 40% pay hike.
NARP will hold
an action committee meeting on Saturday June 21 at the Community
Center No. 15, Quarry Road Dehiwala, to plan out further action.
Meanwhile, in a powerful act of judicial activism and involvement,
Chief Justice Sarath N de Silva has told the government that it
was elected in trust to protect the rights of people and not of
big global companies.
The Chief Justice
was commenting in a Fundamental Rights case filed by AIDS crusader
Dr. Kamalika Abeyratne who has complained that the new bill to be
introduced soon would deny millions of Sri Lankans the right to
get quality drugs at affordable prices. Dr. (Mrs) Abeyratne, herself
an AIDS victim after an infected blood transfusion said the new
code of Intellectual Bill would give priority to the patent rights
of global companies and thus enable them to exploit or plunder unsuspecting
patients. The Chief Justice said the supreme Court's observations
on this bill would be made known to the President and the Speaker.
jealousy,' charges SRAMO
The Society of Registered and Assistant Medical Officers (SRAMO)
has accused the GMOA of being agitated over 'professional jealousy'.
Claiming that the disparity was a mere 7.1 percent, the SRAMO said
it would oppose any attempt to increase the doctors' salary beyond
While the GMOA
charged that the AMOs/RMOs were ahead of them in terms of salaries
despite being lower in the ladder, K.M. Zahir, National Organiser
for SRAMO said it was purely professional jealousy that made the
graduate doctors underestimate their work.
He said it
was unreasonable for the doctors to compare a Grade II medical officer's
salary with the income of a Special Grade RMO/AMO. "Unlike
graduate doctors who reach Grade II within two years, an AMO/RMO
has to work for 25 years to get to the special grade. So it is unfair
to compare the two," he said.
Mahinda Liyanage said whatever increments they had received were
through the Salaries Commission and not through political influence.
According to the SRAMO chief, the Salaries Commission based on the
B.C. Perera Commission recommendations effected the 1997 increment.
increment was given this year based on the Kodagoda Commission recommendations.
Accordingly, AMOs/RMOs, nurses and paramedical staff got a 7.1%
increase following a series of trade union actions.
Let them suffer
Despite the doctors' strike, patients continued to come to hospitals.
Some of them were unaware of the strike while others came there
in desperation. Whether it be minor ailments or just after care,
for several patients who made exhausting trips from far off places,
the trade union action was nothing but unfair.
(44) was distraught and disappointed to find that his niece would
not be treated due to the strike. "We didn't know there was
a strike. Had I known, I would not have come," a disgruntled
from Muttur in the Eastern Province, Wahid accompanied niece Nihara
(30), her 11-year-old daughter and his brother to the National Hospital
in Colombo on Friday. "We left home last night (Thursday) to
make it to the hospital early. We had to travel eight miles by boat
and then take a train to Colombo. But now, we're told to go home."
Earning a meager
income of Rs. 200 a day, Wahid had saved some money to make this
trip over the past ten days. His niece suffering from head pain
had been asked to attend the clinic on June 13 with medical reports.
with great difficulty that I collected this money. Some days, we
went without food and had to skip meals to save for this trip,"
he said. Nihara had come with blood tests and an X-ray, but there
was no doctor to see her reports. "I don't know what to do,"
said Nihara, a mother of four children. "We need money if we're
to stay in Colombo till the strike comes to an end. But if we stay
in Colombo, we will lose our daily income to feed our children at
The Wahid household
does not have a television or a radio. His income does not permit
him to buy newspaper. Thus he was cut off from news on decisions
taken in air-conditioned rooms in Colombo by doctors or health officials.
Wahid and the
family were not alone. We met several others who had come to the
National Hospital from far off places like Polonnaruwa and Anuradhapura.
To hear their sorry plight, there were no doctors or officials.
Don't Wahid and others have a right to healthcare?