Privatization of medical education We have not given up the battle-Dr. Padeniya

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By 2017-12-01


In the wake of Government's resolution to abolish the South Asian Institute of Technology and Medicine (SAITM), parties that took up cudgels against the SAITM private medical institution emerged victorious and put an end to the protests. Speaking to Ceylon Today, Dr. Anuruddha Padeniya, President of the Government Medical Officers' Association (GMOA) said that this cannot be considered a victory over the battle that the interested parties have been fighting.

Commenting on the proposed Constitutional Amendments and impinge on the healthcare sector, Dr. Padeniya said that the authority over country's healthcare sector should be retained by the Government and should not be devolved to the Provincial Councils. "Moreover, the President should have the authority over PCs and a Governor should remain as the representative of the President," he said.

Expressing his views on the relaxation of taxes on beer and the Finance Minister's statement that beer is healthier than soft drinks, Dr. Padeniya noted that alcohol cannot at all be advantageous to health, "Tobacco and alcohol must be eliminated from the country. The colonizers introduced those unhealthy practices to the country, with the intention of deteriorating the health of the locals. Reduction of price of liquor such as beer is an indirect way of promoting its consumption."

Excerpts of the interview:

With the Government's decision to abolish SAITM which includes entrusting the assets, liabilities, staff and the students of the Medical College to a non-government and non-profit making degree awarding institution, do you think the battle has come to an end?

A: No. We have not put an end to our campaign against Private Medical Colleges (PMCs). The students, trade unions and other interested parties have temporarily taken a step back and ended their protests, strikes and stoppage of work in the wake of the Government's announcement to abolish SAITM. It does not mean that we have given up the battle against PMCs.

Is SAITM fully abolished as claimed?

A: Abolition of SAITM was recommended by a Ministerial Committee in 2012 and also by the Presidential Commission in 2017 and presented in Parliament. It is at present recommended that SAITM be abolished and the institution should cease to function.

Unfortunately the Ministers who are in charge of the subject disciplines stand by this fraudulent institution. What the Ministers of Health and the Higher Education should do, is to unite with all interested parties to produce high quality internationally acclaimed doctors in Sri Lanka, and not to degrade the already existing standard of the medical education of the country by supporting institutions that produce low quality doctors.

Do you consider this a victory?

A: This is a pyrrhic victory. We highlighted the damage SAITM can induce to the health sector as well as the medical education of the country, in 2017. But the recommendation and decision to abolish the institution came about, after seven years of our hard work. We have lost so much and have done a lot of sacrifice on our journey to abolish SAITM. The damage could have been averted if the authorities had given ear to us from the beginning.

Hence, it is difficult to accept the decision to abolish SAITM as a victory.

How do the proposed Constitutional Amendments affect the Healthcare Sector of the country?

A: The health service of the country is set up based on a national policy and the citizens of the country can obtain an even-handed medical service anywhere in the country. There is no discrimination in the health services rendered across the country despite the area, may it be Colombo or the rural areas. There is no restriction at present for any citizen to obtain medical treatment at any hospital in the country and this enables the offering of quality and impartial medical treatment across the country, despite provinces.

Some federal countries such as Germany have not devolved the authority of healthcare service among other States in the country in order to render a quality and equitable healthcare service among the citizens of the country.

According to the proposed Constitutional Amendments, if the provincial councils are vested with the authority to appoint the Governor, the provincial councils will have no issue in implementing a provincial statute for healthcare services because the Governor will not be a representative of the Government or the President.

If the executive powers of the President are curtailed by the proposed Constitutional Amendments, specialists and doctors will be appointed by the provincial councils not by the Government.

There is a question as to who are those in need of Constitutional Amendments and if the Amendments are enacted the national healthcare policy will be abolished and the country's health sector will be in a serious hodgepodge.

What is a Provincial Statute?

A: A Provincial Statute is the agreed upon manifesto of a provincial council in relation to a particular subject area. For instance, the provincial health statute is the policy statement on health service of that particular province. The danger and the disadvantage is that any province can prepare the policy statement on health on their own wish and that may contravene and deteriorate the national policy and standard, on health service.

Although according to the 13th Amendment to the Constitution, the health service of the country is decentralized, the Executive President of the country is vested with the authority of having control over the provincial health services and centralize it when necessary.

In order to enact the authority given to the provincial councils on health services, each province should implement provincial health statute. Provincial statute cannot be implemented if the Governor does not give the consent. No Governor in history has consented to implement the provincial statutes due to our insistence to the President.

If the Constitutional Amendments facilitate the appointment of the Governor by the Provincial Chief Minister leading to the nullification of the representation of the President in that province, the Governor is compelled to consent to the provincial statute.

Then the national health policy will be abolished and nine health policies will come to existence for nine provinces which will jeopardize the quality, standard and the equitableness of the health service of the country.

How does the enactment of the provincial health statute affect the healthcare sector of the country?

A: If the provincial statute is enacted, that will detrimentally affect the healthcare service of the country that the citizens enjoy at present, with no inconvenience.

There will be a tendency to experience a dearth of doctors, specialists, and other healthcare officials for certain areas in the country. The country's healthcare service will not be shared by all the citizens equally and the healthcare service that is rendered in all parts of the country in the same standard will be discriminated according to provinces.

This will also hinder the patients' right and ability to be treated freely at any hospital in the country and also it will inhibit the patients from consulting any doctor in any hospital. The doctors, specialists and other related officers that will be recruited to the healthcare sector will be of different standards, which at present is the same everywhere. Complicated situations may arise when the differences in salary scales and other related allowances for the doctors, specialists and other officials in the healthcare sector are created based on provinces.

This will also lead to the nullifying of national standards of the country's healthcare service. What we stress is that the healthcare sector should be administered by the Government and not by any provincial council in order to retain its standards and equitableness to all citizens of the country.

A responsible Minister of the Government stated that 'beer is healthier than soft drinks'. What is your view on the Minister's statement as a medical doctor?

A: Any type of alcohol cannot be good for health and doctors are against the reduction of liquor price. The consumption of liquor cannot be recommended as a medical practitioner and my opinion is that tobacco and alcohol should be eliminated from the country. The practice of consumption of alcohol and tobacco was introduced to the country by the colonizers with the intention of deteriorating the health of the locals to serve their undue purposes.

When responsible persons in the country make such comments, it is sure to affect the image of the country in the international arena.

In terms of the health concerns, I agree that soft drinks are injurious to health due to varied reasons. The sugar content and the toxic substances found in soft drinks can be injurious to health. However, soft drinks have been categorized under unhealthy drinks. The World Health Organization (WHO) has never declared any alcoholic drink as healthy in comparison to any drinks. The healthiest drink found on the planet is water and if you refer to the CDC (Centre for Disease Control) website, water and natural liquids such as fruit juices are the recommended.

So, both beer and soft drinks are unhealthy and can detrimentally affect the health and lead to non-communicable diseases.

If someone compares both liquor and soft drinks and emphasizes that one is healthier than the other, it is akin to asking a person which poison he would like to take to die.



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