Last week was an important week in the country’s health sector. Dr. Rajitha Senaratne, Minister of Health and Indigenous Medicine was recently appointed vice president of the World Health Organization (WHO) which resulted in a felicitation ceremony in Colombo that was the subject of much debate. The same week, Government doctors struck work, crippling government hospitals islandwide, cancelling scheduled surgeries and outpatient clinics, and leaving thousands of patients badly in need of medical care, stranded. The strike was purportedly based on the powerful doctors’ union opposition to the Free Trade Agreement signed between Sri Lanka and Singapore, but featured nine other demands regarding their allowances, promotions and privileges for their children. Also last week, Prof. Colvin Gunaratne, President of the Sri Lanka Medical Council resigned from his post, pointing to major issues with the composition of the Council, where GMOA doctors hold a majority of seats and become judges in their own cases based on patient complaints. The Sunday Observer interviewed Health Minister Dr Rajitha Senaratne, who seems to have a great deal on his plate at this time
Q. You were recently appointed as WHO Vice President, can you tell us how this benefits the country?
A.President and four Vice Presidents comprise the executive board bureau of WHO. The five of us are the supreme body which decides on health issues in the entire world. Representing such a supreme body could be beneficial to our country. Now the WHO is focusing on two things i.e. Universal health coverage and Primary health care. In both areas we are on a top level.
All world leaders have admired the actions taken by our government after 2015. Providing all medical treatments to cancer patients- heart patients and those with impaired eyesight, no shortage of drugs in the public sector, bringing down drug prices in the private sector and granting free cataract lenses are some of the examples. That is how we address universal health coverage. Also, we have improved primary healthcare by setting up 846 healthy lifestyle centres and 906 healthy women clinics. When the Director General, WHO visited Sri Lanka recently, he mentioned that Sri Lanka is one of the best in the world”.
Q. The GMOA is, unreasonably it would seem, demanding to be exempted from PAYE tax on their private earnings, despite this tax being applicable to all workers in the private sector. You have been a staunch critic of the GMOA’s tactics, in the circumstances, why did you decide this week to negotiate tax concessions for them with the Finance Ministry?
A. Doctors in other developed countries earn more. But, at the same time they have spent lots of money on medical education. Here in Sri Lanka, everything is free! So there must be some balance. Other than salaries they (Sri Lankan doctors) are provided duty free vehicles, pensions, overtime payments and much more. Also, the right to private practice. In that scenario you can never justify such demands of the GMOA. They can negotiate, or take some other action, but we cannot endorse their going on strikes, demanding such benefits. However, being a doctor, I have to tolerate certain things. I did it for doctors, not for the GMOA. If they are trying to be too political, I will not hesitate to take firm decisions.
Q. But isn’t their demand, especially about the PAYE tax, unreasonable since other professionals without such lobbying power have no choice but pay?
A. We are not going to grant any tax reduction for doctors. Instead, we have agreed to grant them some allowances. Doctors as professionals are doing a worthwhile service to society. In order to refresh their knowledge, from time to time they have to go abroad. Considering these, the Finance Minister agreed to give a certain provision on the salary scale. It’s the tax relief.
Q. There appeared to be a difference of opinion between you and Minister Mangala Samaraweera this week over tax breaks for the GMOA. Can you explain?
A. Actually I am the one who lead the first delegation with AMS (Association of Medical Specialists). We had discussions with Finance Minister Mangala Samaraweera. Immediately after the second round of discussion, the AMS were satisfied with the proposed formula. How the Finance Ministry would implement it is something else. Anyway, that is the end result.
GMOA demands and Rajitha
“We have discussed and most of the demands are already given. For instance, the DAT allowance is given. Even the GMOA Secretary told me as, ‘Sir, most of the demands are given but not implemented yet’. The other issue is the Singapore Sri Lanka Pact. The same way they fought against the Indian ambulance service. Today, over 600,000 people benefit from that service. Earlier they were against the ETCA, and now they oppose the Singapore FTA. Will Singaporean doctors ever come to Sri Lanka abandoning their jobs in Singapore? Any fool can understand this. During Mahinda Rajapaksa’s time the same GMOA President Anuruddha Padeniya had prepared a document to implement a professional exchange programme with Singapore. I have confronted stronger characters in my political life. These people are not big shots to me.
Q. Is your relationship with the GMOA good or bad?
A. They come to meet me and hold important discussions. At meetings they respect me more than I expect. Then after a lapse of two days or so, they start attacking me. That is no doctors’ culture. Sometimes, they threaten people. Now they have threatened the Sri Lanka Medical Association president. They think that people are scared of them. But, the reality is, many want them to be exposed. Only then can we deal with them. We are now going to intervene into the GMOA’s conduct. We waited for people to understand who the real culprits are.
Q. When he announced his resignation, the SLMC President Prof. Colvin Gunaratne delivered a stinging indictment against the GMOA and the failure of the Council to act in the interests of the patients. How do you respond?
A. His remarks are true. The SLMC’s purpose is caring for the patients. Now the British Medical Council has other professionals in their council body. But in the SLMC, no inquiry ever gives redress to patients with complaints against doctors. What happens is that doctors get together to protect their interests. That is not the purpose of the Medical Council. Secondly, the GMOA representatives in the SLMC have cases against them at the SLMC. So the same people who are accused are also conducting the inquiries.
Q. In the recent past, you have intervened to try and resolve the railway workers’ strike, and been felicitated as ‘suwapathi.’ This week, you negotiated on behalf of the GMOA as well. Is Rajitha Senaratne also building a profile to be a contender at the 2019 Presidential race?
A. If the situation demands that, it is a different matter. Otherwise, I have no such intentions. Always, the situation must tally with the post. That is my political theory. First, we have to come to a unanimous agreement about the next Presidential Election. I have already spoken to both, the President and the Prime Minister. I have brought them together. At the moment both are accepting that both parties should go together. The next problem is who shall be the candidate. All alliance parties should sit together and discuss as to who would be the best candidate or who would be the best combination for the President and the Prime Minister.
As for my interventions, even in earlier governments I have settled trade union grievances. In 2002-2004 the then Prime Minister Ranil Wickremesinghe used to hand over all trade union hitches to me. I have successfully settled them for the benefit of the government. That is because, I myself have a trade union background. I understand their mentality and can speak to them in their own language.