Following a contentious election season, the Government Medical Officers’ Association (GMOA) re-elected Dr. Sanjeewa Thennakoon as the Association’s President amid renewed public scrutiny and institutional pressure.
With the healthcare sector still reeling from the effects of an economic downturn and widespread workforce migration, this transition comes at a critical juncture. In this exclusive interview with the Sunday Observer Dr. Thennakoon discussed the internal dynamics of the GMOA, ongoing safety and security issues faced by medical professionals, controversial policy decisions, and the Association’s vision for reforming Sri Lanka’s public healthcare system.
Excerpts
Q: There have been allegations made by politicians and even members of the GMOA that there is an ongoing power struggle, especially based on political affiliations, within the Association which has made the recent election highly competitive. Is this true?
A: There was a power struggle. We were not driven by party politics, we were an independent group. We heard that certain political elements were supporting the other group, hoping for a certain change within the GMOA through the other party. Going through the election we got to know that certain conditions and certain things were not that favourable in the Ministry of Health for us.
We tried our best, to get certain privileges which are due for us. Which were given to us by President Anura Kumara Dissanayake, but were unnecessarily delayed, so we came to know that certain forces were working against us to achieve their own agendas. So we did have a big struggle to gain those privileges, various fights, to win thesis things.
Q: The GMOA has been referred to as a “Boys Club” in the past due to the lack of women in key positions within the GMOA. Are there any women office-bearers within the association? Has there been a particular reason as to why women have not been given more prominence within the GMOA?
A: We have one female in the exco and two females in the general committee. The GMOA used to be a sort of boys club before and there are fair enough reasons for that. The GMOA in the previous years were in a bit of a fighting mood so none of the female doctors wanted to come in, especially during the former Health Minister Dr. Rajitha Senarathne’s era. But after that we came to sort of a diplomatic mood, so now many females are willing to join us. So now they are represented in the exco and in the general committee as well.
Q: Safety and security of female doctors have been a matter of concern especially in recent years. From Jaffna, Anuradhapura to Galle, female doctors have faced sexual and physical abuse within hospital premises. How will the GMOA address these issues regarding the safety and security of female doctors?
A: This issue is not present only in Jaffna, but in several other parts of the county too. And not only female doctors but male doctors are threatened by thugs and threatened by visitors of the patients. Particularly the incident that happened in the Anuradhapuura Hospital where this lady doctor was returning from on-call duty to her quarters was raped. So there are indeed security concerns all over the island with regards to male and female doctors. Especially for the female doctors. With their nature of duties, especially when they are doing night duties their wards and their quarters are not given any sort of special security. Even at 2 am they have to report for on-call duties. There aren’t any adequate security personnel in place.
We have discussed this matter with the IGP, who has been very responsive and the GMOA has established a special committee to address this matter. We want to set up police posts within the hospitals, with police officers patrolling the wards. We want them to be manned by Police or Army personnel, not by some private security firm. Most of these private security firms are disorganised, their workers aren’t often given adequate training. So we requested the Actg. IGP to at least station some personnel within the main hospitals for the safety and security of the medical officers.
We are also in consultations with the administration to revamp the infrastructure within the hospitals. Most of the infrastructure when it comes to doctors’ quarters and offices are old, the doors do not have proper locks and the corridors are not properly lit. So we want it to be restructured adequately. Right now there are police stations within hospitals but they only look into legal matters regarding patients. But we need Police officers to look into our security as well.
Q: Speaking of security, the Colombo General Hospital, where protocols are not followed when it comes to safety and security measures and where hospital attendants and nurses allegedly peddle drugs within the hospital premises. How is the GMOA going to address this matter?
A: We have heard these allegations. We want the administration to come down and settle these problems. There are certain protocols that are not met. Especially controlling the minor staff. And yes we have heard there are drug addicts and drug peddlers amongst the minor staff, so we want the administration to come down and settle this matter.
Q: The recent Government decision on KDU has caused a debate amongst the general public. What is the GMOA’s stance on this?
A: Actually, the KDU topic specifically has not been discussed by the GMOA. But in general our stance is whether the degree is given by a government party or private party, it should be under the SLMC’s purview. They should govern the particular institute and see if they meet the proper criteria.
What I heard is that KDU has met that criteria. They have fulfilled that criteria and that is why they managed to train several batches of doctors without any restrictions from the SLMC. Whether it is KDU or any other institute for that matter, if the SLMC has recognised that degree program, if the medical doctors produced from a specific institute and someone is to close down such an institute without any rationality behind it, that will definitely have a negative impact on the nation. These doctors are produced for the benefit of our healthcare system, for the benefit of our nation. The President has also given a positive response regarding the matter. But if the issue is to be dragged on the GMOA will get involved in finding a rational resolution.
Q: Following the recent incident at the Jayewardenepura Hospital where a doctor was arrested for prescribing medicine via a third party, reports are coming in that many doctors around the country are refusing to write prescriptions for patients. Your comment?
A: This is really hurting the doctors. Especially on social media certain factions are abusing and insulting doctors regarding this incident. It is disheartening. This should be investigated thoroughly. Almost all doctors have ordered these drugs which are not available in the sector. Sometimes particular drugs are available under certain brand names which are not effective. That is why doctors have ordered these for the benefit of the patients. If someone says that these medicines were prescribed to gain a commission or a financial benefit, it is wrong.
All have been ordered for the patients’ welfare. For example, you take car brands that can all be categorised as a car. Maruti is also a car, Mercedes is also a car. But efficiency, comfort vary widely. So even medicine is like that. There are efficient brands and inefficient brands. If you are going into surgery, you have to have a trusted brand, which has been trusted for years. You are just trying to get the best for the patients and that’s what the doctors have done.
Q: Not only medicine but there is also a severe shortage of doctors in the country. Should the Government impose a stipulation on those doctors passing out in Sri Lanka, that they must work in the Government sector for a mandatory number of years before going abroad?
A: Actually, in the country’s perspective such a proposal is good. But when you think of practical terms, if the Doctors don’t get an attractive remuneration, a good salary and suitable work environment, however much you prevent them from leaving the country, they’ll find a way to leave.
The pay is not enough. Not just that, but other fringe benefits Doctors receive are much less in comparison to other countries. So your first posting always is in the periphery. Maybe Mannar, Jaffna or Mullaitivu where the facilities are not good enough to hold back a doctor. And the thing is most of the time professionals are centred in Colombo, Kandy, Karapitiya in developed cities.
But they have to travel and travelling allowances provided are not sufficient. The salary is not enough for the Doctors to live. So, however, the law can be changed, but the practical aspect is questionable. Look at India, they try to do the same thing but they leave the country in droves. It’s not just this field. It is the same with any field. Be it, engineering or any other job. If there is a more attractive remuneration package, people will leave for another place. That is just how demand and supply works.
It isn’t just that. Even schools for the children of the Doctors. Back then, a good school was guaranteed for the children, but now it is not so easy. Even during the war we got a good salary and the cost of living was low, so doctors stayed back. Now it’s a different scenario.
Q: This brain drain that you speak of has caused a massive impact on Sri Lanka’s healthcare system, since the economic crisis. With a new Government in office and overcoming the brunt of the economic crisis in the past two years, how does the GMOA see the next few years in addressing the brain drain and collaborating with the State to improve the healthcare system in the country?
A: The new Government has been very receptive to the GMOA’s concerns. President Dissanayake and the Minister of Health Dr. Nalinda Jayatissa have been very positive in engaging with the GMOA. They agree that the existing healthcare system, specially the administrative system, must be restructured completely. The Government has taken into account our opinions in this process.
However, we must remind the general public that the GMOA is a democratic organisation. You can always reach out to us. This is not some closed or exclusive organisation. Our members are the most important stakeholders. The people of the country have elected a particular Government and we are not resistant to that.
We will provide the necessary counselling and guidance to the Government through dialogue. People’s expectations are high for both the GMOA and the healthcare system. But massive corruption has taken root in the administrative sector of this system and we as the GMOA will do everything we can to reform it.
