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| Saturday, 12 February 2005 |
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If we only apply: Sri Lanka in Guinness Book in medical strikes - Dr. Jayasuriya Sri Lanka's Health Services could easily be in the Guinness Book of records in medical strikes, if we only apply for it says Dr. Lucian Jayasuriya former Additional Secretary Ministry of Health, in a booklet he has printed titled 'Towards A Better Managed health Service' based on the speech he made on that subject when he delivered the E.M. Wijerama Endowment Lecture in 2003. We received a copy of the booklet at 'Health Watch' last week. With doctors strikes repeatedly in the air these days we thought Dr. Jayasuriya's views on medical strikes merits publicity. Hence this article: Strikes Strikes are the crucial problem faced by the Government health sector.
They are the bane of the health service today and have been so for some time in the past. I am sure that we will be in Guinness Book of Records if we apply for it. From my personal point-of-view, I do not condone strikes. I did not become a doctor to kill people either by commission or omission. However much some may say that strikes in the health service could be organised in such a way that they do not kill people, I do not believe in it. Maintaining ICUs and carrying on emergency surgery during strikes does not absolve us from the guilt of killing by exacerbating conditions that could have been treated earlier. We must also remember that we as doctors have not only to cure but also to comfort and care. I became a persona non-grata I decided early in my career that I shall not strike under any circumstances. I am happy and I thank God that I was able to keep to my resolution. Maybe it was easier for me because I was in management for a long period. Even then, when I was in charge of a provincial hospital when I was ordered by the GMOA to strike, I steadfastly refused. The result was that the house in which I lived received a few stones in the night and I become persona non-grata for a short while. Go deep into your consciences Maybe some or many of you here do not agree with me. We could speak of the right to strike. What about the right to medical treatment and health of the public? This has to be balanced. I request all of you in government service today to go deep into your consciences and decide whether it is right to strike. Of course we can reply that unless we strike nothing happens. Our demands are not granted. There is some truth in this. The Ministry has come to a state that after few days of strike demands will be granted whether they are right or wrong. Voluntary arbitration proposal In this context, I must refer to the proposal that has been there for the past 3 years. The proposal originated from a leader of the GMOA, Dr. Ananda Samarasekera proposed that there should be a method of voluntary arbitration on trade-union matters. This proposal came with the concurrence of all government health sector trade unions. The SLMA has consistently agitated for implementation of this proposal. The present Minister of Health is the 3rd minister to whom we have made this proposal. He has accepted it in principle. However, the apathy with which it is being pursued cannot be explained. While strikes are the main problem in the health service, when a possible solution is proposed, it is not grabbed eagerly. Progress is at a snail's pace. Three years have gone by, how many have died during these three years? Credit of the present minister To the credit of the present minister, I must say that he has accepted this proposal in principle. A committee was to be appointed. Three months have passed. We have not heard about it. I urge the Minister to have an official in the Ministry working only on this. I know that it is not easy. Amendments to the Trade Unions Ordinance and the Establishments Code are necessary. We in the SLMA would give our utmost co-operation to get these done. Sick notes Something more, about strikes. It is we, the doctors who started what is called 'work to rule'. It is we who started the ridiculous thing called 'sick notes'. Sick notes en mass is nothing but a strike. I can remember when I was in the Ministry of Health in 1996, with my encouragement, the Minister of Health A.H.M. Fozwie, sent a Cabinet paper to say that sick notes en mass should be considered a strike. I remember the Minister of Public Administration agreeing. The President as the Minister of Finance also agreed. However, when it came to Cabinet, a committee of ministers was appointed to look into it. I can tell you that the committee never sat. Salary matters and strikes One common reason for strikes is salary matters. After every salaries commission, somebody is going to say that there is an anomaly. Trade union action is taken to rectify that so-called anomaly. After some resistance, the Government gives in. Then another so-called anomaly is created. Another strike is born. I recommend that the Arbitration Board look at salaries in the Ministry of health. Then, when a so-called anomaly is brought-up, they could see the whole picture and make recommendations. They would be able to refrain from recommending ad-hock adjustments which could be the cause of further problems. They could be asked to review salaries in the health sector on a regular basis as happens in the UK. Restore reputation of our noble profession In this country, there is general feeling that all is not well with the medical profession. We must not let our patients down at every turn. I propose that we resolve not to strike, to restore the reputation of our noble profession. I request the Sri Lanka Medical Council to discuss the ethics of strikes and give guidelines to doctors and other healthcare professionals. Ban strikes I would even go to the extent of proposing that the Government bans strikes in the health sector. I am sure that the major opposition parties would agree. Of course to compensate, the Government should have an established conflict resolution mechanism as discussed earlier. Prof. Colvin Goonaratna-authored: doctor's quest for justice goes centenarian by Edward Arambewala The book written by Prof. Colvin Gooneratna on Prof. Priyani Soysa Vs Arasecularatne Case - 'A Doctor's Quest For Justice' created a 'centenarian sales record' at its launch last Sunday by selling over 100 copies at the launch itself.
Prof. Gooneratna heads Sri Lanka first Centenarian Study of people over 100 years old which is the world's first such study being done in arrogation with the Daily News medical page Health Watch, for the twin objectives of finding any specific reasons that can be attributed for a healthy long life, and also generating respect and honour for human life in society. The launch was held at Galle Face Hotel Colombo on Sunday last, with Chief Justice Sarath N. Silva as the chief guest. A large number of professionals mostly those in medicine, attended the launching of this book. Chief Justice Sarath N. Silva made a very illuminating and interesting speech, interspersed with humour giving a clear picture to the gathering how the judicial system works in this country ensuring people's confidence in the system. Since the Daily News in its issue on Monday carried almost in full the speech made by the Chief Justice, here I confine myself to a few observations he made. Touching on the need for both the legal and the medical professionals to get together and evolve some method to ensure that defensive medicine, which will dearly cost the people seeking healthcare, will continue to be kept out of the country, as referred to by the earlier speaker too. In lighter vein the Chief Justice said, that when he went to live in Narahenpita a few years ago, the neighbourhood was not that crowded, but today he finds the surroundings crowded with skyscraper hospitals, all appearing to be doing well in health business not far away also there are equally big undertaker establishments offering VIP coffins to the public. There appears to be some misfit somewhere. The Chief Justice said Prof. Gooneratne's book should be read by all. It is so well written and educative to the public. "He is one of the greatest professionals we have in this country. A person of the highest integrity and honesty who once when there were some allegations about him wanted a full inquiry held to clear his name, saying that he wanted to walk to any boutique buy a loaf of bread and walk back home. "As Chairman of the SPC, when held that office he turned that institution from a mere Rs. 7 million to a Rs. 206 million profit-making state-run business venture." Prof. A. H. Sheriffdeen, President, Sri Lanka Medical Association, who was the guest of honour at the event narrating the work the Sri Lanka Medical Council as a body did to get justice done in Priyani Soysa's case, said, "We don't want to practice defensive medicine in this country, the two professions legal and medicine should get together to ensure this. He said whatever some of the critics say ninety nine per cent of the doctors in this country are upholding the nobility of this profession. To cite an example, he said, a few days ago he went to the eye hospital at 7.15 a.m. and found the doctors already working in the OPD. This showed their dedication towards the public. Prof. Ravindra Fernando, Sam Wijesinghe attorney at law - Chairman Press Complaints commission and Prof. Janaka de Silva also spoke. Tsunami aid Philippine medical team meets PM President Sri Lanka Philippine Friendship Association Joe Aloysius has sent this picture to the Health Watch, taken recently, when Prime Minister Mahinda Rajapakse met a twelve member Tsunami aid Philippine medical team at Temple Trees.
At a dinner given in honour of the medical team, Mr. Aloysius presented Dr. Romeo Almazan Bituin, leader of the Philippine contingent, with a plaque of appreciation depicting stilt fishermen at sea with the following citation: "Our sincere gratitude to the Philippine Department of Health for sending a 12-member humanitarian medical team to render service to Sri Lankan tsunami victims, from January 06 to 25, 2005". Mr. Aloysius also presented each member of the Philippine contingent with an adorned box of tea as a token of appreciation. |
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Mr.
Aloysius in a communication to us states: The medical-civic team was
organized by the Philippine Department of Health and dispatched to Sri
Lanka as part of the Philippines' contribution to the international
humanitarian effort mobilized in the aftermath of the tsunami catastrophe
that hit South and Southeast Asia and even parts of Africa last year.
