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When the tail tries to wag the dog, it can sometimes look very silly. That is what seems to be happening with the Government Medical Officers Association (GMOA). It is trying to tell the government what to do and what not to do. Now they have issued an ‘ultimatum’ to the government with that familiar threat- a doctors’ strike that will put patients’ lives at risk.

Let us look at the doctors’ demands: duty free vehicle permits, de-recognition of the private medical college in Malabe and scrapping a trade agreement with India. Are any of these directly related to patient welfare? We think not. Rather, they are all linked to the jealous self-preservation of their perks and privileges.

Yes, doctors in this country are poorly paid, compared to their colleagues overseas, but so are other public servants, so they do not merit any ‘special’ treatment by way of vehicle permits. The GMOA says they use the vehicle obtained from the permit to visit distant stations, but the statistics show that most doctors sell their permit for an exorbitant sum to car dealers! They must be visiting their ‘distant stations’ by bus! (Of course parliamentarians do not deserve a duty free vehicle permit either but that is a different story…)

Then they want the medical college in Malabe derecognised because it spells the end of ‘free education’. In principle, there could be some merit in that argument. But let us examine the other side of the coin.

Ask anyone in the medical fraternity and they will tell you that a significant proportion of doctors who have had their free education from Year 1 until their MBBS degree leave our shores even without doing their internship. The country educates them free for eighteen years, with free text books and the lot and what does it get in return? Nothing. Another lot go a step further: they milk the system for another five or six years, completing their postgraduate training and then leave the country, never to return. So, in effect, Sri Lanka is a factory churning out medical graduates for developed countries- for free!

Then, visit any private hospital after four o’ clock and you can see how our medical graduates, nurtured under ‘free education’ rake in the rupees. Most of them charge at least a thousand rupees per patient and see forty to fifty patients a day, spending only a few minutes with each of them, which must surely compromise the standard of care they deliver.

Therefore, if the GMOA wants to derecognise private medical colleges to preserve ‘free’ education, so be it. But let us also then bond our doctors who benefit from free education to serve the country for say, five years. Let us also impose some guidelines on doctors’ rights to private practice such as regulating their fees and setting a limit on the number of patients they see per day. That would be only fair, you would think but I wonder whether the GMOA will be happy with that?

Lastly, the GMOA doesn’t want a trade agreement with India because it fears that Indian doctors will flood the local market. Many countries tightly regulate the employment of doctors by enforcing strict procedures of registration for overseas doctors and this can be easily done; the GMOA does not need to lose sleep over this, unless of course, they are worried about more competent doctors from overseas taking their jobs in private hospitals. This wouldn’t happen in state hospitals because the government would have the last word on who they employ. So, once again, it is all about the GMOA preserving their domain in private practice, isn’t it?

It would be naïve to expect the GMOA to change its tune. Rather, it is time the government called its bluff. When the tail tries to wag the dog, the best way to deal with it is to do what you do to rabid dogs: put them down.

It might be difficult to do but in the long run, it will save a lot of lives.