The recent dispute between the doctors’ trade union, the Government Medical Officers Association (GMOA) and Health Minister Rajitha Senaratne highlights how politicised the state run health service has become – and how that has eroded the integrity and efficiency of the sector.
The GMOA, never shy to ask for its pound of flesh despite its members purportedly taking the Hippocratic Oath, staged a strike claiming that the list of post-intern appointments prepared by the Ministry had been tampered with. Minister Senaratne’s son then took aim at the GMOA, launching a scathing personal attack on its members.
Minister Senaratne is a dentist by profession. He cut his political teeth as a trade unionist, being the Secretary of the Government Dental Officers Association (GDSA) for almost fifteen years. That was a time when the GDSA was working hand in glove with the GMOA during the J.R. Jayewardene era to oppose the North Colombo Medical College in Ragama. So, he should know all about the workings of health sector trade unions.
More recently, he was in the forefront of the bandwagon against the Rajapaksa regime, arguing that nepotism had created an oligarchy in Sri Lanka. However as Minister of Health, he is not embarrassed about his wife holding a senior position in his Ministry. Nor does he condemn his son, a parliamentarian, taking up cudgels against the GMOA. Clearly, he believes in one set of standards for the Rajapaksas and a different set of rules for the Senaratnes.
Then we have Senaratne (Jnr). A neophyte parliamentarian, he took to the media to lambast the GMOA in foul language, calling its members ‘sex addicts’. Even Senaratne’s Cabinet colleagues publicly denounced the tirade. We do not know whether the older Senaratne wanted this outburst. He certainly hasn’t condemned it. The GMOA has now threatened to sue the young MP for his efforts.
The doctors’ trade union does not comprise of angels either. They believe that anything and everything in the Ministry of Health should be run according to their dictates. There was a time when they acted as the ‘watchdog’ against malpractices committed by the Ministry bureaucracy. Now, the watchdog has become a law unto itself.
Days before the strike, the GMOA was demanding the resignation of Minister Senaratne. Senaratne is not lily white and may have his faults but hiring and firing ministers is the prerogative of the President and not the GMOA. Drunk with the power that it wields because it can stage strikes that inconvenience millions of patients and thereby embarrass the government, the GMOA will soon want to decide who the Minister of Health should be!
There was a time when the trade union was a principled organisation. Not anymore. To cite just one example, they vehemently oppose private medical education in the country. On the one hand, they claim that the private medical school in Malabe does not provide adequate facilities for clinical training. However, when the government makes an attempt to provide such facilities in the state sector, they object to that too!
Even so, they are not opposed to private practice for doctors or any kind of regulation over the amount of private practice that doctors are entitled to engage in. So, their philosophy is that while the state should foot the bill to train doctors, once trained, they are free to fleece patients through their private practice. The private sector, which is good enough for them to earn money, is however not good enough to train doctors!
What we have then is a bigoted trade union and a stubborn minister, surrounded by family members who believe they are running his ministry. It is a formula for disaster. And, each time the GMOA and Minister Senaratne lock horns, it will be the millions of helpless patients who will be at their mercy.
President Maithripala Sirisena, we hope, will remedy this recipe for disaster. After all, he himself was Minister of Health not so long ago. Or is it too much to expect, even from the President?