Doctor Shortage In Medical Field
By Dinouk Colombage
Health Minstry’s negligence has created a shortage of heart specialists in the government sector
While heart disease remains the number one cause of death in Sri Lanka, a decline in the number of cardiologists and negligence on the part of the Health Ministry has done little to alleviate the issue.
Sri Lanka is facing a serve shortage of heart specialists in the government sector, according to Director of Administration at the Ministry of Health, W.M.M. Jayasooriya. “Doctors who are trained in cardiology often choose to pursue a career in private practice as there is more money,” she said.
According to Jayasooriya the cost of heart surgery in the private sector could amount to as high as a million rupees. “The national health sector cannot compete with the private sector in terms of salaries. We can only hope that more young doctors would be willing to take up cardiology in the state sector,” she added.
However, a heart specialist at the National Hospital, on the condition of anonymity, explained that the continual neglect by the Health Ministry on the cardiologists in the national sector was the main reason behind the decline of the number of doctors.
“They expect us to combat this growing killer in the health sector without providing us with any support. The hospitals are poorly equipped and often we cannot do our job,” the source said.
The specialist went on to say that doctors who are leaving the national sector for the private health care are not doing it only for the money. “Private health care may be more expensive, but they also offer far better support to both the doctors and the patients. These doctors believe that they can better offer their services if they go across to private health care,” he said.
Jayasooriya countered these allegations saying “we are sometimes limited by our budget, but the doctors must remember the national health sector is catering to a far larger number of patients. Private health care can charge high fees as they cater to the wealthy; these high fees go back to the hospital.”
She declined to comment on whether or not the national budget allocation to health care should be raised to counter the issues faced by the doctors.
However, the heart specialist agreed that the national health budget should be increased if they are to counter these issues. “I agree that some doctors are swayed by the money that is offered in private health care, but the Health Ministry must realise that a higher budget would enable hospitals to improve their facilities that would make the work easier for doctors,” the specialist said.
The specialist drew attention to the Kurunegala Teaching Hospital which is severely understaffed, “this hospital was built with the aim of reducing the burden on the Cardiology unit in the National Hospital. Instead there have been no heart surgeons appointed to the hospital.”
Jayasooriya responded that “as it is we are heavily understaffed in this sector, it would be unwise to further spread out the few doctors we have.” She went on to explain that they had decided to concentrate on fewer hospitals, which would allow them to provide far better care.
Sources confirmed that a private unit specialising in heart surgery is to be opened in the Northern Central Hospital in Jaffna. This takes place 30 years after the closure of the national heart surgery unit.
Jayasooriya said that the national heart surgery unit was closed down in the 1970s due to a lack of funding. “With the war having ended it is good news that investors are going in to the region and a heart surgery unit is to be opened,” she said.
She did not believe that it was the duty of the Ministry to have immediately reopened the heart surgery unit in Jaffna. “As I continue to point out, we are extremely short staffed it would be unwise to have opened a new unit there. The National Hospital in Colombo or the Kandy Hospital will have to cater to patients who cannot afford private care. Eventually we will look at opening a cardio surgery wing in the North, but before that happens we need to increase the number of doctors in our service,” she said.
While the administration and doctors continue to pass the blame, it is the patients who are forced to suffer. Lalith Jayakody, a father of a former heart patient, explained how his son passed away last year after his treatment was delayed.
“My son Sujith needed to have heart surgery, but the waiting list was too long. While his condition continued to deteriorate the doctors could not push him up the list. I did not expect my son to go ahead somebody who also needed the surgery, but it seems like for such a prevalent disease the medical industry does not have a plan in combatting it,” he said.
Jayakody added that his case was the not the first he had heard of, “while we were back and forth to the hospital I had heard stories of other patients who have passed away while waiting to be treated. It is one thing to die from a disease, but it is unacceptable to suffer simply because there are not enough doctors to serve the public.”
Director General of the National Hospital, Dr. Hector Weerasinghe, refused to comment on this issue.
Most heart disease is preventable. There needs to be mass health education on prevention – on lifestyle, diet, early signs & symptoms etc. This is a priority in many countries.
I qualified as a doctor from a reputed University in India in 1991. I wanted to come back and work in my motherland Sri Lanka. I was asked to do another year of internship and do an exam called Act 16.
My class mate with same qualifications who was an Indian Citizen was allowed to work in Apollo hospital. He didn’t have to go through these bureaucratic hurdles.
So double standards for Lankans and foreigners. I protested and left my motherland.
I love my country but not the bureaucrats and politicians.
I agree with gamarala. Our health system is focusing on the ill health but has neglected promoting health -the well health. It is true that overseas trained medical grads are facing many issues in SL. because of the red tapes and bureaucratic processes implemented by SLMC/GMOA . They think that (Western) Medicine was born in SL and Sri Lankan Med grads are the best in the world. Huh !!
We all know that doctors and med students do not like to see “graduate” nurses, “graduate” physios, “graduate” medical physicists and other “graduate” allied health professionals. Though the govt (present) wants to produce grads in these fields, who is opposing it ? – Doctors & Medical Students !!
But this is not the case in developed countries where all the health professionals work together as a team to deliver high quality healthcare.regardless of public or private hospitals.
That is the difference !!
Ask Karauna KP Pillaiyan Donkymuthu they will provide some. Or cant you kidnapp some from overseas.
These doctors do not complain those things when they are practicing training on operating on poor mans heart .As soon as they get rich they dont like the smell of the average people but want to reach the rich class.Paradox of Free Education System in Sri Lanka.
Tax payers millions on training these people & govt should change funding Free Education to Loan system like other countries where professional pay back these loans once they get employment (or before leave the country).That way system can train more people to take up those jobs who are leaving.
They need up to date equipment and infrastructure to perform effectively for the benefit of the people. This is what they are asking for.
Also, they need to change their attitude as well.
pity the people. doctor and average man. pay for care is not a option for many but few who pay does not guarantee good care all depend on proper diagnoses and treatment plan. many diseases may be diagonosed but cannot be cured. so kindness and good communication is vital. time is money so a good communicator with the sense of honesty give hope need time space so need to get paiid. rapid public hospital crowds ignorance from public who expect miracles no space time little time for communication explanation.
shortage of doctors burecracy too much political intervention lack of peace persoal safety. too much this and that. favouritism interference
This news item consists of lots of misinformation.There ii no shortage of Cardiologists in Srilanka. Cardiology is very attractive field for young doctors for reasons well known to them. But there is a severe shortage of Cardiothoracic Surgeons in the country. We have only 15 cardiothoracic Surgeons to care for 20 million populations.Cardiothoracic Surgery is not very attractive field for young surgeons. Operations are very complicated and time consuming with lots of stress and strains for the surgeons. Simplest operation needs at least 3 hours to finish.Professional fees for these operations are not acceptable to surgeons with compared to other less complicated surgeries which takes about half and hour to finish.
Secondly It is not true that the government hospitals have less facilities.The government hospitals are better equipped than any private hospitals in the Country. The government’s heart surgeons perform more complicated surgeries than private sector heart surgeons for free of charge.If these surgeries are performed in the private hospitals hospitals bills runs in to multimillion rupees.
To be continued…
Take away 15% of the defence expenditure and spend it on health sector.
Cost of heart surgery in the private sector is unbelievable.There is a very big profit for the hospital from each operations.Private hospitals prefer to recruit Indian surgeons over Srilankan surgeons because of two reasons. one is cheap labor at the expense of quality of care given to the patient.Second reason is Indians do off pump operations which is cost effective.( which yields an additional 100000 rupees as profit for the hospitals).But, hospitals package for on pump and off pump surgery is the same.What they say is off pump surgeries associated with less complications than on pump surgeries which is the Gold Standard against which all other comparisons are made.Off pump surgeries are more profitable than on pump heart surgeries,because private hospitals reuse certain disposable surgical instruments about 10 to 20 times( for ten to twenty patients)before discarding, with risk of spreading some blood born diseases from patient to patient .In the western world, these disposable surgical instruments are never reused due to this risk and these disposables surgical items introduced to the health care services to minimized spread of blood born diseases such as HIV, Hepatitis B and more serious CJD infections similar to bovine spongiform encephalitis.Therefore, in the western world cost for on pump and off pump bypass opera rations are almost the same.Hence, majority of Western Surgeons prefer to do on pump operations for the patient,s safety and Surgeons safety. (To avoid litigation) All most all Srilankan Surgeons are trained in western countries and they do not favor off pump surgeries and they cannot be pressurized to do off pump surgeries.Therefore, private hospitals are very reluctant obtain services of Srilankan Surgeons.Even if they do it is for very low salary.As a result Srilankan Surgeons donot have adequate private practice for their survival. Their pensionable salary ranges from 45000 to 700000 rupees per month in the government sector. Therefore, Cardiothoracic surgery is not very attractive field for young budding surgeons.As a result there will be severe shortage of heart surgeons in Sri lanka.The government will have to import more and more Indians to fill the gap, unless the authorities encourage surgical trainees to take up Cardiothoracic surgery for their higher surgical training.
My relative recently had a heart operation at NHSL and I was amazed by the dedication of the doctors. There are many operations done everyday without charging a cent and I thought of making this note appreciating the commitment of those hard working doctors. The health ministry has no network to look after these doctors and they survive on their own apparently with minimal wages.
The best is when some one is trying to help this problem by building a fully equipped medical training school in Malabe, some of our so called very well learned MP’s(Laugh! ) are trying to stop it. What a bloody Joke.! By the way I think this article is too old. Dr. Hector Weerasinghe is in Los Angelese as the Sri Lanka Consulate for the last one year.