Doctor Shortage In Medical Field
By Dinouk Colombage
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.