Hospital services to be paralysed

By Ranee Mohamed 

Commencing with a fast unto death, a nationwide strike beginning Tuesday, June 29 will cripple 569 hospitals islandwide. The strike will affect 407 hospitals all over the country and 250 other medical establishments, including rural dispensaries. The first symptom of this crippling strike will appear when health workers stage a protest outside the Health Ministry.

"We have had enough," says Convenor, Health Services Trade Union Alliance (HSTUA), Saman Rathnapriya. "The UNP set aside Rs. 3.5 billion to solve our problems, now the present United People's Freedom Alliance (UPFA) is refusing to allocate this money to bring solace to us," he charged.

Rathnapriya said that the HSTUA will also begin a hunger strike. "We cannot cope with pressure from the minor employees who want to fast unto death in their quest for justice and this hunger strike will draw light to the inefficiency of the health authorities of the present government," said Rathnapriya.

"The health minister does not know what he is doing. He is now talking about the Tissa Devendra Report when the UNP government had already found a solution to our problem and promised us that a certain sum of money has been allocated. Now these people are talking about a fresh report. They are not interested in solving our problems at all," alleged Rathnapriya.

The strike will also cripple all government OPD services. "Do not let them strike," said 60 year-old Dharmadasa. "We cannot afford the private doctors. I come to the OPD often and bring my wife here too. I am not in good health at the moment and the strike will mean that we will be deprived of treatment," he said, looking worried about being denied his basic right to medical treatment.

Poor people worst affected

"My husband is suffering with complications of an infection, I am told that it may be dengue fever. We are poor people and I am pregnant with my second child. We are unable to have a square meal. What will we do when the government hospitals are unable to give us medical treament?" asked 25-year old Kanthi waiting at the OPD with her husband.

The proposed strike will, as usual, worst affect the poor, who spend long hours at the out patient departments of the government hospitals and is expected to be the cause of much suffering for men, women and children of low-income families who have no means of seeking private medical treatment.

At a time when both the viral fever and dengue are reaching epidemic proportions and hospitals, both state and private, are full to the brim, the impending strike is expected to have far-reaching consequences. 

According to Rathnapriya about 4,000 nurses, registered and assistant medical officers, laboratory technicians, pharmacists, medical laboratory technicians, x-ray technicians, health clerks, drivers, telephone operators, Public Health Inspectors (PHI) and midwives and the OPD will stop work at all government hospitals on June 29.

"We are prepared for this strike action. The last time they resorted to strike action, the relatives of the patients helped by being with the patients and even wheeling them in and out of hospitals. But we had a problem because they did not bring the wheelchairs and the trolleys back to where they were taken from, hence the patients had to be helped to walk out of the hospitals or be carried in and out of hospital," recalled Acting Director of the National Hospital, Colombo, Dr. Ranee Fernando, . "Most of these medical services can be obtained from the private sector - like obtaining tests and reports," pointed out Dr. Fernando, who felt that the authorities at the National Hospital were fairly  confident of being able to handle the crisis.

Armed forces assistance

"This time I will be seeking the help of the armed forces. As the drivers will be on strike I will seek the help of ambulances from the army and about 25 army personnel. As the supplementary services could be obtained from outside, last time we were able to cope with the strike," said Dr. Fernando. She said that the relatives of the patients will be expected to assist these supplementary workers.

The HSTUA has been agitating on a salary anomaly issue since July 2003, which involves a salary anomalies circular which the trade union claims is vague about salaries for Health Ministry workers in the provincial councils.

"This circular has been made effective for some and not to others. Over 4,500 casual and temporary workers have been neglected and the Registered Medical Practitioners (RMP) too have not been given their due salaries," said Rathnapriya. "The Ministry of Indegenous Medicine and hospitals and institutions belonging to it have also been ignored," he said. "Why are they not giving us the money that Choksy and the previous government allocated to solve our problems? We will give them only one week and then we will take serious action," he threatened.

He said that Health Minister Nimal Siripala De Silva spoke to them and instead of solving their problems laid emphasis on the Tissa Devendra Report. "We are not interested in reports, we want a solution," said angry HSTUA members. "The Minister is trying to dangle a carrot in front of us. We will not be fooled," they said.

When asked about the fate of the poor patients, Saman Rathnapriya said that they have always thought of the poor patients, but nobody has thought of the plight of the workers in the hospital services. "We plan  to exclude the Lady Ridgeway Hospital for Children, the Cancer Hospital, Maharagama, De Soysa Maternity Hospital, Castle Street Maternity Hospital, the Intensive Care Unit and the Emergency Services from the strike. No one can accuse us of being heartless and irresponsible. It is the authorities who are heartless and irresponsible," said Rathnapriya. "What will the authorities do about our fellow colleagues who want to fast unto death? There are so many of them and they cannot be controlled," said Rathnapriya.

Two issues

Health Minister Nimal Siripala De Silva when contacted said that the strike is based on two issues - that the salary increase given to the health sector workers in the central government has not been extended to those in the provincial council sector. "I have had extensive discussions with all trade unions, which took over three hours and we identified the problem.There seem to be some difficulties interpreting the circular. Some provincicial councils have paid in terms of the circular while some needed clarifications and therefore the money was not paid. I have summoned governors and health secretaries and members of the finance authorities, public administration and the Treasury together with representatives of the alliance unions. I have persuaded all provincial councils to pay the health workers," explained the Minister.

Complications

"According to what they are asking, support staff - like for instance a driver in the provincial council has to be paid. This will lead to complications since this system will mean that a driver working for the irrigation services in the provincial council will have to be paid as well. We have to work out the modalities," explained the Minister.

"We have agreed on a very comprehensive solution. They left the meeting agreeing to this. They even thanked me. Then they went on a token strike demanding something that was never discussed - that they want back wages beginning from 1997. This will run into billions of rupees," said the Minister. The Minister also said that together with the health authorities, he had discussions with parallel trade unions and that it was the HSTUA that was being difficult.

The Minister also said that this is the first time in history that a Minister attempted to sort out this problem this way by sitting down with the trade unions and summoning government officials and governors.

Minister De Silva said that this is a problem created by the previous regime and not one of his making. "This matter has been going on for a long time, this is not something that we created," he explained.

Meanwhile, Military Spokesman Colonel Sumedha Perera said that the army has always helped in emergency situations in the health sector. "We have helped with army drivers, cooks attendants etc. We are able to cope with any situation but we cannot deplete our own health services. We cannot take over the responsibility, but we can certainly help in an emergency situation," said Colonel Perera.

A spokesperson for the Sri Lanka Navy too said that the navy has always helped to ease the situation when the health services have struck work. "We are geared to meet such emergencies," said a spokesperson for the Sri Lanka Navy.

Hospitals islandwide are expected to seek aid from the armed services to overcome the difficulties that this health services strike will create, in order to bring relief to the sick and ailing. 

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