When you talk about the healthcare sector in Sri Lanka, there are pluses and minuses which need to be taken in to consideration.
Despite the fact that healthcare accounts for only two percent of the Government total expenditure, nowadays, there is a trend in most of the state hospitals to maintain the cleanliness, providing a healthy and pleasant environment for the patients, mainly through the influence of the management of such hospitals.
In addition, such hospitals use the latest technology for treatments. Most of the time, doctors and nurses treat patients very well and look after them. You feel the difference right from the moment you enter the hospital. In some public hospitals you can even find separate dining rooms for patients and caretakers.
However, all of their efforts are tarnished when prescriptions are given to patients, with verbal instructions to purchase the medicine from private pharmacies. This has become a habit of most of the governments hospitals, as they are helpless and don’t have abundant stocks of required medicines.
In addition, you often find instances where minor staff behaves unethically. They are rude, arrogant and are sometimes inhumane, as they treat poor patients unkindly and expect bribes from them. This has become a curse in healthcare sector in Sri Lanka.
Then take patients on the other hand. They do not care of the environment. Though there are waste bins, they throw litter everywhere. Washrooms stink because people don’t flush after using toilets and they wet the floors. But I assume, that these are the very people who should keep these places clean. In addition, how many of them are taking the free medicine given (based on the availability) till they recover completely? Or else, they throw it out when they go home from the hospital because it’s free.
Spending money for the healthcare sector alone, is not enough. I believe the Government has to focus disease prevention programmes. Hospitals have to organise simple awareness campaigns for their staff. They must have mechanism to brief patients initially when they get admitted to the hospital, emphasising on the aspects of personal hygiene, environment and the importance of taking medicine on time and continuously, as required.
In this comment, I have not spoken about the Out Patient Departments (OPDs), because that is a whole different story.
Expanding Semi-government hospitals such as the Sri Jayewardenepura General Hospital can bridge the market gap, serving citizens with the help of the government and private sector healthcare. Under this concept, people can obtain treatment under subsidised rates which are less expensive than the private sector.
I am proud to note that Sri Lankan people are blessed with a free healthcare system. The Government allocates a fair share of funds from the annual budget to provide free healthcare services.
However during the last decade there has been a complete breakdown in the system, with the funds being plundered by politicians and administrators. As a result, patients who visit state hospitals have to undergo grave hardships, as they have had to purchase medicinal drugs and obtain laboratory services from external sources.
Many of the healthcare workers from top to bottom play a committed role, but because of few individuals, the good name has been tarnished.
It is commendable that the present Minister of Health, who is a medical professional himself, has taken up the challenge to transform the healthcare sector, maximising efficiency. This cannot be achieved single-handedly, without the support of different groups. The red tape and corrupt practices that exist presently, must be removed.
The network of hospitals and medical centres should be developed throughout the Island, to provide the basic healthcare services, particularly to the low income earners. Currently, various organisations and corporate entities have come forward to develop the healthcare service. So the Government could initiate public-private projects to add value and thus provide a streamlined and efficient service.
Local healthcare largely concentrates on ‘treatment’ based services. It would have been proactive if healthcare services can be significantly invested on ‘preventive’ mode as well, which will improve the health of people and cut down on trivial healthcare expenditure, so that it can be saved for emergencies and serious health treatments. One such example is the prevention of diabetics among children and young people from sedentary life styles and bad food habits.
In terms of perception too, patients maintain a diverse categorisation on hospitals and services.
The main hospitals are overly crowded with patients who come from long distances. There are many patients who come to main government hospitals in Colombo, even though the main hospital in their towns are well equipped to handle such treatments.
A typical example is the Castle Street Hospital for women. Overcrowded with patients the service quality and cleanliness standards encounter many challenges. In contrast, a base hospital in a remote village faces a dearth of staff – doctors and nurses who prefer to serve for a shorter period and most of them seeking a transfer to a hospital in a town with better living conditions. As such these villagers prefer to patronise the nearest district hospital or flock to the main hospitals.
These are good eye openers to reshape the outlook on our healthcare services and set expectations for both parties, the government and people.
There are the organisations that constantly talk, urging middle and lower level employees to eliminate non-value adding activities and minimise waste to enhance efficiency. Thus, thin profit margins are overly concentrated, failing to see that the management is not eliminating waste at the right point where substantial costs are actually generated. As such, companies see the benefit of reducing paper costs, and do not see the escalating cost of higher pay and perks which occur when each new layer is added – a case of seeing the ant and not the elephant.
These are the very organisations where a top person is added to almost every business or service unit, when the CEO or General Manager changes. These are the organisations that aim to grow large and strong, by appointing a new layer. The reason for their decision seems like a blind adoption of a strong assumption that happens to be fragile or baseless. Perhaps as a modus operandi, new corporate management may think that adding layers is like a makeover or face-lift to boost corporate image.
When a tall structure is made taller, reporting lines, authority lines and approval times all tend to lengthen and be ambiguous and complicated. The middle and lower level staff would also feel a psychological blow when they have to climb a much taller career ladder and their career advancement is slowed down.
These employees are deprived of core work and the skills and traits connected with it, which if given would make them shine.
It would not be easy nor fair to rate and generalise the valuable service provided.
It can be observed that in the local healthcare system, the service offering and quality vary depending on the section of the particular institutions. For instance, take one of the main teaching hospitals in a city or suburb. All types of patients are treated in the OPD wards at general hospitals and therefore, such wards are often crowded and the number of patients exceed the number of beds. And the level of attention given by the staff and the chance of getting a clear explanation of the diagnosis are also limited.
On the other hand, specialised units in the same hospitals such as neurology and orthopaedic display good service standards where the staff are more attentive, accommodative and focussed. In this situation, the patient receives almost a world-class healthcare service.
Health is the greatest wealth. We should extend our gratitude for the efforts and expense borne to provide healthcare services to the citizens of Sri Lanka, and thereby uplift the living standards of people.
In many government hospitals, there are resources and the necessary equipment so that the respective unit operates as a fully fledge unit. Given the availability of manpower, expertise and resources, services are provided in a comprehensive manner.
A classic example is the dental unit, which is also referred to and operated as the Dental Institute, as part of the General Hospital. It is equipped with a wide range of equipment to provide the complete range of dental and oral care services, some of which may not be available at private hospitals. The doctors too are experts and the staff is well-trained to handle even the most complicated dental and oral issues. Sometimes, treatment for complex issues might not be available at private institutions even if you are willing to pay a fee.
Many of us are not aware that such services are available at a high standard in the state healthcare system. Due to this fact, people tend to depend on services of private institutions which are generally expensive and have to be handled carefully. It is noteworthy that, unlike many units in governmental hospitals, there are hardly long waiting lists for patients who need to undergo complicated dental surgeries.
This is a facet of satisfactory and high standard healthcare in Sri Lanka.
Healthcare is one such facility in our country which is taken for granted. There are many patients who do not, at least, continue the drugs given by the hospital, while some get back to those poor health habits which they were advised to avoid. The Government spends taxpayers’ money for healthcare and these patients fail to grasp the gravity of their own actions.
There are two noticeable commonalities with the public and private sector healthcare service providers.
One is the limited time allocated per patient. Whether you receive the service without any fee or pay for the consultation, doctors and specialists allocate a small time (on an average 10-15 minutes) per patient. One argument in favour is that in state hospitals the number of patients per doctor is high and as such, few minutes may be allocated per patient. Benchmarks would mean that for certain patients, the diagnosis may need to be, say close to 30 minutes. The doctors may be experts in the given field and will identify the sickness through symptoms at the first instance of the diagnosis within minutes, in most cases. But patients need to be assured and given confidence that they have come to a suitable doctor for treatment.
The second commonality is that regardless of the doctor’s expertise and exposure, only a few of them explain the background of the diseases clearly to the patient. Where the medical profession is concerned, it is an obligation on the doctor’s part to spend sufficient time to make the patient understand the conditions of the illness, aspects of post-recovery and future prevention and as to why a regimen of drugs are prescribed, side effects and etc.
The confidence that the patient has placed on the doctor too is part of the treatment. When a patient is confident about the doctor’s competency, it helps build faith, and create a positive mindset, automatically driving the patient towards a speedy recovery.
The success of Sri Lanka’s health sector is largely due to its effective public delivery system, which provides both preventive and curative care at low cost. Government-provided healthcare is free for all citizens and accounts for almost all preventive care and most treatments. However, the public health sector has inadequate capacity, limited access to specialised treatments and inconsistent service standards. The availability of complex surgical procedures and specialist care in the public sector is limited to the National Hospital of Sri Lanka and a few other large hospitals in major cities. Although there is a long wait for specialist care and advanced procedures in the public sector, the private sector plays a role in addressing this gap, but requires payment up front.
The ageing population and rise in non-communicable diseases (NCDs) will increase the burden on the healthcare system, but rising incomes are likely to increase opportunities for the private sector with higher demand for private hospitals.
There are 555 government hospitals in Sri Lanka, in addition to several hospitals providing Ayurvedic treatments. Ayurvedic Medicine is one of the world’s earliest known healthcare systems. A large number of private hospitals have appeared in Sri Lanka providing more luxurious services than government hospitals, but they are mostly limited to Colombo and its suburbs.
To begin with, I’m certainly grateful to the government for offering free healthcare to all people. While the haves and ‘have-yachts’ may find very little to appreciate about it, for the majority who has limited means, it’s a huge blessing. Often, critics of the healthcare system cite the poor work ethics of healthcare workers; the inefficiencies; corruption of the management and the lackadaisical attitude of political leadership whose sole interest is in paying lip service to the enhancement of the system. In my understanding, however, these behavioural issues don’t render the overall system a failure even though they have certainly undermined it. What we truly need is exemplary visionary political leadership who can address the divisiveness among the major stakeholders of the system and rally them together to serve the noble purpose of healing people.
Also, it’s a fact that every now and then, we come across news reports about medical miracles at government hospitals. I’m optimistic that the majority of the healthcare workers from doctors to attendants are good people committed to their service, but, it’s perfectly normal for them to feel apathetic where they see wrongdoers go scot-free. Healthcare authorities should open their eyes to these ground realities and introduce prompt measures to address them.
When you talk about the healthcare sector in Sri Lanka, there are pluses and minuses which need to be taken in to consideration.
Despite the fact that healthcare accounts for only two percent of the Government total expenditure, nowadays, there is a trend in most of the state hospitals to maintain the cleanliness, providing a healthy and pleasant environment for the patients, mainly through the influence of the management of such hospitals.
In addition, such hospitals use the latest technology for treatments. Most of the time, doctors and nurses treat patients very well and look after them. You feel the difference right from the moment you enter the hospital. In some public hospitals you can even find separate dining rooms for patients and caretakers.
However, all of their efforts are tarnished when prescriptions are given to patients, with verbal instructions to purchase the medicine from private pharmacies. This has become a habit of most of the governments hospitals, as they are helpless and don’t have abundant stocks of required medicines.
In addition, you often find instances where minor staff behaves unethically. They are rude, arrogant and are sometimes inhumane, as they treat poor patients unkindly and expect bribes from them. This has become a curse in healthcare sector in Sri Lanka.
Then take patients on the other hand. They do not care of the environment. Though there are waste bins, they throw litter everywhere. Washrooms stink because people don’t flush after using toilets and they wet the floors. But I assume, that these are the very people who should keep these places clean. In addition, how many of them are taking the free medicine given (based on the availability) till they recover completely? Or else, they throw it out when they go home from the hospital because it’s free.
Spending money for the healthcare sector alone, is not enough. I believe the Government has to focus disease prevention programmes. Hospitals have to organise simple awareness campaigns for their staff. They must have mechanism to brief patients initially when they get admitted to the hospital, emphasising on the aspects of personal hygiene, environment and the importance of taking medicine on time and continuously, as required.
In this comment, I have not spoken about the Out Patient Departments (OPDs), because that is a whole different story.
Expanding Semi-government hospitals such as the Sri Jayewardenepura General Hospital can bridge the market gap, serving citizens with the help of the government and private sector healthcare. Under this concept, people can obtain treatment under subsidised rates which are less expensive than the private sector.
I am proud to note that Sri Lankan people are blessed with a free healthcare system. The Government allocates a fair share of funds from the annual budget to provide free healthcare services.
However during the last decade there has been a complete breakdown in the system, with the funds being plundered by politicians and administrators. As a result, patients who visit state hospitals have to undergo grave hardships, as they have had to purchase medicinal drugs and obtain laboratory services from external sources.
Many of the healthcare workers from top to bottom play a committed role, but because of few individuals, the good name has been tarnished.
It is commendable that the present Minister of Health, who is a medical professional himself, has taken up the challenge to transform the healthcare sector, maximising efficiency. This cannot be achieved single-handedly, without the support of different groups. The red tape and corrupt practices that exist presently, must be removed.
The network of hospitals and medical centres should be developed throughout the Island, to provide the basic healthcare services, particularly to the low income earners. Currently, various organisations and corporate entities have come forward to develop the healthcare service. So the Government could initiate public-private projects to add value and thus provide a streamlined and efficient service.
Local healthcare largely concentrates on ‘treatment’ based services. It would have been proactive if healthcare services can be significantly invested on ‘preventive’ mode as well, which will improve the health of people and cut down on trivial healthcare expenditure, so that it can be saved for emergencies and serious health treatments. One such example is the prevention of diabetics among children and young people from sedentary life styles and bad food habits.
In terms of perception too, patients maintain a diverse categorisation on hospitals and services.
The main hospitals are overly crowded with patients who come from long distances. There are many patients who come to main government hospitals in Colombo, even though the main hospital in their towns are well equipped to handle such treatments.
A typical example is the Castle Street Hospital for women. Overcrowded with patients the service quality and cleanliness standards encounter many challenges. In contrast, a base hospital in a remote village faces a dearth of staff – doctors and nurses who prefer to serve for a shorter period and most of them seeking a transfer to a hospital in a town with better living conditions. As such these villagers prefer to patronise the nearest district hospital or flock to the main hospitals.
These are good eye openers to reshape the outlook on our healthcare services and set expectations for both parties, the government and people.
There are the organisations that constantly talk, urging middle and lower level employees to eliminate non-value adding activities and minimise waste to enhance efficiency. Thus, thin profit margins are overly concentrated, failing to see that the management is not eliminating waste at the right point where substantial costs are actually generated. As such, companies see the benefit of reducing paper costs, and do not see the escalating cost of higher pay and perks which occur when each new layer is added – a case of seeing the ant and not the elephant.
These are the very organisations where a top person is added to almost every business or service unit, when the CEO or General Manager changes. These are the organisations that aim to grow large and strong, by appointing a new layer. The reason for their decision seems like a blind adoption of a strong assumption that happens to be fragile or baseless. Perhaps as a modus operandi, new corporate management may think that adding layers is like a makeover or face-lift to boost corporate image.
When a tall structure is made taller, reporting lines, authority lines and approval times all tend to lengthen and be ambiguous and complicated. The middle and lower level staff would also feel a psychological blow when they have to climb a much taller career ladder and their career advancement is slowed down.
These employees are deprived of core work and the skills and traits connected with it, which if given would make them shine.
It would not be easy nor fair to rate and generalise the valuable service provided.
It can be observed that in the local healthcare system, the service offering and quality vary depending on the section of the particular institutions. For instance, take one of the main teaching hospitals in a city or suburb. All types of patients are treated in the OPD wards at general hospitals and therefore, such wards are often crowded and the number of patients exceed the number of beds. And the level of attention given by the staff and the chance of getting a clear explanation of the diagnosis are also limited.
On the other hand, specialised units in the same hospitals such as neurology and orthopaedic display good service standards where the staff are more attentive, accommodative and focussed. In this situation, the patient receives almost a world-class healthcare service.
Health is the greatest wealth. We should extend our gratitude for the efforts and expense borne to provide healthcare services to the citizens of Sri Lanka, and thereby uplift the living standards of people.
In many government hospitals, there are resources and the necessary equipment so that the respective unit operates as a fully fledge unit. Given the availability of manpower, expertise and resources, services are provided in a comprehensive manner.
A classic example is the dental unit, which is also referred to and operated as the Dental Institute, as part of the General Hospital. It is equipped with a wide range of equipment to provide the complete range of dental and oral care services, some of which may not be available at private hospitals. The doctors too are experts and the staff is well-trained to handle even the most complicated dental and oral issues. Sometimes, treatment for complex issues might not be available at private institutions even if you are willing to pay a fee.
Many of us are not aware that such services are available at a high standard in the state healthcare system. Due to this fact, people tend to depend on services of private institutions which are generally expensive and have to be handled carefully. It is noteworthy that, unlike many units in governmental hospitals, there are hardly long waiting lists for patients who need to undergo complicated dental surgeries.
This is a facet of satisfactory and high standard healthcare in Sri Lanka.
Healthcare is one such facility in our country which is taken for granted. There are many patients who do not, at least, continue the drugs given by the hospital, while some get back to those poor health habits which they were advised to avoid. The Government spends taxpayers’ money for healthcare and these patients fail to grasp the gravity of their own actions.
There are two noticeable commonalities with the public and private sector healthcare service providers.
One is the limited time allocated per patient. Whether you receive the service without any fee or pay for the consultation, doctors and specialists allocate a small time (on an average 10-15 minutes) per patient. One argument in favour is that in state hospitals the number of patients per doctor is high and as such, few minutes may be allocated per patient. Benchmarks would mean that for certain patients, the diagnosis may need to be, say close to 30 minutes. The doctors may be experts in the given field and will identify the sickness through symptoms at the first instance of the diagnosis within minutes, in most cases. But patients need to be assured and given confidence that they have come to a suitable doctor for treatment.
The second commonality is that regardless of the doctor’s expertise and exposure, only a few of them explain the background of the diseases clearly to the patient. Where the medical profession is concerned, it is an obligation on the doctor’s part to spend sufficient time to make the patient understand the conditions of the illness, aspects of post-recovery and future prevention and as to why a regimen of drugs are prescribed, side effects and etc.
The confidence that the patient has placed on the doctor too is part of the treatment. When a patient is confident about the doctor’s competency, it helps build faith, and create a positive mindset, automatically driving the patient towards a speedy recovery.
The success of Sri Lanka’s health sector is largely due to its effective public delivery system, which provides both preventive and curative care at low cost. Government-provided healthcare is free for all citizens and accounts for almost all preventive care and most treatments. However, the public health sector has inadequate capacity, limited access to specialised treatments and inconsistent service standards. The availability of complex surgical procedures and specialist care in the public sector is limited to the National Hospital of Sri Lanka and a few other large hospitals in major cities. Although there is a long wait for specialist care and advanced procedures in the public sector, the private sector plays a role in addressing this gap, but requires payment up front.
The ageing population and rise in non-communicable diseases (NCDs) will increase the burden on the healthcare system, but rising incomes are likely to increase opportunities for the private sector with higher demand for private hospitals.
There are 555 government hospitals in Sri Lanka, in addition to several hospitals providing Ayurvedic treatments. Ayurvedic Medicine is one of the world’s earliest known healthcare systems. A large number of private hospitals have appeared in Sri Lanka providing more luxurious services than government hospitals, but they are mostly limited to Colombo and its suburbs.
To begin with, I’m certainly grateful to the government for offering free healthcare to all people. While the haves and ‘have-yachts’ may find very little to appreciate about it, for the majority who has limited means, it’s a huge blessing. Often, critics of the healthcare system cite the poor work ethics of healthcare workers; the inefficiencies; corruption of the management and the lackadaisical attitude of political leadership whose sole interest is in paying lip service to the enhancement of the system. In my understanding, however, these behavioural issues don’t render the overall system a failure even though they have certainly undermined it. What we truly need is exemplary visionary political leadership who can address the divisiveness among the major stakeholders of the system and rally them together to serve the noble purpose of healing people.
Also, it’s a fact that every now and then, we come across news reports about medical miracles at government hospitals. I’m optimistic that the majority of the healthcare workers from doctors to attendants are good people committed to their service, but, it’s perfectly normal for them to feel apathetic where they see wrongdoers go scot-free. Healthcare authorities should open their eyes to these ground realities and introduce prompt measures to address them.