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| Sunday, 23 November 2003 |
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Local doctors not consulted - GMOA : Health Master Plan under fire by Shanika Sriyananda The health Master plan initially scheduled to be submitted for Cabinet approval on Monday, November 24 but held back for rescrutiny has raised a hornets nest of protest with many likening it to a master plan to privatise free healthcare. The master plan drafted with JAICA and World Bank funding and dubiously dubbed 'people friendly' proposes strategic frame work for Sri Lanka's health development for the next 10 years. It also promotes the concept of empowering patients to fight for their rights and introducing an national health insurance scheme as a substitute for the free health service. However, Patients, medical professionals and health experts are critical of the recommendations and view them as moves to privatise the sector, depriving the poor of free health care, under the guise of a 10-year development plan. The Government Medical Officers' Association (GMOA) sidelined in the drafting of the master plan claim that local doctors had not invited to give their proposals for the development of the health sector. They also allege that there are factual errors in the drafted master plan. " We heard that we may have to pay for medicine from next year. Is that true ?" asked 72-year-old Hendirik Appuhamy, who had come with his wife Siriyawathi, to the Colombo National Hospital. Appuhamy, who is suffering from diabetics and has a heart aliment had been referred to the CNH by the Kanthale base hospital for specialist treatment. Worried and 'frightened' by the 'bad news', he said that he and his wife would prefer to die without begging money for treatment from their children. "Our children earn a living from seasonal cultivation. We are already a burden to them. Anyhow they give us money for travelling. But, if we have to pay for treatment and drugs...? his expression portrayed their pathetic plight. Chandrapala Perera, retired employee of the Government Press who had came to know about the Master Plan couldn't believe the government would do such a thing. " I do not think that the government will introduce such a foolish Master Plan to kill poor people. This will be a human rights violation", he said. "Millions of poor patients will die without treatment, if this Plan is implemented", he added. Annoyed by frequent strikes by health workers, Chathuri Gamage a mother of two-year-old baby girl, was of the view that the government should not take any steps to privatise free health care service. " We will be helpless if this system is introduced. We cannot afford to get treatment from private hospitals", she said, echoing the sentiment of many others. But she was happy that an ombudsman system would be established under the master plan. Awareness programs The National Movement for the Rights of Patients (NMRP) has condemned the Plan, will hold awareness programs to educate the public on the Health Master Plan. A spokesman for the NMRP told the 'Sunday Observer' that the ultimate goal of the Master Plan was to privatise the health care system, on which 95 per cent of the locals depend on for treatment. "According to Health Ministry statistics only 5 per cent are seeking treatment in private health care institutions. Therefore the government should protect those who do not have the means for private health care", he said. He also said that if the government introduced such a Master Plan millions of poor people would suffer and die without treatment. " The British public health care system has improved greatly, but it is still under state control. A majority of Sri Lankans cannot afford private health care facilities due to poverty", he added. The NMRP is of the view that the country needs a Health Master Plan that does not seek to transform the sector into a profit making venture. "It should be a Master Plan to develop the public health sector, which allocates more money to upgrade state health care institutions", he pointed out. Meanwhile, government doctors have also strongly protested against the Master Plan which they claim is a move to privatise the public health sector under the recommendation of 'foreign' experts. The GMOA on Thursday decided to take strong action against the Ministry, if the government implements the proposed Health Master Plan. "This is a Plan that has been prepared by a team of foreign experts who are not aware of the country's health situation. The sole aim of the proposed Plan is to privatise the state health sector", said Dr. Ananda Wijewickrama, a GMOA Committee member. According to GMOA officials, the Master Plan recommends that all state hospitals function under independent hospital boards, which will decide on allocations, income generating facilities and appointments. " They take the Sri Jayewardenepura Hospital as a model," they pointed out in disbelief. "The Sri Jayewardenepura hospital, which gets more state funds than the CNH, the countries largest hospital, is a 'white elephant'. If the Master Plan recommend this system for other hospitals what will happen to state hospitals and the poor people who depend on these," questioned Dr. Channa Perera of the GMOA. Dr. Ranjini Gamage, Consultant Neurologists alleged that the views of local health experts, on how to develop the state health sector had not been considered in the preparation of the draft master plan. "It was based solely on the recommendation of JAICA and World Bank. According to the Master Plan, the second serious health problem in the country is abortion. Can we implement a Master Plan based on this kind of harsh observations", she asked. Dr. Sunil Perera, Consultant Neurologist of the Colombo National Hospital also said that no Ministry officials investigated the shortcomings in respective units of the hospital before preparing the Plan. According to GMOA officials, the Master Plan seeks to introduce a National Health Insurance scheme, a substitute to free health service while privatizing the laboratory and ambulance services. Dr. Thushara Fernando, Director Planning, Ministry of Health said that this was only a draft document and the final draft would be prepared after consultations with the professional bodies, trade unions and other stakeholders. " Work on the Master Plan commenced in 2002 with financial and technical assistance from the World Bank and the JAICA. The final draft of the Master Plan is an outcome of 25 studies covering all aspects of the health sector. Over 100 local and Japan experts participated in the study with consultations of district and provincial stakeholder", he said. Strategic objectives Government officials claimed the Master Plan had been drafted with the goal of strengthening health system to improve facilities for the people and to help to achieve the highest attainable health status by responding to people's needs while ensuring access to comprehensive, high quality, equitable, cost effective and sustainable health services. The Master Plan has five strategic objectives - to ensure delivery of comprehensive health services, which reduce the disease burden and promote health, to empower communities towards more active participation in maintaining health, to improve human resources for health development and management, to improve health financing, resource allocation and utilization and to strengthen stewardship and management functions of the health system. "This is the Master Plan to address the new and complex demands and challenges for the next 10 years", Dr. Fernando said. |
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