National Drugs policy in the offing:

Health Ministry to provide satisfactory service

By Ranil WIJAYAPALA

Controlling non-communicable diseases such as diabetes, cancer and heart disease among Sri Lankans is a challenging situation the health sector is facing today. "The Health Ministry, with the allocation of funds by the President in the 2011 budget, is now working on a four-year program to control these diseases", Deputy Health Minister Lalith Dissanayake said.

In an interview with the Sunday Observer, the deputy minister said that the Ministry of Health is doing its utmost to construct necessary buildings for major hospitals in the country to ease congestion.

"We need to provide better health services to the people and we need modern equipment which is costly. The Government is committed to provide all these facilities to the public with great difficulty. This is a major challenge the health ministry is facing and people should be mindful when they enjoy the benefits of free health services", he added.

Referring to the forthcoming election, he said " I am confident that the UPFA will win more than 80 percent of the local bodies," Following are excerpts of the interview.

Q: The Government is spending heavily on the health sector, have we achieved the desired targets with such a heavy investment?

A: Sri Lanka is having free health and education services. They are enjoying the benefits of these free services. If we take the health sector, the free immunization program has reached WHO accepted standards and targets. In respect of life expectancy, the child mortality rate we are rated high in the Asian region.

When we compare our health sector with these indicators, we are in a high position at regional and global level. But with regard to non communicable diseases our health standards are comparatively at a low level. One out of every ten people are suffering from diabetes in this country. Some people are suffering from diseases like mental stress.

Non communicable diseases are on the rise as the elderly population is on the increase with the increase in life expectancy. We can see many people dying due to heart failure and cancer but the numbers are far less in the case of dengue or rabies.

Q: What action is the government taking to overcome a situation of this nature and to control non-communicable diseases?

A: President Mahinda Rajapaksa allocated Rs. 900 million in the recent budget for a four-year program to control non-communicable diseases. The President has regarded this situation and given it top priority. For this year alone Rs.300 million has been allocated. Parallel to this program, the World Bank after evaluating the importance of this program has agreed to assist. We are going to implement a program at national level in association with provincial health ministries and other relevant ministries to control these diseases. The health ministry alone cannot handle this program as we have to change the food patterns among the public and inculcate the habit of daily exercise.

Q: The Government is investing a lot of funds to improve health infrastructure facilities, like buildings for hospitals and other health institutions. In some instances people are not reaping the expected benefits from these projects. What is your position about this situation?

A: If we take major hospitals like, Colombo, Kegalle, Kandy, Karapitiya and Peradeniya, there are no unutilised buildings, in fact there is a severe shortage of buildings. There maybe some buildings that are not in use in the provincial and rural sector. We need Rs.430 million to construct a building complex for the Sirimavo Bandaranaike Hospital in Kandy but we only have an allocation of Rs. 40 million for this year. If we have enough funds we can have another major hospital for children, apart from the Lady Ridgeway Hospital in Colombo and ease off congestion in Peradeniya and Kandy Hospitals. Even at the Kandy General Hospital, the operating theatre complex is under construction for more than four years. If we can expedite the construction of these buildings we can ease congestions. We are maintaining the health sector under such difficult circumstances, as we faced a three decade long conflict in this country.

Q: The health ministry launched programs to control vector-borne diseases like the dengue epidemic at national level. But people are not enthusiastic any more in these programs. What is the current situation of these programs?

A: There is a perception that programs of this nature are implemented when there is an epidemic. This is wrong. We are implementing these programs continuously at national and provincial level.

Although malaria has been controlled to a great extent, we are even implementing a program to keep the disease in check. A TB control program is also in place.

However, we have found that people take effective measures only when there is an outbreak. With regard to hygienic conditions in food, our systems are operating at regional level with Public Health Inspectors. Since there is a dearth of officials there is difficulty in carrying out these programs.This is the reason why incidents like the one in Vavuniya where a school girl succumbed due to an adulterated during she had consumed. However, now we are monitoring the supply and manufacture of these drinks being distributed in the country. Traders get the advantage of the situation where individual checks cannot be made. But when something happens, it is the health authorities that have to take the blame. There are deficiencies in the free health service because we are not equipped with all the facilities. Therefore, people should also be mindful about this situation.

Q: There are complaints from the people that they have to bribe health officials and minor employees to get work done in hospitals. This situation has become a very common feature in the Cancer Hospital in Maharagama. What steps does the health ministry envisage to curb such a situation?

A: There are two sides to this. People do whatever they can to get their work done and they are even ready to bribe the health staff in order to get their work done. It is because of this that they do not bring it to the notice of the authorities. This should not happen and should not be allowed under any circumstances. According to my knowledge, the health authorities are taking every possible step to avoid such situations. But, people should also be mindful not to give bribes or resort to unnecessary methods in order to get the work done. If we receive any complaints, we will take action against those who are responsible.

Q: What steps has the health ministry taken to fill vacancies in the health sector?

A: We had to fill a large number of vacancies among minor staff. After many years we gave promotions to labourers as a result fresh vacancies have arisen for labourers. This has had a domino effect and hospitals are finding it difficult to run their services smoothly. Therefore, we are in the process of filling these vacancies. We have also recruited a large number of nursing staff over the past few years and trained them at the Nurses Training Schools. We are also able to fill vacancies in the Medical Laboratory Technicians cadre.

Although, we could not fill 100 per cent of the vacancies, we have achieved a satisfactory level by filling nearly 70 to 75 per cent of the vacancies in the health sector. We also recruited 500 mid wives a few months back and we are going to recruit another 500 mid wives very soon. We have also recruited large number of doctors.

Q: There was a program to train some health staff like nurses and send them abroad. What is the present status of this program?

A: We are facing some problematic situations with regard to these programs. We can train them and send them abroad. But, we also need their services in our hospitals. There are groups who are against such programs. If there is no trade union action we can join the Vocational Training Ministry and train people who have a knowledge in English for good jobs and solve the unemployment problem to a great extent.

Q: What are the steps the health ministry has taken to change the attitudes of health staff towards patients?

A: Since a change in attitude towards patients is an essential, health sector institutions are conducting several programs to train employees. Programs are being conducted mostly at Provincial level. We are conducting programs to change attitudes to run a better health service and to settle problems relating to their jobs.

Q: What is the plan with regard to providing quality drugs at lower prices for the patients?

A: We have launched a program to formulate a National Drug Policy which can satisfy all segments of society. We understand that this is a very difficult task. We are discussing certain issues at this stage and we expect to present the Policy to Parliament shortly.

Q: Strikes and other trade unions actions resorted to by health sector employees put patients into a dilemma and this happens several times a year. What are the steps taken by Ministry to minimize such situations?

A: When we take the health sector there are 104 health sector trade unions. The first thing we have to remember is that there is no health service without patients. They are paramount. If we are healthy people we do not need a health service.Now we must look at it from the patient's angle as well as from the health service angle. We have to think of these situations afresh and resolve these matters through discussion. We continue to resolve trade union matters through discussion.

Q: The national immunization programme faced some problematic situation in the last year. What is the current situation of the national immunisation programme?

A: The national immunization programme was hit due to the death of a girl after taking the rubella vaccine. The entire programme was criticised by the media following this incident. They should be mindful of all the factors before criticising it. I don't think that such things happen intentionally. If there was negligence we could take action against the parties concerned. We are streamlining the national immunization program after the setbacks we faced last year. There was speculation over the vaccination we used for AH1N1 alleging that the vaccines had expired. We are continuing with our program, now nobody is talking about it. It is good to be alert but it is not fair to make undue criticism.

I have to say that all health sector employees, Specialist doctors, nurses and all the other health employees are working with dedication and commitment to provide a better service to the public.

Q: What is the relationship the Health Ministry has with Provincial Health Service?

A: We have a very good relationship with the Provincial Health Service.

According to the 13th Amendment a major part of the health sector programs are implemented under provincial health ministries, but they alone cannot solve the problem. For example, the dengue eradication campaign was successful because all the Provincial Health Ministries, Local Bodies and the Police and other organisations worked together. If we worked as individual organisations, we could not have achieved that task. Health problems are not a problem with regard to doctors or the Health Ministry, We should work together to overcome the issues.

Q: What are the challenges the health sector will face in the near future?

A: We have to get high technology to provide the best service to the public. But these are very expensive equipment. The government is taking maximum effort to purchase the equipment and provide the best possible service to the people.

That is the most challenging situation we have to overcome in the health sector. People should understand this when they enjoy the benefits of the free health service.

Q: How do you see the forthcoming Local Government elections. How do you think the UPFA will fare in the elections?

A: The UPFA has done a lot to the rural areas and also for the entire country. President Mahinda Rajapaksa has also fulfilled all his obligations by the people. Therefore, I am confident that the UPFA will definitely win the election.

Q: But there is severe criticism over the soaring cost of living by the Opposition?

A: There is no government which could bring down the cost of living.

First thing we should consider is that we eat rice. But no one is talking about the reduced rice price. To reduce the price of rice we have taken steps to provide a fertiliser subsidy to farmers. In some countries like Egypt, the leaders had to go home.

In some countries in the Asian region, there are street protests against the soaring cost of living. But there is nothing like that in Sri Lanka, because there is no such burning issue in the country, although the Opposition is trying to draw the people into street protests. I am not saying that everything is hunky dory.

People are facing problems but there is no situation where people are dying of hunger. There are ways and means for people to earn, if they work hard.

The prices of tea, rubber and cardamom has been increased. But no one is talking about this. All they are talking is about prices going up like in the case of chillies.

Q: What do you predict at the forthcoming Local Government elections?

A: I believe that the UPFA will win more than 80 percent of the Local Bodies.