Online edition of Sunday Observer

The tug of war between paramedics, the Ministry of Health and nurses looks set to continue for awhile, as no assurance has been forthcoming from the Ministry of Health about granting the demands of the paramedics.

But, appreciating, Prime Minister Ranil Wicremesinghe's decision to appoint a Cabinet Sub Committee, the JCPSM has engaged in emergency services in 10 hospitals including the two premier maternity hospitals, the De Soyza Maternity Hospital and Castle Street Maternity Hospital.

The paramedics will now engage in emergency services in Kalutara Ragama, Peradeniya, Batticaloa, Ratnapura, Ampara and Galle hospitals. Routine work at the Cancer Hospital, Maharagama is expected to return to normalacy from Monday.

"In the rest of the hospitals, we will only engage in life saving cases until we get a strong assurance that our demands will be granted", M.I.M. Jabir, General Secretary of the JCPSM, told the 'Sunday Observer'.

According to Jabir, the paramedics will not report for duty at the CNH and the Kandy General Hospitals until they receive a written request from the Directors of the two hospitals. " The Directors said that they are maintaining a satisfactory service without our intervention. So we will continue the strike in these two hospitals until we receive requests from the Directors", he said.

Meanwhile, Dr. Athula Kahandaliyange, Director General of Health Services, has notified the JCPSM in writing assuring that their demands would be considered and also explaining the future action of the Ministry regarding the demands.

The contents of the letter include : an assurance that the JCPSM will be kept informed about future actions of the Ministry on the Junaid Report; the necessary measures that are being taken to improve training courses for the professions supplementary to medicine; and assurance that steps are being taken to present the draft Bill on the proposed Constitution of the Professions Supplementary to Medicine to the Cabinet before the end of next month. Jabir however dismissed the Director General's letter as just a consideration, and not a promise to solve their problems, and said that they could not trust him enough to call off the strike.

Chandradasa and his wife are heart patients, on regular medication. Ideally, they shoudn't be subjected to stress or trauma of any kind. Nor should they forgo their medicine. But the paramedics strike, which effectively brought the health service to an inhumanly jarring halt, has forced thousands like the Chandradasa couple to spend hours in long queues braving the inclement weather, for their quota of life sustaining medication.

Hungry... sick... and ... feeble, we found 52-years-old Chanadradasa and his wife in the serpentine queue at the 'Rajya Osu Sala' outlet, Town Hall. They had been in the queue for hours to buy their monthly 'quota' of drugs prescribed at the Outdoor Patients Department (OPD) of the Colombo National Hospital.

"Solve this problem and ease our torment. Every time when there is a strike we are the ones who are forced to suffer. We are not hostages to win their demands", said Chandradasa who travels from Bulathsinghala to the CNH every month. Every patient in the queue echo his plea and appeal to striking paramedics - "Please don't hold our lives to ransom to win your demands".

The appeal is nothing new. Every time the medical service resort to trade union action, the long suffering patients have been pleading not to put their lives at risk. But to no avail. Few months ago the Assistant Medical Officers went on strike demanding a salary increment, then it was the nurses turn. And now it is the paramedics. Is this going to be the trend of free medical care, until some drastic and unpopular action is taken at some point in future?

Health services in the entire country has been limping to the agonized cries ones of poor patients who can ill afford the exorbitant price of drugs since paramedics launched their much criticized strike action to regain their 'lost professional status', seventeen days ago.

While the much tainted 'Professional Status' acquires a question mark in the wake of callous and selfish strike action, the reality is that daily routine work in most of the hospitals came to a standstill with thousands of outdoor patients being turned away daily. The only government hospital that was functioning smoothly was the Lady Ridgeway Children's Hospital, Colombo.

Over 3,000 paramedics, including radiologists, laboratory technologists, pharmacists, physiotherapists and occupational therapists were on strike, demanding to cancel the recommendations of the Junaid Commission Report.

The strike action has not only crippled the health services and heaped hardships on the poor, but also proved to be a costly affair. According to the Assistant Secretary of the Joint Council of Profession Supplementary to Medicine (JCPSM), M.K.C. Nalaka, the Colombo National Hospital alone has paid over Rs. 3 million every day for laboratory tests including MRI scanning and CT scanning tests to private hospitals since the trade union action came into effect. Fears were expressed about the strike leading to drug shortages in hospitals next year.

However, Dr. Jayasundara Banda, Acting Director of the Medical Supplies Division (MSD) assured that there would be no shortage of drugs next year, but admitted that there would be a shortage in the first quarter of 2004, because the revising of drugs specifications for that year have been delayed due to the strike.

According to Dr. Jayasundara although over 30 pharmacists attached to the MSD were on strike, the Medical Supplies Division had supplied the necessary drugs directly to the hospitals. "We assured the safety of the drugs and distributed the lot daily. The MSD supplied all necessary drugs without any delay during the strike", he added.

According to the MSD Director, the drugs supplied to each hospital exceeds their annual allocation. "There would be no loss because once the hospitals come back to normalcy, the drugs that had been locked in the stores will be issued to patients", he said.

The paramedics strike has also seen the nurses stepping in to fill the void created especially by the pharmacists. But the action is being criticized by the JCPSM which claims it is unethical and illegal for the nurses to handle drugs. However, Ven. Muruththettuwe Ananda Thera, President of the Public Services United Nurses Union (PSUNU) claimed that nurses were more qualified than pharmacists in handling drugs. He also said that although the JCPSM had the right to resort to trade union action to win their demands, they should also be reasonable about what they are asking.

"Demanding a salary equal to that of the nurses who have three years of training cannot be justified. The nurses are in the second grade and they have more responsibilities than the paramedics. The nurses are on duty for 40 hours every week including night shifts, but the paramedics work less than 30 hours and they don't have nigh shifts other than being on-call", the Thera claimed.

Ananda Thera said that the public as well as the Ministry should appreciate the support given by nurses at a crucial time, since there is also a severe shortage of nurses.

Meanwhile, the Government Medical Officers' Association (GMOA), which is in the fore front of the health sector trade union action for due 'professional rights', has expressed disappointment at the way the Ministry of Health handled the issue. "They also alleged that the adhoc decisions would bring a relief to one section by neglecting the others. This would create more problems", Dr. Rukshan Bellana, Assistant Secretary of the GMOA claimed.

Dr. Bellana also said that the Minister of Health should take prompt action to avoid any inconvenience to poor patients. "The routine work of hospitals has been totally paralysed for weeks due to the strike, but the Ministry took weeks to reach an agreement", he said.

He also pointed out that the GMOA was forced to resort to frequent trade union action during the past five years due to the political culture of the country. R.B. Priyantha Kumara, Deputy Director of the Trade Unions of the Ministry accused trade unions of voicing views of their political parties. "Almost all trade union action taken during the past were not to win employees rights, but to for personal benefit", he charged. Kumara also said that the Committee appointed by the Prime Minister would solve most of the disputes in the health sector since Ministers of different sectors were in the committee.

A Cabinet Sub Committee comprising five Ministers was appointed by Prime Minister Ranil Wickremesinghe last week to probe the JCPSM strike and has been instructed to submit recommendations to resolve the issue.

The Committee is headed by Minster Karu Jayasuriya and comprises P. Dayaratne, Dr. Rajitha Senaratne, Vajira Abeywardena and Alick Aluvihare.

* The longest strike: Islandwide strike launched by the GMOA in 1987 over the private medical colleges.