STATE hospitals need to be treated with greater care if the aim is to safeguard public funds and assure reliable services. Reports indicate that the Sri Jayewardenepura Hospital incurred losses of Rs. 827 million last year and if this is any indication, then State hospitals around the country are causing more hazards than curing them.
The service that the public health sector is doing in Sri Lanka cannot be ignored. The ideal of maintaining universal healthcare is a worthy one and it must be remembered that as a developing nation, there are many positives in ensuring that the vulnerable sections of society obtain proper healthcare to found a healthy nation.
For decades, Sri Lanka has managed to maintain strong maternal health, birth and longevity rates due to universal immunisation and healthcare campaigns that have funnelled public funds to creating a healthy country. The country has managed to stay ahead of many countries, some more economically-sound than ours, and on course to achieving Millennium Development Goals (MDGs) because of free healthcare.
Nonetheless, the cancer of corruption has been slowly eating away at our health sector. The level of mismanagement is nothing short of astronomical and if the Sri Jayewardenepura Hospital is one example, then the picture is bleak indeed. While last year saw a loss of Rs. 827 million, the other numbers are equally daunting. The hospital administration obtained a Government grant of Rs. 775 million. The hospital earned Rs. 722 million, while the expenditure stood at Rs. 1,549 million, with the salaries of the staff, including the consultants, amounting to a whopping Rs. 842 million in 2009.
The hospital had owed Rs. 309 million to the Medical Supplies Division last year for the purchase of medicine and equipment. Meanwhile, Rs. 39 million is owed to the National Water Supply and Drainage Board while Rs. 78 million should be given to freight companies, Rs. 3.6 million to the State Pharmaceuticals Corporation and Rs. 6.6 million to Wickremaratne and Company. The Chief Accountant of the hospital has informed the Board of Management that if not for the revenue from the car park amounting to Rs. 5.5 million, the loss would have been higher.
Given how dramatic these losses are, the Health Minister is expected to intervene and has already made three Government appointments to the Board; yet the environment for changes to be implemented must be created or the salaries and other perks given to these people will only worsen the situation, especially since they do not directly increase the services standards provided to the patients.
Doctors make money from private practice, which is known, but what is more startling is how they operate on patients in private hospitals and then have them moved to Sri Jayewardenepura Hosptial as the post-operative care is not only better but cheaper. Hence, the Intensive Care Unit of the hospital has been incurring massive losses as the more serious patients end up at a Government hospital after all.
This is clearly an indication that the private hospitals as well as public ones need to be overhauled. If the patients who go to the former are treated properly, then they would not turn to the State hospitals; however patients are people who need help and whatever procedures that the Government puts in place must assist them. Making doctors more ethical would be a good place to start so that patients can not only have better services, but also get advice that they can trust. Anyone who has had a loved one fighting for his life in a hospital would agree with this.
On a more pragmatic level, a closer look at finances is needed. Public enterprises need to be run as efficiently as possible with special consideration reserved for special cases. The administration needs to be depoliticised as much as possible and doctors must understand that they have a huge responsibility in this regard. Finding solutions is never easy, but they save lives.