Why clinical governance is missing piece in Sri Lanka’s private healthcare

If Sri Lanka’s healthcare sector wants to keep growing responsibly, we must start embedding clinical governance as a core value, not an afterthought 

The quality gap behind the growth

Sri Lanka’s private healthcare sector has grown rapidly over the past decade. From small clinics to multi-specialty centres, patients now have more options than ever before. Yet behind this growth lies a quiet challenge, how do we ensure consistent, safe and accountable care across such a diverse system?

Unlike large hospitals that have formal quality departments, most small and medium-sized clinics rely on goodwill and professional ethics to maintain standards. Staff do their best, but systems are often informal, undocumented or mostly reactive. When something goes wrong, the response is usually “we’ll make sure it doesn’t happen again”, without a structured way to track or prevent recurrence.

This is where clinical governance becomes essential.

What clinical governance really means

Clinical governance isn’t another bureaucratic requirement or checklist. It’s a framework for accountability and improvement, simply put, a way for every health service, big or small, to ensure that patient care is safe, effective and continuously improving.

In practical terms, it means having systems in place for:

• Clear policies and procedures that staff can easily access and follow
• Incident reporting that promotes learning rather than blame
• Regular clinical audits and quality reviews
• Ongoing professional development for staff
• Having adequate risk register and resources
• Patient feedback used constructively to improve care

When these elements work together, they create a culture where safety and quality aren’t occasional discussions, they become part of the everyday rhythm of a clinic.

Why Sri Lanka needs to talk about governance now

While Sri Lanka has many skilled and compassionate healthcare professionals, the systemic structures to support them are often missing.

Many private clinics operate without formal policies, clear documentation of incidents or internal review mechanisms. This creates several risks:

• Variation in patient care standards between facilities
• Missed opportunities for improvement
• Limited accountability during audits or legal reviews
• Reduced patient trust in private healthcare

With increasing patient expectations and international partnerships, our healthcare sector can no longer afford to treat governance as optional.

Small clinics can lead the way

The misconception is that governance requires large budgets or dedicated departments. In reality, small clinics can implement strong governance systems with a few simple changes:

• nAssign a staff member as a quality and safety lead
• nHold short, weekly “governance huddles” to review one key topic (e.g., infection control, patient feedback)
• nKeep a shared folder for updated policies and incidents
• nCelebrate and document every improvement, however small

These small steps not only improve compliance and patient safety, they also build staff confidence and teamwork.

An action for healthcare

If Sri Lanka’s healthcare sector wants to keep growing responsibly, we must start embedding clinical governance as a core value, not an afterthought. It should be part of how every clinic trains its staff, evaluates its performance and measures its success.

Investing in governance isn’t just about meeting standards, it’s about protecting patients, supporting staff and building a stronger, more trusted health system for our country.

(The writer is a clinical governance educator/advocate and orthoptist trained at the University of Technology Sydney (UTS). She aims to work with healthcare practices to strengthen systems for safety, compliance and continuous improvement. You can reach her on email: [email protected].)