Sunday Times 2
SAITM to be run as public private partnership
Having read the article on the above subject appearing in the Sunday Time on July 30 2017, I thought of expressing my views as the only surviving clinical professor of the first private medical college in the country “North Colombo Medical College”(NCMC), which was put up by the college of general practitioners of Sri Lanka in 1981 and taken over by the State in 1990 and converted to the Ragama Medical Faculty of the University of Kelaniya, without any payment by the State as compensation for the beautiful professorial units that were put up by the College of General Practitioners of Sri Lanka, and the buildings put up for the Pre-Clinical Departments and Para-Clinical Departments.
We had no problems like SAITM as the college was run on a private public partnership for the first time in the country, as there was a State hospital with Government consultants and the professorial units were managed by the professors and lecturers appointed by the NCMC and paid for by them. We had enough and more clinical material for our students to learn their work. We passed out eight batches of over 800 students, most of whom I am proud to say are holding consultant posts in the State and the universities of Sri Lanka and many foreign countries. We not only taught them medicine but more importantly to treat their patients with tender loving care.
In 1986 the GMOA and Government Dental Surgeons Association became politicised with the JVP and this led to the closure of the universities for nearly three years. The first batch that entered the NCMC in 1981 passed out after nine years in 1990, holding the world record for the longest medical course in the world.
Now that SAITM hospital has been taken over the by the State, it will be run like Sri Jayewardenepura Hospital as a public private partnership. The State will appoint a director to run the hospital and the medical and nursing staff and all other staff will be appointed by the Government. There will be nine consultants from the State and five professors. So each unit will have around 70 beds. The students will therefore be able to do their clinical appointments and satisfy the SLMC requirements.
The three Pre-Clinical Departments and five Para-Clinical Departments, which have been put up by SAITM, will be run on a private basis with a director appointed by SAITM. The Government’s idea is to have at least 10 private medical colleges in various parts of the country, where a general hospital is already established with consultants available for teaching purposes and for clinical training by the students.
I quite agree with Prof. Mudiyanse that SAITM hospital, being a private one, had hardly any patients for teaching purposes. Thus the students who have passed out from that institution have not had clinical training of six months in each specialty, which was what we did as medical students in our time, and which we carried out at the NCMC. So there is no need for the SAITM MBBS program to be terminated as suggested by Prof. Mudiyanse in his article, as there will be enough and more clinical material for the students.
According to the World Health Organisation (WHO) our doctor to population ratio of 1 to a 1,000 is like any developing country. WHO is insisting that we should double that figure to 2 to 1000 which will require 20,000 more doctors for the country. The State faculties are producing less than 1,500 doctors a year. We have to produce at least 4,000 doctors a year. Each college and faculty should admit 200 students an year. So that 4,000 students will pass out every year, to provide a very satisfactory service like the developed countries in the world. This is why we have to be like Malaysia and have at least 10 private medical colleges. Cuba has the best health services in the world with a doctor population ratio of 6.5 to 1000. It has a population of 11 million and 11 medical faculties.
The GMOA, a trade union, should look after the interests of their members in Government service. Medical education is not the job of a trade union. The SLMC and the academics of the medical faculties of universities are there to look in to those matters. Unfortunately the GMOA like in 1986 has been politicised once again, and with the present regime of a democratic state, they and all other trade unions have been given the freedom of the wild ass, to conduct protest marches and go on strikes as and when they like it. This country should have a guided democracy, as with Singapore, which is today a highly developed country.
The poll conducted by the Ragama Medical Faculty is obviously a biased opinion with around 60% wanting a closure of SAITM permanently. I know for certain that most of the academics are against private medical education. The correct thing should be for the Sri Lanka Medical Council to ask for the views of 20,000 odd members and conduct a poll, which I am sure will reveal a different opinion. I know fully well that many of the academics and consultants in this country send their children abroad to follow higher education and many of them never return to the country.
I agree with Prof. Nilanthi De Silva and Prof. Ranil Fernando of the Ragama Medical Faculty that the minimum standards for medical education which should have been prepared by the SLMC many years ago, have not been gazetted up to now. There are so many defects in the SLMC which was established way back in 1926. We have not followed the General Medical Council of UK, because in UK the council consists of an equal number of medical doctors and non medical persons, where as our council is constituted of only medical doctors.
Freedom of education is a fundamental human right where as free education is not so. Very few countries in the world have free education in schools. We are probably the only country that has free education up to university. I had no free education during my schooling. Fortunately for me Dr. C.W.W. Kannangara, a southerner from Galle who was the education minister in the State Council established free education, “A pearl of great price” from grade one to university in the 1940s. Thus when I entered university in 1946 we were one of the earliest batches to have free education. Otherwise I would never have been a doctor.
Doctors are not the only profession that require both a qualification and a licence to practice. Even lawyers have to abide by the same rules. The job of a pilot is quite different to a doctor’s, if a doctor makes a mistake only one patient will die, where as if a pilot makes a mistake over 100 lives will be lost.
Whatever said and done the Government is determined to establish private medical education in the country on a private public partnership basis. Many private medical colleges will be established in various parts of the country with the Government offering the general hospitals enough clinical material for the students. Once the Supreme Courts give the final verdict, it will be binding on the SLMC, GMOA, SAITM and everyone else, and will put an end to this controversy once and for all.
(The writer can be contacted at wilfred.perera@yahoo.com)