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Why I resigned: SLMC President hits out at archaic Medical Ordinance
“Enough is enough.”
Prof. Goonaratna holds up the Medical Ordinance to make a point at the news conference. Pic by M.A. Pushpa Kumara
This is how the President of the Sri Lanka Medical Council (SLMC), Prof. Colvin Goonaratna who stepped down from his post this week described why he did so.
It was not a sudden decision, he says, explaining that it was mainly due to the archaic Medical Ordinance under which the SLMC has been established. This makes the SLMC ineffective in achieving its primary objective — ensuring the welfare of the public of Sri Lanka.
Prof. Goonaratna told a media briefing held at the Centre for Society and Religion in Maradana on Friday that he informed Health Minister Dr. Rajitha Senaratne about a month ago of his resignation as SLMC Head, giving due notice.
The Medical Ordinance is a legal deterrent which keeps the SLMC from taking important and wise decisions to meet its main objective. “We have long discussions about trivial matters such as minimum standards when our mandate is to ensure the welfare of the public of Sri Lanka,” he pointed out, adding that it does not happen because of the Medical Ordinance.
This Emeritus Professor walked in at 1 p.m. alone and sat alone at the head table, held up the Medical Ordinance with blue covers, whenever he wished to stress a point, explaining that he looked at the Medical Ordinance closely when he was a member of the SLMC for about five years earlier and more recently when he took up the post of President of the SLMC, albeit with some reluctance nine months ago in October last year. There was no option but to resign from this honorary post which he was supposed to hold for five years, because the primary purpose of the SLMC was not being achieved.
The SLMC website states that it is a statutory body established for the purpose of protecting health care seekers by ensuring the maintenance of academic and professional standards, discipline and ethical practice by health professionals who are registered with it.
Prof. Goonaratna was categorical that there has been no political pressure for him to step down but reiterated that the SLMC discussed minor matters and took decisions on those matters without any statistical or logical reasons, purely on a subjective basis.
He tried to bring about changes in the Medical Ordinance but only a few of the SLMC members, “one or two”, agreed with the idea of changing it, but not as a group.
Picking up one aspect – the composition of the 25-member SLMC, Prof. Goonaratna said that, according to the Medical Ordinance, the President is nominated by the Health Minister. One member each, usually the Dean, is elected by the Faculty Board of each of the eight Medical Faculties to be on the SLMC, while another eight members are elected by those registered by the SLMC under Section 29.
Four of these eight members were elected recently from among the Government Medical Officers’ Association (GMOA) leadership, he said, explaining that the GMOA, a trade union (TU) has a membership of about 20,000, with about 16,000 (of those registered under Section 29) not being members of the GMOA. So in an election, who will win is a foregone conclusion.
Even though the SLMC election was held like a general election, under the strict supervision of the Elections Commissioner, to cutout controversy, Prof. Goonaratna said that there was lobbying by the GMOA and on the day of the election, 50 buses carrying GMOA members converged on the SLMC.
Taking up the election of Deans to the SLMC, he pointed out that they are part of the respective Faculties of Medicine Teachers’ Associations, which are also TUs. So, of the SLMC members, 16 or 2/3rds were from TUs.
Next, he asked the media what the aims of any TU would be and got the answer that it was to look after the interests of its members. How do patients’ safety and rights fit into this picture?
Yes, patients can complain to the SLMC about medical negligence, but who prosecutes, who judges and who decides on the sentence, he asked, answering that all those roles were played by doctors themselves. What happens to the complainant? Is there justice?
Citing a research on ‘Medical negligence claims in Sri Lanka’ by lawyer Dr. Avanti Perera, Prof. Goonaratna said that she had carried out structured interviews of 60 people who had made complaints to the SLMC in this socio-legal qualitative study. What was the view of the people – horage ammagen pena ahanawa wage, had been the majority view.
According to him there are about three complaints from patients each month, but as far as he can recall not a single doctor has been found fault with.
So, minor amendments to the Medical Ordinance, which is a museum piece, won’t do, said Prof. Goonaratna, urging a major re-haul of it after studying such laws in developed countries such as Canada, Australia and the United Kingdom (UK).
The UK’s General Medical Council (GMC) has only 12 members, of whom six are doctors and the other six from other professions such as law, architecture, journalism, business management. The GMC members are appointed by a Special Commission which, in turn, is appointed by the Privy Council.
Going back in time to when he was offered the post of SLMC President, when Prof. Carlo Fonseka retired, he said that he told the Health Minister that he could not take up the position because “I don’t like the way it works”.
Then the Minister had asked four others – Prof. Sanath Lamabadusuriya, Dr. Palitha Abeykoon, Prof. Lalitha Mendis and Dr. Ajith Mendis – who refused take up the post. There was much political persuasion and Prof. Goonaratna considered the matter a few months more before reluctantly accepting it.