The SAITM debacle: was it a lost cause?

Completing a troublesome decade of turmoil, confusion, public unrest and corruption, the SAITM saga has finally come to an end with the Supreme Court adjudicating that 82 SAITM students be given provisional registration (to commence internship). 

By Dr. Sankalpa Marasinghe

Completing a troublesome decade of turmoil, confusion, public unrest and corruption, the SAITM saga has finally come to an end with the Supreme Court adjudicating that 82 SAITM students be given provisional registration (to commence internship). 
The end, as it seems, may come as a shock to many who campaigned against SAITM as the judgment simply enables 82 students to undergo internship training after following an undergraduate training, which the Sri Lanka Medical Council (SLMC) has not supervised or approved. The proposed additional training (bridging course) for those 82 medical students by the SLMC which took almost a year for the SLMC members to formulate never reached the courtroom. 
Hence, in spite of the last report of the SLMC subcommittee headed by Prof. Narada Warnasuriya recommending that the undergraduate medical course of SAITM be de-recognized, the court has ruled that these very students should be allowed to undergo internship and subsequently become medical practitioners registered under Section 29 of the Medical Ordinance, the same as any other doctor who graduates from a state university.

Has this battle between two very different, yet powerful camps finally come to an end? Who are the victors at the end of this long-standing tussle which brought ‘collateral damage’ to both camps?
SAITM, the South Asian Institute of Technology and Management as it was named at the inception commenced its operations in 2008. Advertised as “a fully recognized medical faculty” by the SLMC and all foreign Medical Councils, SAITM attracted many students who were willing to pay a hefty sum of money in return for a medical degree. 
However, SAITM neither had recognition nor the bare minimum facilities to conduct a medical undergraduate course. Unhindered by the daring shortcomings, the management of SAITM repeatedly requested the SLMC to grant “recognition” for its medical course. The SLMC, at that point, responded to these requests by highlighting the status of Medical Ordinance which does not have provisions to recognize local private institutes offering medical degree programmes. In fact, the SLMC published a paid advertisement in the national newspapers informing the public about this.

Through 2009 till 2010, many communications between the SLMC and SAITM finally ended the debate, with the SLMC itself suggesting that the only “way out” for SAITM was to acquire degree-awarding status.
This in my opinion is the most important point in the entire saga which many fail to understand. If one is to fully comprehend the long and complicated course of developments during the 10 years which had many twists and turns, it is important to understand the process of recognition and the legal standing of the SLMC and the University Grants Commission (UGC).
 
Simply, although the SLMC is responsible for the quality of medical education in the country and the standard of medical practitioners, the Medical Ordinance does not have provision to recognize private medical faculties started within the boundaries of Sri Lanka. In fact, the power to recognize new private medical faculties is vested with the UGC. This glaring deficiency in the law paved the way for SAITM to acquire its ‘degree-awarding status’ with the full blessing of the then Higher Education Minister S.B. Dissanayake in 2011.
The degree-awarding institute is a state of recognition granted by the UGC under the provisions of the University Act. There is a specific and stipulated path to follow when seeking and granting degree-awarding status. This pathway was abused and degree-awarding status was granted to SAITM which did not even have a hospital to train its students. 
The University Act recognizes two very important reports to be submitted before the authorities accept or reject the institution under inspection when granting degree-awarding status. These reports are: The Institutional Review Report and the Subject Review Report. 

Interestingly, only two medical experts were invited from the SLMC to the Institutional Review Committee and just one expert from the SLMC was invited to the Subject Review Committee. Dr. Sarath Gamini de Silva, Dr. Lalantha Ranasinghe and Dr. N.J. Nonis who represented the SLMC on these two committees unanimously refused to grant degree-awarding status to SAITM. However, a final report was formulated without the signatures of these three medical experts, which recommended the UGC to grant degree-warding status to SAITM. 

The worst part was that by securing degree-awarding status, SAITM stood  qualified to acquire registration from the SLMC under Section 29 of the Medical Ordinance. An amendment to the Medical Ordinance in 1988 included degree-awarding institutes as one of the three types of institutions the SLMC could recognize under Section 29.

In spite of a few failed attempts at courts to reverse this degree-awarding status, SAITM went on to recruit more and more students (two batches per year) and built a teaching hospital with a huge loan facility from state banks. While SAITM was establishing itself with the full blessings of three consecutive governments, growing public unrest and agitation by university students and lecturers boiled into a huge protest campaign.

Interestingly, the response of the Government Medical Officers’ Association (GMOA) to the situation was very dubious. While taking jabs at the government every now and then for supporting SAITM and appearing to lock horns with the Health Minister, GMOA spokespersons reiterated that the union was not against private medical faculties, it is the policy of the government and the GMOA was only concerned about the quality of medical education. This strange attitude kept its raging membership at bay and simply allowed crooked politicians and the SAITM administration to make more money and keep on enrolling students. 

In 2015, a 10-member committee of medical experts from the SLMC visited SAITM for inspection as it had already acquired degree-awarding status and came under the preview of the ordinance. The committee, after visiting and inspecting SAITM, recommended that the institute be de-recognized as the facilities for undergraduate training were not up to standard for it to produce medical graduates. 

However, the Health Minister should authorize this recommendation for it to be implemented by the SLMC and de-recognize SAITM. This never happened and SAITM stands as a recognized medical faculty as far as the law is concerned to date. This was the matter at debate in two consecutive court cases of which the last one ended with the recent judgment ordering the SLMC to register the 82 students who went to court against SLMC.

With the 10-member committee report being published but pending the authorization of the Health Minister, a few students of SAITM moved court to give an order to the SLMC to register them for internship. This sparked a great uprising among medical students and the entire university student population rallied behind them by the end of 2017. University lecturers also joined hands and the protest escalated into a major public uprising. This prompted the government to intervene and a very violent and explosive campaign by the student movement came to an end with the government succumbing to pressure and agreeing to abolish SAITM.

However, a crucial matter remained unresolved: the plight of the 900-odd students who had already being enrolled to SAITM. In reality, the cunning SAITM owners used these very students as a “human shield” just as the LTTE used innocent civilians at Nandikadal. Proposals were forwarded to incorporate these students into the state universities or send them abroad.
 
However, a final decision was made to absorb them to the medical faculty of the Kotelawala Defence University (KDU). Yet, 82 students who had already completed the degree programme at SAITM remained resilient and pursued a judgment to acquire provisional registration from the SLMC.

Technically, there was nothing to prevent them from being given registration except the argument by some in the anti-SAITM camp that it was never recognized by the SLMC. However, looking at it from a purely legal perspective, SAITM had degree-awarding status since 2011 and hence, its students are legally registrable under Section 29 of the Medical Ordinance. This was the basis for the recent judgment by the Supreme Court. However, the members of the SLMC foresaw this and out of concern for the public who would be the ultimate receptors of the services provided by the doctors who get registered under the Medical Ordinance formulated a bridging course for those students who had already completed the course. After months of deliberation, they finally came up with a 38-week additional training programme. But with four GMOA executive committee members coming into the SLMC, this proposal was rejected.

So now, at the end of this exhausting battle what is the status quo?

The South Asian Institute of Technology and Medicine is no more. The SLMC has been ordered to register the students who completed the degree programme. The SLMC has absolutely no way of assuring the general public that these 82 doctors are fit to practise medicine. Whether Neville Fernando will restart enrolling students and bring us back to square one remains to be seen.