The GMOA’s trade union action over the Nurse-Surgeon dispute at the Colombo National Hospital, is a much-talked of topic among those concerned with the independence of the public service disciplinary process.

Almost all the administrative posts from the Secretary to the Ministry down to the level Divisional Director of Health Services and District Medical Officer are manned by the members of this profession. Supposedly all of them are members of the GMOA or are sympathetic to its cause. Further, all officers delegated with powers of disciplinary control in the line Ministry as well as in all provincial health Ministries are members of this profession and the GMOA.

Therefore, they, as authorities delegated with powers of disciplinary control are responsible to ensure that the rules of disciplinary control are strictly observed under all circumstances.

The GMOA’s strike action has to be viewed against this backdrop. The independence of the public service disciplinary process is guaranteed by Article 60 of the Constitution of our country. It says, "Every person who, otherwise than in the course of his duty, directly or indirectly, by himself of by any other person, in any manner whatsoever, influences or attempts to influence any decision of the Public Service Commission or of any Committee thereof, or of any member of such Commission or of any public officer exercising any powers delegated by such Commission or Committee, shall be guilty of an offence and shall, on conviction by the High Court after trial without a jury, be liable to a fine not exceeding one thousand rupees or to imprisonment for a term not exceeding one year or to both such fine and such imprisonment".

Further Article 55 (5) of the constitution states that even a court of law or tribunal shall have no power to call in question any order or decision concerning any matter of disciplinary control of public officers.

Thus, it would be seen that the GMOA’s strike action against this disciplinary decision is tantamount to a collective attempt to influence the decision of the Public Service Commission and therefore, if not the whole membership that took part in the strike, at least the leadership is guilty of a gross violation of this disciplinary law.

In this instance, it should have acted with due regard to the independence of the disciplinary process and if its member was actually aggrieved by the disciplinary order, it should have directed him to seek legitimate remedy, for any aggrieved party has a legitimate right of appeal for redress, in terms of disciplinary rules.

The members of the GMOA are public servants. As everyone else, they too are expected to have their allegiance to the state at all times and on all occasions when the state has a claim on their services.

They are also required to observe all administrative and disciplinary rules applicable to state officers. According to popular definition, a doctor is one who makes it his profession to take responsible charge of the treatment of the sick with a view, if possible, to cure or palliation. Therefore, nothing is more important to a doctor than delivering said medical care of the highest possible standard to a patient, mother and baby or a client.

There is a host of ethics, practices, rules and regulations that makes this duty obligatory on the part of a medical practitioner.

On taking the Hippocratic Oath, a doctor is bound to observe the code of medical ethics derived from that great Greek physician of the 5th century. On joining the profession, each and every member is required to come to recognition of its collective responsibility for maintaining the standard of conduct expected of it.

More importantly on registration by the Sri Lanka Medical Council, a doctor, whether in public service or in general practice, is required to adhere to the professional conduct set out by it.

According to the booklet on Serious Professional Misconduct issued by the SLMC, the first and the foremost serious misconduct listed there is "Neglect or disregard by doctors of their professional responsibility to their patients for their care and treatment". In pursuance of its primary duty to protect the public, the Council institutes disciplinary processings when a doctor appears to have disregarded or neglected this professional duty.

Thus, the public are entitled to expect that a registered medical practitioner will afford and maintain a good standard of medical care and treatment of the sick that comes under his purview.

Today, the government medical officer is the busiest, the most over-worked man in the country, playing his role in the wards and clinics of the state hospital, although with apparent lethargy, from 8.00 a.m. to 4.00 p.m. and rushing to his Channelled Centre or private dispensary, to be mobbed by hundreds of patients awaiting his arrival, some with sickness and some without. There are also some who do little private practice stealthily during office hours, of whom, few even get netted by Flying Squads.

Further, due to his external interests, today’s doctor is unable to see the patient as a whole person. Dr. Kingsley Heendeniya, a retired health administrator of great reputation, writing an article to the press, recently on "Medical Arrogance and Professional Negligence" quoted an imperious opinion made by the President of the GMOA at a seminar some years back. He is said to have stated "patients are cattle and it is unnecessary to explain anything because they cannot understand". Although this was reported to have been withdrawn on the immediate intervention of the late Prof. R. Kottegoda, the irresponsible way the GMOA wields its weapon of strike shows that it still views the patient as such.

However the poor patient still hopes that the GMOA will one day come to recognize that the business of medicine is healing and not striking against healing.
A. R. M. T. B. Ratnayake
Colombo