‘The Island’ of March 19, quoting Health Minister Nimal Siripala de Silva, said that 48 doctors serve at the OPD of the Colombo National Hospital daily. Accordingly, on any given day we can expect at least around forty doctors serving in this vital health centre.

As a frequent visitor to the OPD, I am yet to see at least half of them stationed at the OPD. Early in the morning there will be a huge rush and after around 11.30 many doctors will quietly leave the office and not return to see the patients. They are the most blessed public servants in the country. Nobody knows where they are. At the end of the month they will receive their full pay with over time payments as well. There is no need for them to prove their attendance. It is an open secret that only half of the doctors will be present daily and others will be on private practice. Even half of those present in the morning will not be there in the afternoon.

Generally, in the public sector, the cadre is created based on a needs assessment. But as far as the doctors are concerned, it is they who create cadres for themselves each year as and when the doctors come out for post internship appointment. The rationale should be to appoint doctors to hospitals where there are vacancies. But here, according to the terms dictated by the GMOA, each year doctors will be appointed to major hospitals, such as, national and teaching hospitals, where the cadre will be irrationally expanded.

Once the Health Minister asked the GMOA to specify how many doctors need to be stationed under a consultant. But the GMOA still keeps silent and as a result in major hospitals there are much more than 15 to 20 doctors working under a consultant, an unprecedented situation in rest of the world.

It is only now we understand why the doctors stand in the way of many proposals put forward by the Health Ministry. They even opposed the introduction of a Patients’ Charter, leaving behind other progressive proposals, such as prescribing medicine in generic names. As The Island previously editorially commented, many deadlines set by the Health Minister for the health sector ended as mere headlines in the media. Once, when the doctors were on a work- to- rule campaign, the then Health Minister said it is more than enough if they work- to- rule in hospitals. Because, the patient can see the doctors work in the OPD till 4.00 pm daily.

Therefore, I humbly request the authorities in the saddle of the Health Ministry to if they are unable to bring a Patients’ Charter, to introduce a mechanism to show how many doctors are on duty at OPD.

Health and education are the two major public goods provided free of charge to the poor masses but it appears that these two sectors are maintained now not for the benefit of the masses but for the mere survival and growth of their work force.

For obvious reasons, I wish to remain anonymous.