Thursday, April 20, 2017

SAITM – We need some clarity here!

All parties for and against SAITM appear to be pursuing their own vested interests and attempting to score political brownie points, and statements are constantly made by parties that DO NOT MAKE any logical sense, by either party, so that when it comes to the debate and argument amongst citizens they are pontificating about this from THEIR UNDERSTANDING which they believe is right, and that is due to confusing reports by each side, all aimed at confusing, and not CLARITY of each parties’ point of veiw regarding it.

Added to all this at a press conference JUST held with Media Heads, the President has added a further confusing set of statement by speaking in tongues like some kid of saint or holy man, in language that the listener DOES NOT KNOW how to interpret, and like religion, depending on your interpretation of the statement come to conclusions.

The latest salvo is that SAITM is to be listed on the CSE, when last we heard it was going to be taken over by the State to run under the AEGIS of the Government without being a burden on the Government. These kinds of confusing interpretations, meant to clarify are actually adding to the conflicting interpretations, and the public being none the wiser are now being treated to a pigs breakfast of UNTRUTHS!

So lets merely consider the statement of a PUBLIC LISTING of SAITM. If it is a Privatization of the Neville Fernando Hospital then it is straight forward. This is going to be the FIRST listed educational institution in Sri Lanka. So just as the first private medical college that charged fees has cause NO END OF CONFUSION, the SAME WILL HOLD for the listing, of the whole Institution including the Medical School which is JUST ONE PART of SAITM.

The same allegations can then be made if not more! As with a listing, the whole OBJECTIVE of the management is to maximize the return on Investment to the shareholders, and unlike an institution owned by one person, the profit motive is the total basis on which all management decisions will be made.

So if Private Hospitals are OK to run at a profit, and we know the many problems therein, due to unregulated pricing in a system where often, patients making life and death emergency decisions about their loved ones do not really have a choice, then here too there will be no guarantee of standards being met if profit is the overall objective. In terms of regulation, it is fraight with danger, as the state has little experience and knowledge in doing this right. It depends on who is given the task of regulating, and what their motivations are!

It must be remembered that most of the Medicine Practiced in the USA is of what they call NOT FOR PROFIT INSTITUTIONS that do not put shareholder returns at the top, but who try to ensure charges are made so that the institution is able to continue in operation. There is a HUGE difference if those hospital corporations are listed!

All this detracts from the main purpose of say, the Medical School @ SAITM. I believe it should be to provide the BEST possible academic instruction of ANY institution in Sri Lanka for the teaching of Medicine, bar NONE! As students pay a high fee, they can then pay for the best teachers, many of whom are moonlighting from State Sector, and instead giving of their best @ SAITM because they are PAID TO DO SO, and if they are not good they will be fired. At the state Medical Schools, even hopelessly inadequate academic staff can continue in service as NO ONE takes the firm decisions to remove, incompetent faculty.

The single most important argument for SAITM MUST BE that they actually provide a BETTER education than ANY state faculty, and at present as the teaching faculty at SAITM is better than any state medical school, the ONLY area which is used to belittle the quality is the lack of patients of ALL types of illnesses at the Neville Fernando Hospital in order to get the needed training in practical areas of medicine. That is merely a short term issue that can easily be overcome, and appears soon that Avissawella and other state hospitals can be used to provide the needed practical training to ensure they lack for NOTHING.

As can be seen, the detractors and protaganists are losing the wood from the trees, and need to re-focus on the objective of training the best doctors we can possibly train, both in state and in private and semi-private (KDU for example) institutions. If our only objective is to produce the most competent doctors, then we in Sri Lanka have nothing to worry about or care where they come from.

Frankly, due to the insistence on denigrating the skills of the foreign university qualified doctors, they are actually the most fortunate as they get sent to rural hospitals that Sri Lanka qualified state qualified doctors refuse to be assigned  to. You only have to go to Trincomalee hospital to realize that most of the doctors are foreign qualified getting their training there, and one wonders where the Sri Lankan qualified ones have gone to! 

Perhaps overseas with their free SL education, but I digress from the main intention of this essay to raise the readers awareness on the real issues we face as regards who or what is the BEST institution to get a Medical Education and why we think so with proof of that assumption, rather than let emotion get in the way of making a level headed analysis of each to come up with a fair assessment and for the user (patient) to then conclude who they would prefer to treat their illness in full knowledge.