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.
I would like to make some clarifications here. It is based on the merit list that appointments are given to doctors. The foreign graduates are placed at the bottom of the list. Invariably they will have to go to remote areas. So working in remote areas is not a choice they make. 1 - 2 years after working in remote areas they will do their maximum to getin to "better" place.
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