The Hon. (Dr.) Hansaka Wijemuni - Deputy Minister of Health

¶ 01 Hon. Presiding Member, I thank Hon. Amila Prasad for presenting this question paper to the House today during the Adjournment Debate. He raised a number of questions.

¶ 02 First, I must say the health system is a sector that must be built and demonstrated with great care. We approach and advance it entirely on a scientific basis. As a Ministry, we have a ten-year plan to guide our work, and to operationalize it we have developed a Strategic Plan. We work within that Strategic Plan. Health is not merely putting up buildings or dispensing medicines; it encompasses a wide range of concepts—from disease prevention, to providing facilities for patients who are severely ill, to arranging the environment needed for post-condition management. Our responsibility spans a very wide range.

¶ 03 On the hospital system, we have a plan for how buildings will be constructed over the next five years, how recruitments will be made, and how equipment needs will be met, integrated through internal management. You also know that the highest-ever allocation in history has been made for the health sector.

¶ 04 It was presented that there is a shortage of doctors and of nurses. Yes. All categories of the health workforce are facing shortages. This is not something that happened overnight; it has developed gradually over time. One reason is that our health system expanded not according to a coherent, structured, integrated plan, leading to various deficits.

¶ 05 As for doctors, there are currently 22,623. By the end of 2025 and 2026, 8,133 doctors are scheduled to be recruited. That means we will be recruiting a number equivalent to nearly one-third of the current cadre, which clarifies the scale of our response.

¶ 06 Similarly, there are about 40,000 nurses. We have planned to recruit a further 13,000. In addition to doctors and nurses, we need other technical professionals who cannot simply be sourced ad hoc; they must be produced through planned training. At present, about 2,500 doctors are added to the system annually. With this, we can expect to address the shortage of doctors soon. However, we will continue recruiting doctors to ensure not only quantitative expansion but also qualitative improvement of services. Our objective is to transform the service into one that is both quantitatively adequate and qualitatively strong.

¶ 07 All other staff categories also have shortages. To address them, we are proceeding with a clear work plan. The number of doctors required, nurses required, and other staff required is determined through a cadre revision. Unfortunately, many previous cadre revisions have been unsuccessful. Therefore, the Ministry of Health, the Ministry of Finance, and other institutions have formed a committee to develop a scientifically grounded cadre revision through extensive consultations. This is now in its final stage. Within about a month, we will be able to determine the exact cadre required for each hospital by year.

¶ 08 On medicines, I believe there is now much less talk about drug shortages in Sri Lanka because many issues have been resolved. Nevertheless, occasional scarcities can arise anywhere in the world, and supply-side challenges can occur. We are discussing how best to face such situations and are seeking appropriate solutions. To make the medicines procurement process more efficient, with the assistance of the Asian Development Bank we have devised a structured new procedure, which is also in its final stage of discussion. We are strengthening inter-institutional coordination and connectivity and implementing the necessary procedures for that. We also convene the Medicines Review Committee every week at the Ministry.

¶ 09 To resolve distribution issues, we are using technology to the maximum. We are rolling out the SWASTHA software across all hospitals. As Hon. Aruchuna pointed out, more remains to be done, and we will do it even if some are not very comfortable with digital systems. Currently, the system operates at the drug store level; we are extending it downward to ward level and OPD level. This will enable anyone in the country to transparently see what drugs are available and what are not.

¶ 10 We have allocated the largest-ever sum in history—Rs. 185 billion—for purchasing medicines and surgical equipment. Regarding pharmacists in private pharmacies, some owners raise concerns. However, our calculations show that there are currently about 600–700 qualified pharmacists not in employment in Sri Lanka. We therefore urge pharmacies to hire their services—both degree-holders and diploma-holders. We are also increasing the output of diploma-holders and degree-holders. The diploma examination has a high failure rate; we have proposed alternative methods to reduce it, and these will largely be implemented from this year.

¶ 11 Hon. Presiding Member, please allow me one more minute.

¶ 12 On the progress of Primary Medical Care Centers, we have already established centers, but it is too early to fully assess progress. After at least 500–600 new centers come into operation, we can better evaluate outcomes. We have developed the necessary tools to monitor progress at this stage and are proceeding accordingly. We are pleased to note that these centers are functioning close to expected levels.

¶ 13 We must also address staff recruitments. You all know how recruitments to the Ministry of Health were done in the past—one time from Polonnaruwa, another time from Kalutara, another time from Ratnapura—and now our biggest challenge is granting transfers to return these staff to their home areas. We have not done that. For the first time in Sri Lanka, we issued a Gazette for recruiting minor employees. Previously, a paper notice outside the Ministry would say “Staff will be recruited,” and selections were made from MPs’ lists or the Minister’s list—often excluding even the Deputy Minister’s list. This time we are making appointments on a district basis with no political involvement.

¶ 14 However, there is a practical issue: we cannot call all applicants for interviews. We can recruit 1,900, but we received 102,000 applications. Deficiencies in the process can occur, and we are monitoring for any. But there will be no politically-influenced recruitments. Regarding Hospital Committees, appointments are made entirely through a lawful process. If any unfairness arises, we will consider it; similarly, if the public in an area proposes a person to serve on a Hospital Committee, we can consider that as well.

¶ 15 About the Jaffna Hospital drug store fire that Hon. Aruchuna mentioned—it is a very serious matter. If it was an act of arson, that is even more serious. He personally came to the Ministry and lodged a complaint. I immediately called for an investigation, and we expect rapid progress.

¶ 16 In conclusion, as a Ministry we are moving in a more structured and organized direction. We continuously measure how successful that journey is. We believe we can take all necessary steps to deliver a better health service for the country. Your positive and negative feedback is very important to us as we proceed.

¶ 17 Thank you very much for this opportunity.