The Hon. (Dr.) Kavinda Heshan Jayawardhana

¶ 01 That should be said by the Health Minister. The debate is also being opened by a doctor.

¶ 02 Hon. Minister of Health, you know there is a serious medicines crisis. Of the 862 essential medicines in the country, 131 are nationally out of stock. At the MSD, 218 items are out of stock. I table the list titled “Nationally Out of Stock Medicines,” obtained from the Ministry website, which shows around 160 medicines out of stock nationally, and I also table “Out of Stock Medicines at MSD.”

¶ 03 What should we do? We must strengthen local pharmaceutical manufacturing. Previously, prior to your new Director’s appointment, product registrations for local manufacturers took 400–500 days; now it has dropped to around 200. But to compete regionally, note India takes 30 days and Bangladesh 90 days. I request reducing our timelines to 50–60 days at least, for formula approvals, manufacturing licences, new registrations, provisional registrations and renewals.

¶ 04 On pricing: the National Medicines Pricing Committee sometimes sets arbitrary prices, even different prices for the same product. Countries like India and Bangladesh benchmark to European standards/prices. We should adopt a single national policy. Bioequivalence and evaluation: some firms get biowaivers and comparative dissolution against innovator brands; others are cleared on generics alone. We need one consistent policy.

¶ 05 For example, the same composition Amoxicillin + Clavulanate Potassium 1000 mg tablet is priced at Rs. 70 for one company and Rs. 197.12 for another. I table documents. We need a single pricing formula.

¶ 06 Another urgent issue: appointment of proper Directors to major hospitals, including the National Hospital, Colombo, and Kandy National Hospital. At the National Hospital, about 26 biochemical tests are intermittently stopped — including blood sugar, cholesterol, SGOT/SGPT, creatinine. Troponin I testing is sometimes done only during daytime and not at night.

¶ 07 More gravely, for CABG and other cardiac surgeries, due to lack of consumables, patients are asked to bring items from outside; I have the list and a bill for Rs. 105,434.45, which even includes VAT Rs. 12,868.04, despite promises to remove VAT on medical devices. Many poor patients cannot afford this. Of five angiogram machines at the National Hospital, four are reportedly down. Can a single machine clear massive waiting lists? In the South, only Karapitiya has an angiogram machine; in the East, there is none. Patients’ lives are at risk.

¶ 08 Our indicators remain leading in South Asia due to the dedication of doctors, nurses and health staff, despite drug and lab constraints. The Government should address doctors’ longstanding demands. The GMOA wrote on 30.07.2025 to H.E. the President seeking a special service category and salary structure reflecting performance, quality and market value. These are reasonable. DAT (Disturbance, Availability and Transport allowance) should reasonably be around Rs. 260,000 per month; the previous Government only increased it from Rs. 35,000 to Rs. 70,000. They also request inclusion of all eligible categories under Circular 22/99 for official transport, and conversion of extra duty allowance into a fixed monthly allowance; these are fair.

¶ 09 The postgraduate foreign living allowance predates COVID-19 and inflation; it should be revised. On vehicle permits: a Rs. 3 million tax concession was effectively provided; if we cannot permit imports, alternatively provide official vehicles as for MPs, or create a practical transport facility. Doctors contribute significantly to tax revenue; adjust PAYE to give relief.

¶ 10 Promote a research culture with funding; it improves adaptability and job satisfaction.

¶ 11 Many benefits are not paid: one-third duty allowance, one-third leave allowance, 35% research allowance; around two months’ salary is effectively lost to taxes, leaving 10 months’ income; lack of tax-free vehicle access costs about Rs. 60,000 per month; concessions under 1076 are not provided.