Hon. (Dr.) Hansaka Wijemuni – Deputy Minister of Health

¶ 01 Hon. Chairman, recently the head of the World Health Organization stated that among low- and middle-income countries, Sri Lanka is the best model for health. It is a privilege to open, on behalf of the Government, the debate on the Ministry of Health’s expenditure head today in a sector that is internationally acknowledged.

¶ 02 We are a nation with many achievements in health. But our task is not to keep repeating them; we must consolidate those gains and also pursue what we have not yet achieved. As a government, we plan and work to attain those unachieved victories.

¶ 03 In planning for the health of our people, we face many challenges: demographic change with an aging population; changing disease patterns, the emergence of new conditions, and the re-emergence of others; a clear increase in non-communicable diseases; climate and weather-related health challenges; vulnerabilities in pharmaceutical supply chains due to factors beyond our control; and rapidly evolving scientific knowledge that we must translate into our system. Beyond hospitals, irrational antibiotic use creates further challenges.

¶ 04 Our biggest challenge is that health, an extremely sensitive subject, has been used as a political tool—to win over electorates and capture opportunities. Often front pages sensationalize health stories. As the previous Member said, there were reports like “All surgeries to stop at Karapitiya.” I personally called Karapitiya Hospital; the Director said he had not made such a statement. Yet the newspaper front-paged it, attributing it to the Director, and later carried a small corner correction while running an editorial stoking fear. Even today, certain associations circulate such items. This politicization is the biggest challenge. We say: do not weaponize sensitive health matters. We acknowledge doctor shortages, but do not exaggerate based on dubious lists.

¶ 05 We are now formulating a 10-year National Health Policy with an accompanying strategic plan, grounded in people’s mandate, research, and data systems. It outlines short-, medium-, and long-term reforms: prevention, health promotion, early detection, rapid initiation of treatment, rehabilitation, and palliative care—integrated across the system.

¶ 06 We must strengthen primary care, identify and fix hospital system gaps, and reorganize where needed. Human resources must be optimally utilized; currently, the sector does not fully leverage its workforce. We are preparing measures for maximum efficiency, with relevant budgetary allocations this year.

¶ 07 We have provided for strengthening the pharmaceutical distribution and supply chain and for modernizing the health system with new technology.

¶ 08 An Hon. Member earlier read from a sheet apparently circulated by a professional body. Those sheets contain a mix of truth and falsehood; distributing them to all MPs does not make everything accurate. As a physician of 25 years, I do not wish to publicly debate doctors’ salaries; in any case, a basic salary of Rs. 58,000 for a doctor is not the present reality. More broadly, doctors, specialists, nurses, and all cadres do vital work—much of our health service rests on a tradition of voluntary, unpaid dedication beyond duty. Do not caricature doctors as chasing money. For example, despite grave issues, Maharagama Cancer Hospital doctors historically avoided union action; this time, under pressure from some union leaders, even they were drawn into action. We urge all unions: let us resolve issues through structured, high-level dialogue, not turn individual professionals’ concerns into political footballs.

¶ 09 On medicines, we are resolving shortages. Statistics show improvement. Claims of 200–300 items missing sourced from our website are not borne out—I routinely monitor it. If such lists exist, provide them; we have nothing to hide. Our data systems are transparent to all. We are correcting gaps in the supply chain. At the NMRA, we cleared backlogs of files. Internationally, new drug registrations should be within 300 days; we are meeting that. Unlike past years where allocated funds were not utilized, this year procurement funds were fully and properly used. When we took office last year, MSD had not placed timely orders; we streamlined this. All 2026 orders were issued by 31 January; required 2027 orders have already been issued by 30 November—an excellent position. We are also reforming procurement with ADB support, recognizing medicines are not procured like rice or cement.

¶ 10 Sri Lanka uses around 803 drug items and about 15,600 categories of devices. Of the ~800 medicines, there are issues with about 50; among them, roughly 30 have no registered local supplier and have not been in private pharmacies nor used by clinicians for years—so we must question their necessity and consider alternatives. At hospital level, though about 50 items are short, we have allocated substantial funds for decentralized local purchases—equivalent to the full-year 2024 allocation if needed.

¶ 11 On equipment: angiography (cath) machines—country has 14; in the South, only Karapitiya has one, which had broken down. Many machines exceeded their 10-year lifespan and lacked service agreements. Even devices procured around 2018 need overhauls. We are now instituting service agreements and completing backlogs. Beyond the current 14 angiography machines, we plan to add 15 more this year. MRI machines total 13, with two down, 11 functional; we will add six more. CT scanners are 46; we will add seven more this year. We will ensure service contracts and maximize utilization. Many MRIs stop operating after 4–5 p.m.—we must change that. Mammography units are underused due to tradition of requiring female radiographers; yet most VOGs are male. We must re-examine such practices scientifically.

¶ 12 Our work this year mapped gaps and charted reform pathways; next year is about implementation—senior to junior, one team, embracing change, with better central planning, digitalization, and appropriate use of AI.

¶ 13 We stand for health workers’ rights. We likely know more details than the Opposition about union demands. But we must see issues in the broader economic context. The economy is stabilized, not yet strong. We will address legitimate demands at the earliest feasible opportunity—some dating back 10–20 years were ignored by predecessors. We are engaging unions to find balanced, sustainable settlements; do not grandstand by waving negotiation drafts here.

¶ 14 Hon. Dayasiri Jayasekara: Is that a threat?

¶ 15 No, not a threat—just asking not to misread negotiation papers.

¶ 16 On quality, our average bed occupancy is around 60–65%, yet floors appear crowded. We have asked all institutions to develop plans to address this.

¶ 17 Accountability for medicines lies not only with MSD, SPC, SPMC, and NMRA; hospitals too must function. Many hospitals have not held Drug and Therapeutics Committee meetings for years. Items listed as short are often in MSD stock but not indented properly. Regular DTC meetings would resolve much. Some Regional Directors are unaware of available stocks in their provinces; vigilance must improve.

¶ 18 We also lack storage for increased medicine stocks; this budget allocates funds to double or triple MSD storage capacity and expand MSD distribution vehicles. We imposed ceiling prices in government procurement, significantly reducing costs. Unfortunately, an interim court order prevented regulation of private pharmacy retail prices; we sought relief and gained court’s concurrence to proceed—now we have maximum retail prices and ceiling prices, enabling reductions on about 350 items, as detailed in the Sunday Observer of 2025-11-16, which I tabled.

¶ 19 We have many challenges; let us face them together. Finally, do not name individual officers here based on lists given by hostile companies or unions; many at SPC, NMRA, and MSD are working under threats. If there are allegations, raise them properly—not by abusing parliamentary privilege to endanger lives.

¶ 20 Thank you.