Hon. Sajith Premadasa – Leader of the Opposition

¶ 01 Hon. Chairman, it was stated that the world has recognized Sri Lanka’s 76-year health record of excellence—declines in infant and maternal mortality, increased life expectancy, and many positive indicators. That is progress over 76 years. Those who speak of a “76-year curse” ignore WHO, UNICEF, and UNFPA who acknowledge these gains.

¶ 02 Comparatively, life expectancy at birth: Sri Lanka 77.2, world 71.4, South-East Asia 68.4. Maternal mortality per 100,000 live births: Sri Lanka 18.3, South-East Asia 96.3, world 197.3. Neonatal mortality per 1,000: Sri Lanka 4.1, world 17.3, South-East Asia 16.1. Are these not 76 years of progress?

¶ 03 Hospital beds per 1,000 (circa 2020): Sri Lanka 3.6; South Korea 12.8; Japan 12.6; USA 2.7. We must improve further—especially ICU beds: we have about 2.5 per 100,000; it should be at least 50.

¶ 04 Today there is a severe medicines crisis. Nationally out-of-stock items are around 100; at MSD, 218 items are out of stock. These are not union handouts; I take responsibility for these figures and will table documents. At the National Hospital noticeboard, a list shows tests not being done at the Medical Research Institute: Total IgE, Vitamin B12, dsDNA, Allergen-specific IgE, dengue PCR, Hep A/E, HSV, Mumps, Rubella, ANA, etc. These are essential for diagnosis; why are they unavailable in a free health system? I table the lists of MSD out-of-stocks and nationally out-of-stocks.

¶ 05 I acknowledge that instant fixes are hard; there are equipment shortages and system strains. Patients are told many investigations must be done outside: endocrine (TSH, cortisol, insulin, C-peptide), biochemistry (free calcium, ALT, amylase, magnesium), hormone panels, etc. Is this your “system change,” while you deride the 76-year legacy?

¶ 06 We face a brain drain. Before the economic crisis, about 200 doctors left annually; in 2022–2023, around 1,800 left. What’s the retention policy? Push factors: low pay, high cost of living, poor working conditions. Pull factors: better pay and quality of life abroad. A general doctor here earns about Rs. 58,000; in the UK roughly Rs. 1.75 million (equivalent), Australia Rs. 1.54 million, Oman Rs. 0.96 million, UAE Rs. 2.74 million. Specialists here earn about Rs. 88,000; in the UK ~Rs. 3.7 million; Australia ~Rs. 2.7 million; Oman ~Rs. 1.6 million; UAE ~Rs. 3.3 million. Will they stay?

¶ 07 I show photos of hospital quarters—poor conditions. If we want brain retention, adopt measures: extend unpaid leave options; consider limited private practice within state service; revise DAT; introduce retention-oriented tax policy; amend Circular 22/99 on official transport; increase foreign living allowance for trainees; enhance research allowances and promotions. This is not only for doctors but across cadres. Also consider vehicle permits or equivalent facilities to retain highly skilled professionals—doctors, senior officials, engineers—practically, not as unusable paper.

¶ 08 Our professionals are leaving fast; without them, no government can take the country forward. Break old mental boxes and adopt global best practices to retain talent.

¶ 09 You say the economy is stabilized—at what cost? Poverty is estimated at 25% by CPAN, with others suggesting 40–50%. You raised revenue via steep direct and indirect taxes while cutting essential spending. If the IMF revenue target is 15% of GDP, you’ve gone to 15.9%—an extra Rs. 287 billion. Keep to 15% and use the 0.9% (~Rs. 287 billion) to support MSMEs, farmers, fishers, workers, and entrepreneurs, reviving the hundreds of thousands of MSMEs collapsed due to COVID, Easter attacks, and bankruptcy.

¶ 10 On primary balance, the IMF requires 2.3%; you’ve pushed it to 3.8%—an extra ~Rs. 490 billion. Why not invest that in people’s livelihoods and business revival? Health, education, agriculture, and industries should be fundamental rights. Enshrine them in constitutional reform.

¶ 11 Thank you.