Hon. (Dr.) Kavinda Heshan Jayawardhana

¶ 01 Hon. Chairman, I move,

¶ 02 “That a sum of Rs. 10 be cut from the Recurrent and Capital Expenditures of each Programme, as per the tradition, out of the Heads of Expenditure Nos. 111, 210, 211, 220 and 308 pertaining to the Ministry, other departments and institutions coming under it and scheduled to be taken up for discussion today, Thursday, 06th March, 2025, at the Committee Stage Discussion of the Appropriation Bill, 2025.”

¶ 03 Hon. Chairman, the Ministry we debate today is of utmost importance. Speaking on the health sector, the Government has focused on digitizing the health system and allocated funds accordingly. This is positive, as new technology is essential for diagnosis, prevention and treatment, and allocations are also made for Primary Health Care and for epidemic preparedness, learning from our COVID-19 experience.

¶ 04 Funds are allocated for children with conditions such as autism; we welcome such measures. Mental health is also crucial in a developing society; attention to stress and related issues is important. Rs. 7.5 billion is allocated for nutrition for pregnant mothers. Under the Good Governance administration in 2015, we initiated a nutrition pack worth Rs. 28,000 for pregnant mothers — we appreciate the continuation.

¶ 05 We launched the “Suwaseriya” ambulance service under Good Governance. Though criticized at inception, it has demonstrably saved hundreds of thousands of lives. The present Government has allocated Rs. 4.9 billion to continue it. Rs. 12.5 billion is allocated for medicines — I urge the Hon. Minister to consider further increases.

¶ 06 Hon. Minister, on a day like today, 10 December 2015, you spoke from this side when Dr. Rajitha Senaratne, also from Kalutara District, was the Health Minister. He then said he wished to one day see you as Health Minister. Today you are.

¶ 07 Your remarks are recorded in the Hansard of 10.12.2015 at Column 1272, noting Sri Lanka’s high global recognition in health, including reductions in maternal and infant mortality from 1945 to 2014. You also then noted the shortage of nurses (31,000 vs. a need of 66,000). Now, as Minister, we trust you have addressed such gaps. You highlighted issues like limited usable Neurotrauma Unit beds due to deficiencies — we believe action has been taken.

¶ 08 Sri Lanka’s health sector ranks around 47th globally, ahead of many, thanks to the dedication of our doctors and health officials over decades and across administrations. Officers often work over 8 hours a day — more than 240 hours a month — and deserve appreciation. Doctors’ additional duty claims are limited (e.g., 4–6 hours a day; roughly 120 hours a month), often overlapping with core duties, teaching and management.

¶ 09 Health staff cannot take breaks for Poya, Fridays or religious observances like Maha Shivaratri; there is no OT for executive officers; and OPD doctors may see up to 300 patients a day. Surgeons operate at maximum capacity amid long waiting lists. They request about Rs. 6 billion for extra duty payments — even phased provision would be valuable.

¶ 10 We recall Rs. 20 billion for loss-making SriLankan Airlines, Rs. 4 billion to restart diesel power after a system trip due to a monitor lizard incident, and Rs. 5 billion tax concessions to Mendis Arrack. In contrast, the health sector treating innocent patients seeks only about Rs. 6 billion. In 2016, the Good Governance Government increased public sector salaries by Rs. 10,000 and provided structured extra duty payments (2018–2020), with cumulative increases (64% in 2018 up to 107% by 2020), during which there were no strikes.

¶ 11 Globally, one hour of a doctor’s extra duty is often valued at three standard hours; following the 01.10.1980 struggle, doctors secured an extra duty allowance equal to 1/80th of basic pay per hour. These established norms should be respected.

¶ 12 We must motivate doctors, nurses and allied health professionals to serve here. Due to neglect, from 2019 a severe brain drain occurred. When the former Health Minister reduced retirement age to 60 and removed vehicle permits, professional satisfaction eroded. Training a specialist (MBBS, postgraduate, super-specialization) takes many years; yet many face lack of drivers, transport, accommodation and even basic facilities; in difficult areas, many rent at personal cost and remain on-call 24/7.

¶ 13 From 2021–2024, 195 specialist doctors left; from 2020–2024, 2,440 doctors left. Also 103 dental surgeons, 1,027 nursing officers, 283 other health professionals, 79 auxiliary and MN 1 officers, and 108 other related professionals left. If we do not act now, we will regret it.

¶ 14 Our Leader, Hon. Sajith Premadasa, met the Government Medical Officers’ Association; across parties we formed a doctors’ caucus and helped secure the Rs. 70,000 DAT allowance. However, doctors still deserve around Rs. 260,000 under DAT based on criteria.

¶ 15 As per The Morning headline “President announced a historic budget allocation for health sector in 2025,” Rs. 604 billion is allocated; Rs. 185 billion for medicines; Rs. 7.5 billion for pregnant mothers’ nutrition packs; and Rs. 5 billion for Thriposha. We are thankful, but allocations alone are insufficient if staff are dissatisfied.

¶ 16 Further, allied health, nursing and paramedical cadres oppose converting the 1/160 off-hour allowance to 1/200. We urge restoring the previous rate. Also, the holiday allowance has reportedly been changed from 1/20 to 1/30; we request restoration of 1/20. Basic salary increases are welcome, but do not remove existing allowances.