The Hon. (Dr.) Nihal Abeysinghe

¶ 01 Hon. Deputy Chairperson, I’m pleased to join the debate on the Heads of Expenditure of Health and Mass Media. First, to clarify a misconception being spread: the Opposition claims that with the salary increases, allowances of doctors, nurses, and allied health staff have been cut. In fact, we increased basic salary, which raises all percentage-based allowances. For example, a medical officer’s basic salary in the initial grade rises from Rs. 54,290 to Rs. 94,150, increasing take-home pay and all related allowances. In 2024 the Ministry spent Rs. 45,338 million on salaries, Rs. 39,716 million on overtime and holiday pay, and Rs. 50,449 million on other allowances—showing many allowances in addition to OT and holiday pay. While some rates changed, the total received does not decrease with the higher basic. Annual increments, disaster loans, and pensions also rise. This is arithmetic, and the narrative of “cuts” is incorrect.

¶ 02 This is a special Budget of the new Government of the National People’s Power, giving high priority to Health—Rs. 604 billion allocated. We aim to restore Sri Lanka’s lost health excellence. In 1978 at Alma-Ata, Sri Lanka was showcased for Primary Health Care. Due to strong PHC up to the 1990s, our health indicators rose: life expectancy ~75 years; infant mortality 6 per 1,000 live births; under-5 mortality 10 per 1,000; maternal mortality 25.38 per 100,000—comparable to developed nations. Our immunization program is exemplary—controlling whooping cough, diphtheria, measles, rubella, congenital syphilis, malaria, polio, etc. Sadly, in the last 20–25 years, services declined; we must correct this, hence the strong health focus in our Budget.

¶ 03 We also allocate for digitalization—Rs. 6,000 million, with Rs. 200 million this year—to build a robust health information system, so a patient’s history is accessible across facilities, improving efficiency.

¶ 04 We set aside Rs. 6,668 million to strengthen the health system; Rs. 12,190 million to build a strong primary care network; and Rs. 183 billion for adequate, quality, safe medicines and equipment. Rs. 12.5 billion is allocated for nutrition of pregnant mothers, preschoolers, and schoolchildren.

¶ 05 We plan to assign a Family Physician for populations of 5,000–10,000 at the primary care level. Today, treatment decisions are made individually or via acquaintances; with a registered family physician unit, people will consult their team, receiving proper guidance. This will reduce unnecessary flow to secondary and tertiary urban hospitals, easing congestion. Past governments focused on upgrading urban hospitals, neglecting peripheral ones. Our policy prioritizes peripheral hospitals and family physician-led primary care to reduce overcrowding and keep services close to where people live.

¶ 06 Family physician teams, including a Public Health Nursing Officer, can control NCDs at primary level. The STEPS survey shows 14% diabetes and 34% hypertension among ages 18–69; about 70% of deaths are due to NCDs. CKDu clusters and cancer incidence are rising—37,753 cancer cases reported in 2021. One in five citizens is aged 60+ today; by 2041 it will be one in four—NCD burden will rise further. Family physician units will also support palliative care, currently accessible mainly via private sector at high cost.

¶ 07 Working with Medical Officers of Health (MOH), we will strengthen dengue and epidemic control and injury prevention. Every minute, eight patients are admitted due to injuries; annually about 1.3 million hospitalizations and over 10,600 deaths (2021). Every three hours, someone is admitted with trauma. Strengthened primary care and family physician teams will guide patients, arrange transport, referrals, and follow-up within their communities. This is our path to a resilient health system. Thank you.