The Hon. (Dr.) Janaka Senarathna

¶ 01 Hon. Presiding Member, of our 159 government MPs, 16—about 10 percent—are doctors. Many professionals, including doctors at home and abroad, lent great strength to this historic political change. Becoming a doctor in Sri Lanka is not easy. Even after an A/L pass and a local degree—or after spending millions abroad for a foreign degree—only after completing internship and post-intern primary grade training, at age 29–30, does one become a medical practitioner. They sacrifice much during those years. On average, one doctor carries responsibility for roughly 1,000 people (about 985 by simple division). The WHO suggests 2.5 doctors per 1,000 population; we have fewer than 1.1 per 1,000. The global average is 1.7 per 1,000; we lag behind, ranking not within the top 100 countries but in the second hundred.

¶ 02 With the economic collapse and bankruptcy, in the last two years about 10 percent of our doctors—around 1,800—left the country. Another 25 percent—around 5,000—are in a position to leave.

¶ 03 Annually, about 6.3 million inpatients are treated in government hospitals, and about 55 million visits are treated in OPD. With a population of 22 million, 55 million OPD encounters occur in the public sector, and a similar number in the private sector.

¶ 04 Health cannot exist in isolation. It is intertwined with education, transport, economy, environment, food and nutrition, agriculture, sports, arts, culture, research and development, communications and media, state policy, public communication, public participation, water resources and waste management, among others. Therefore, in this Citizens’ Budget we have increased allocations across sectors. We reduced overall state expenditure by Rs. 2,700 billion—by about one-third—and more than doubled development allocations compared to last year. Without any trade union struggle, we have given unprecedented salary increases. For nine years, basic salaries of public servants were not raised, while inflation and cost of living climbed, pushing thousands to emigrate.

¶ 05 A professional’s dignity does not rest on a bundle of allowances patched together but on a reasonable basic salary. At present, a doctor’s basic pay is around 20–21 percent of total earnings. For example, when a primary grade doctor’s total pay is Rs. 246,000, the basic pay is about Rs. 54,200—just one-fifth. Where is the dignity in that? Our aim is to provide an economy with a solid basic salary so one can live with dignity. Due to human resource shortages, in some units a single doctor works 24–36 hours continuously.

¶ 06 Our first Budget is before you; four more Budgets lie ahead. Our hope is to build a system where a doctor can work structured 6-, 8- or 12-hour shifts with weekends and adequate leave, maintaining a satisfactory professional life and better socio-economic standards.

¶ 07 After Sri Lanka’s formal declaration of bankruptcy on 12 April 2022, President Ranil Wickremesinghe introduced PAYE tax. Juniors paid Rs. 20,000–30,000 per month; seniors Rs. 50,000–60,000—deducted from already eroded salaries. Though protests were launched, they were quietly set aside based on a six-month discussion promise with the IMF. Now, professionals who left are returning. To them we say: we are committed to fulfilling the expectations and trust you placed when you voted on 21 September and 14 November. Let us move forward together to make this diverse and beautiful island your best home.

¶ 08 Thank you.