The Hon. (Dr.) Nalinda Jayathissa - Minister of Health and Mass Media and Chief Government Whip

¶ 01 Hon. Presiding Member, I thank Hon. Ruwan Wijewardena for bringing a motion to the House during an allotted time debate regarding the health sector, and I thank Members from both the Government and the Opposition who contributed. We appreciate your interest in uplifting the health sector. We constantly expect your intervention to develop hospitals in your areas and identify shortcomings. I have about eleven minutes, so I may not be able to answer all your questions, but we hope to address them during the Committee Stage of the upcoming Budget.

¶ 02 The Hon. Gayantha Karunathilaka, Chief Organizer of the Opposition, focused on the Karapitiya (Galle) National Hospital. I rarely go on inspections, but the first hospital I visited was the Galle National Hospital. It is currently in the transitional phase of upgrading from the status of a general/teaching hospital to that of a national hospital. As stated, it has around 2,000 bed capacity. Regarding the issue in the cardiac catheterization unit, the problem with the catheterization tube can be resolved within the next 10 days. The hospital administration said it could be resolved within 7 days; taking some buffer, we said 10 days. Accordingly, it will be fixed within 10 days. The second machine required for the cath lab had been ordered through a tender, but after awarding, the end user preferred a different supplier than the third-lowest bidder, causing a price gap of Rs. 70 million. Therefore, we had to retender without the first bid specification. Such issues occasionally hinder procurement. Nonetheless, we accept that a second machine is needed for a national hospital. As for ambulances, the hospital says all 11 are operational, so there is no acute need at present; if any issue arises, we can discuss.

¶ 03 On the estate hospitals issue raised by Hon. Kaviratne, yes, there is a problem. There are 42 estate hospitals across 11 districts (including Central, Uva, and Sabaragamuwa Provinces). Since 1997 there has been a process to vest these with the Central Government, but it has not reached the final stage. These hospitals provide a significant service. We hope to expedite conclusion of this process and provide services through the Central Government. She also spoke about dengue assistants. That is correct. About 600 remain. This problem has persisted for eight years. They performed a major role in dengue control. We have already submitted a Cabinet paper to regularize them. Delays in recruitments in the past prevented their appointments. We will work to regularize their service promptly.

¶ 04 Members repeatedly raised recruitment issues. All recruitments to the public service had been stopped earlier—education and health included. But in a service like health, that is untenable. Therefore, after our Government assumed office, we have expedited recruitments. Within the next month—within the next four weeks—we will recruit 3,500 nursing officers, 976 Public Health Inspectors/Family Health Service Officers, 110 pharmacists, and 42 radiographers. Thus, we can provide a considerable solution to shortages of nurses, radiographers, pharmacists, and family health officers in many hospitals.

¶ 05 Further, within the next two months we will recruit 110 graduates to be employed as radiographers and 23 as audiologists. Additionally, 42 school dental surgeons, 150 dispensers, and 60 ECG technicians have been selected for training; we will fast-track training and appoint them to the public service. These are measures we aim to complete in the coming months, clearing long-pending matters.

¶ 06 Some Members noted that while certain base hospitals have been upgraded, there are difficulties in providing specialists. To deliver a standard health service nationwide, we need about 2,800 specialist doctors; we currently have around 2,000. By extending retirement to 63, we expected to retain some service. However, we cannot immediately produce specialists. For various reasons—political instability, heavy taxation, and others—many specialists and other health staff left service or the country. I now make a special appeal to all such professionals to return to service. Your service is essential to the nation. You were educated, trained, salaried, and given experience with the people’s tax money. We urgently need trained staff; if they return, it will greatly help sustain the health service.

¶ 07 A key focus in this debate was the medicines issue. One Member said these four institutions still work in silos. Although the NMRA, the State Pharmaceuticals Corporation (SPC), the State Pharmaceutical Manufacturing Corporation (SPMC), and the Medical Supplies Division (MSD) are separate entities, we have instituted coordinated, process-driven collaboration to achieve progress.

¶ 08 Accordingly, at the NMRA, there had been a backlog of 2,100 files pending registration. We have reduced this to 447. In the last calendar month alone, we cleared 330 files submitted for registration. We are fast-tracking this. By April, we aim to clear the longstanding NMRA registration backlog and thereafter follow WHO-accepted timelines for registration processes.

¶ 09 Once a medicine is registered, the relevant next institution is the MSD. There was a problem: even when hospitals submitted their medicine estimates to the MSD, orders could not be placed with the SPC in time. This caused months of delay. SPC’s tender process typically takes about nine months from tender opening, TEC evaluation, awarding to a supplier (often in India or Bangladesh), manufacturing and delivery back to MSD, and then distribution to hospitals—often a little over nine months.

¶ 10 Therefore, we must place next year’s orders in the early months of the current year. MSD had not been able to do this historically. I am pleased to state that, for the first time in history, by January 31 the MSD placed orders with the SPC for approximately 862 medicines and nearly 5,000 categories of ACS equipment required for the following year, thanks to the voluntary dedication of its staff. Despite various past legal and procedural constraints, they worked beyond usual limits to complete this by January 31.

¶ 11 We are reorganizing these institutions and working with their teams to build efficiency and accelerate processes.

¶ 12 A Member said there are shortages of about 300 medicines. When the central medical stores show a stockout, it does not necessarily mean the medicine is absent in regional stores or hospitals. Sometimes it’s not in the central database, yet available regionally or at facility level. Therefore, when alleging shortages, the claims should be accurate. Sensational claims through media and social media create fear and open the door for off-register procurements, bypassing tenders, at arbitrary prices. That is how, in the past, a vasodilator costing Rs. 380 was procured for Rs. 76,000, Rs. 48,000, or Rs. 56,000. After we came to power, we procured it for Rs. 380. We must not fall into such traps. We should also reflect on the motives and affiliations behind some public claims.

¶ 13 I thank all Members who shared views. We are proceeding according to a structured national plan to provide, through the public hospital system, high-quality, safe medicines free of charge. Our biggest current effort is to gazette reduced prices for all essential medicines, enabling meaningful relief through retail pharmacies as well. By implementing these measures, we will deliver a sustainable solution to the medicines issue.

¶ 14 Thank you.