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

¶ 01 Thank you for the question, Hon. Leader of the Opposition. As you raised multiple issues across five areas in health, I will respond concisely.

¶ 02 1. Under the preamble of the 2018 No. 18 Suwa Seriya Foundation Act, the newspaper notice has not removed the “1990” number or the name “Suwa Seriya Foundation.” The Act clearly states the Foundation’s objective as providing pre-hospital ambulance and emergency response services. No decision has been taken to change the colour of the ambulances. The 2015–2020 Government of then Prime Minister Ranil Wickremesinghe and Hon. Harsha de Silva introduced these green ambulances; we will keep that colour. The key is modernization and strengthening emergency medical services while keeping “1990” registered in the public mind. There will be no change to the “Suwa Seriya Foundation,” the “1990” identity, or the green colour. We will modernize with new technology, training Emergency Drivers and Emergency Medical personnel. For 2025 alone, Rs. 5,000 million has been allocated. Recruitment is underway; we are discussing 100 ambulances with India, and a further 45 (20 under concessional financing and 25 as a grant) from the Asian Development Bank, targeting a fleet of 500 with trained, higher-technology staff.

¶ 03 2. In line with the Act’s preamble, there has been no policy decision to change the service’s purpose; no new regulations were gazetted in the past year regarding pre-hospital and emergency response under the Act.

¶ 04 3. Brain drain and staffing: - Medical Officers (Grade cadre as at 2025.01.31): Approved 25,573; in service 24,278; 1,374 Grade Medical Officers newly appointed under the post-intern scheme as at 2025.09.15. We are revising cadres and expect to increase staff before year-end. - Nursing Officers: Approved 46,263; in service 43,195; vacancies 3,068. Recently 3,147 recruited; 294 more appointed last week; about 5,200 are in training. We will further increase approved cadres.

¶ 05 On pay: Across the public service, including health, we granted significant basic salary increases in the last Budget. Illustratively: - Specialist Medical Officer basic increased from Rs. 88,000 to Rs. 156,000. - Medical Officer Grade II from Rs. 58,305 to Rs. 101,370. - Medical Officer Grade I from Rs. 71,805 to Rs. 125,670. Allowances such as extra duty and those linked to the 1711 scheme are pegged to the 2027 basic for take-home improvements. For nurses: - Nursing Grade III from Rs. 32,525 to Rs. 54,920. - Grade II from Rs. 37,635 to Rs. 64,110. - Grade I from Rs. 44,965 to Rs. 77,330. For Medical Laboratory Technologists: - Grade III from Rs. 32,080 to Rs. 54,120. - Grade II from Rs. 37,190 to Rs. 63,310. - Grade I from Rs. 44,520 to Rs. 76,530. Corresponding overtime/leave-day allowances adjust accordingly. Detailed conversions are in Annexes 01–03 placed in the Library.

¶ 06 On reasons for migration: It is not solely salary. Within fiscal constraints, substantial increases have been given; as the economy improves, we can review further. We are addressing administrative and workplace issues to retain staff.

¶ 07 Fistula needles for dialysis: Monthly need is ~40,000, with two types—fixed and rotatable. The successful bidder supplied fixed instead of the required rotatable type. We cannot accept items contrary to specifications or through process violations. Therefore, we enabled local procurement at hospital level, expedited procedures, and released funds. Consequently, prices in the local market spiked from Rs. 57–60 per needle to as high as Rs. 7,000–8,000 in some places, even Rs. 11,100 in instances—an unacceptable market distortion. We have since negotiated and brought 460,000 rotatable fistula needles; SPC clearance is underway, and hospitals will receive supplies within about a week.

¶ 08 On Kebithigollewa and other difficult areas: Thank you for your donation (e.g., a B. Braun haemodialysis machine). Some hospitals lack continuous staffing to operate equipment. In North Central Province (Anuradhapura and Polonnaruwa), nursing allocation currently exceeds approved cadre; pending cadre revision and incoming trained nurses, gaps will persist briefly. We are: - Strengthening primary and secondary care via Arogya Suwatha centers, and World Bank/ADB-supported programs. - Upgrading infrastructure at secondary/tertiary institutions. - Continuing recruitments. - Tightening project/program monitoring. These actions target human and physical resource gaps in difficult districts.

¶ 09 On Field Mosquito Control Assistants (dengue): - In line with Cabinet decision of 2016.08.17, 1,500 were recruited on two-year contracts from March 2017. Repeated requests (2017–2020) to regularize were delayed; many left; 1,169 remained. - We split them into two: those with Grade 8 (847) were given NVQ training; 640 received appointments in June; a further 27 in August; now 606 Grade 8/NVQ holders have been made permanent. - The remaining 301 with GCE (O/L): across Government there are ~6,000 O/L-only contract staff in various institutions; to ensure uniform policy, the PM-led Committee has deliberated. We decided to give priority to dengue assistants, but need a general approach and vacancy mapping. In the upcoming Budget, the President/Finance Minister will announce regularization. Meanwhile, I will submit a Cabinet paper next week to extend their contracts (about two months processing) so service is uninterrupted; thereafter, proceed to permanent appointments.