WHAT NEXT FOR GMOA CARTEL?

SC ruling compels Health Minister to revamp Medical Council

The Supreme Court (SC) on September 21, 2018 upheld the Court of Appeal (CA) ruling of January 2017 that requires the Sri Lanka Medical Council (SLMC) to provisionally register the petitioner, a medical graduate of SAITM.

The SC ruling had left the GMOA and its protesting allies in complete disarray as to what would now be the fate of their two-year plus “ANTISAITM” campaign.

The SC ruling also raises issues as to what the fate of the present SLMC should be.

Everything about the medical faculty of SAITM very plainly revolves around the SLMC -- its refusal to accept the SAITM medical faculty as good enough a medical education institute to teach and train medical practitioners.

The CA decided otherwise in January 2017. It was in line with the petitioner’s position that the SAITM medical faculty is far better equipped than even the Kotelawala Defence University(kdu) medical faculty.

This was said in plain language by Health Minister Dr. Rajitha Senaratne in Parliament on February 9, 2017.

Responding to JVP MP Dr. Nalinda Jayatissa, Minister Senaratne said, “……a hospital with 1,000 beds (referring to SAITM) was decided not enough for ‘clinical’ practice. How was KDU given approval? KDU was approved in 45 minutes. That report had only two pages. You know the SLMC report, don’t you? What was said? ‘Excellent training’ it said. But there was no hospital. Even without a hospital (SLMC) said ‘excellent training’…..” (Sinhala/ Column 1144 in Hansard)

The competency and bona fide of this same SLMC were very much questioned and left in serious doubt by the SC itself on September 21, when it delivered its ruling on the petition filed by the SLMC, requesting the SC to rescind the ruling given earlier by the CA.

In delivering its ruling the SC wrote: “The SLMC has claimed that it is the sole regulatory authority with regard to the medical profession and has professed that it is deeply concerned with the standards of medical education.

“If that was the case and if the SLMC was bona fide of the view that SAITM was not entitled to be recognised as a ‘degree awarding institute,’ the SLMC would have, undoubtedly, sought to challenge the validity of ‘P4’ and ‘P5’ when they were issued in 2011 and 2013.

“However, the SLMC did not make any application to a court disputing the validity of ‘P4’ and ‘P5’.”

The SLMC under Prof. Carlo Fonseka’s presidency was also proved to have altered the ‘10-member’ committee report on the “status and quality of medical education at SAITM medical faculty” with all but three members opposing such indecency and incivility.

“Now it is public knowledge, Professors Narada Warnasuriya, Nilantha de Silva and Colvin Goonaratna opposed any alterations to the committee report. Those who wanted it altered to suit their uncompromising “ANTI-SAITM” stand, were all medical professionals representing trade unions (GMOA and FMTA) that publicly stood for the abolition of the SAITM medical faculty.

The alteration, therefore, was made to say the SAITM medical faculty degree cannot be accepted by the SLMC for registration.

The alterations in Page 18 of the said committee report was mentioned by the CA as well and had mentioned in the SC ruling too.

It says, “In this connection, SAITM has annexed, as part of the documents annexed to P-20, an unsigned report said to have been prepared by the tenmember team appointed by the SLMC.

The body of this unsigned report is on similar lines to the detailed report P-19 (d).

However, the conclusion is a recommendation by the team that the SLMC “recognizes graduates of the Faculty of Medicine SAITM as suitable for provisional registration, subject to following conditions:” these conditions include the provision of access to a “busy state hospital, so that students can be given intensive clinical exposure of one month each in Medicine, Surgery, Paediatrics and Obstetrics and Gynaecology…..”, (emphasis added)

We thus have an SLMC whose conduct and bona fide was twice condemned and deplored, once in Parliament by the Health Minister under, whose purview the SLMC is and now for the second time, by the apex body in our judicial system, the SC.

If SLMC members have any self-respect left with them, they should all resign now from the SLMC for such open and public condemnation of their conduct.

They don’t seem to have such self-respect even the often ridiculed politicians have in this country. During the last three years, we saw three ministers resign, condemned by the public. Not so, the medical professionals in the SLMC, even after the SC questioned and doubted their bona fide very much.

All of it now demands a total revamp of the SLMC on public interest. The present SLMC loaded with medical professionals elected and nominated by two trade unions, with the rest also being medical professionals have proved, it decides solely on the interest of trade union representatives.

On the present Medical Ordinance, the GMOA has the muscle power to elect eight members to the SLMC.

Another nine deans of national university medical faculties sit, with their nominations endorsed by Faculty of Medicine Teachers’ Associations (FMTA), who have often given into pressures of the university students as well.

This, as Prof. Colvin Goonaratne publicly said, totals 17 TU representatives out of 23 members in the SLMC.

This was said to be the main reason for his resignation as SLMC President for a mere nine months.

These “trade unionists” it is claimed, don’t even allow any serious discussion at SLMC meetings, forcing their pre-decided TU positions on the SLMC. The SLMC altering its ‘10-member’ committee report was none but that.

With the existing Medical Ordinance, this number will keep increasing further.

Two medical faculties have already been approved for Sabaragamuwa and Wayamba Universities. These would be functional in about four months from now. Thus in 2019, there will be not 9 but 11 deans sitting in the SLMC. These numbers are not restricted and depend on the number of State university medical faculties.

Therefore, there is no guarantee this number would remain as 11 deans in the SLMC, with two more medical faculties proposed for Moratuwa and

SC ruling left the GMOA and its allies in complete disarray

What would now be the fate of their two-year plus “ANTI-SAITM” campaign?

Uva-wellassa Universities by a private member motion in Parliament, mooted by JVP MP Dr. Jayatissa.

The SLMC should not be under medical professionals alone for reasons that are best known to the minister.

The conduct of this SLMC was exposed by Minister Rajitha Senaratne in Parliament on February 9, 2017, who said it had double standards. One for KDU and another for SAITM.

“Taking registration for that (KDU), they now send students to the Sri Jayawardenepura General Hospital. Now that’s how registration was taken. If Neville Fernando appointed Gotabaya as CEO then, it would have been approved then itself,” he said.

Health Minister Senaratne, therefore, should not allow this to continue. It is his responsibility and duty to immediately intervene in revamping the SLMC, in the interest of public and national health. In public interest, the SLMC should not be “the sole regulatory authority with regard to the medical profession.” It is said, Prof. Colvin Goonaratne has provided Minister Senaratne with a proposal, outlining how the SLMC could and should be restructured anew with other professionals and civil society representatives included. Perhaps, he has a time frame too for this restructuring proposal.

I have written in these pages, how modern and democratic Medical Councils are constituted in countries like the UK, Australia and Canada.

Perhaps, Minister Senaratne has better and more access to such democratic “models” that can be adopted to suit our national health needs.

It would be best if the minister entrusts the responsibility of restructuring the SLMC to Prof. Goonaratne, a medical teacher, SLPC Chairman continuously for almost a decade, a member of the SLMC till his appointment as its President, apart from his other achievements the minister may know better, if, as we have heard, he has already made a proposal for restructuring of the SLMC.

It is also the responsibility of Minister Senaratne to have the proposal for restructuring in public domain. Restructuring SLMC should not be a closed door, politico-academic exercise. It is also the social responsibility of Prof. Goonaratne to now make it a public document if he had handed over such to the minister.

These restructurings need serious social discourse before they get into legal form. Now is the time for that with the SC further consolidating the CA ruling with an emphatic mention, “.….if the SLMC was bona fide of the view that SAITM was not entitled to be recognised as a “Degree Awarding Institute”, then the SLMC should have challenged it without delay.

Yet, “the SLMC did not make any application to a court disputing the validity of P4 and P5,” that defines the validity of SAITM as a medical degree awarding institute. That, therefore, makes SLMC and GMOA irrelevant in deciding a total revamp of this discredited SLMC. The decision is with the Health Minister and wishes he would stand up to that responsibility.

If SLMC members have any self-respect left with them, they should all resign from the SLMC for such open and public condemnation of their conduct