Patients punished, but unions threaten to resume strike from Wednesday
A 48-hour strike by healthcare workers, other than doctors, this week severely disrupted services at government hospitals nationwide and caused inconvenience to patients, but unions threaten to resume the strike action if their demands are not met before Wednesday.
Thousands of patients could not attend regular clinics and collect medicines, while indoor patients also faced severe inconvenience due to the shortage of caregivers.
The strikers' main demand is that they also be given the Disturbance, Availability, and Transport (DAT) allowance given to doctors.
Workers representing 72 healthcare professionals' unions took part in the strike action.
The trade unions launched the strike after the government failed to honour its pledge that a solution would be found soon after the president returned to the country from Davos and Kampala.
Two weeks ago, the Joint Council for Professions of Supplementary Medicine met State Finance Minister Shehan Semasinghe and Health Minister Ramesh Pathirana to press ahead with their demand. It suggested the same formula adopted to raise doctors' allowance should be applied to them.
Its president, Ravi Kumudesh, said that since there was no resolution in sight, they decided to relaunch their walkouts on Thursday (February 1).
He said doctors receive a vehicle, a personal chauffeur, and fuel. Conversely, those in the supplemental medicine field must request a separate allowance to cover these expenses, and their overtime rate and other allowances have not increased over the past years, he pointed out.
He noted that, due to these issues, medical professionals, including nurses and paramedics, were leaving the country in search of better opportunities and higher wages.
Mr. Kumudesh called for the setting up of a national wage commission to ensure fair procedures and equality.
However, to address the issue, the Health Ministry and the Finance Ministry have invited the trade unions for talks on Tuesday.
Based on the outcome, a decision would be made on whether or not to resume the strike action on Wednesday, said Upul Rohana, the President of Paramedical Services Front (PMSF) and Joint Convener of the Trade Union Alliance.
“We call for economic justice and equality for all in the health service, not only on DAT but also on other issues. We are in need of an allowance given the challenges faced by our members during these hard times,” Mr. Rohana said.
He also pointed out that there were other unresolved issues, such as their transportation and uniform allowance increases.
Dr. Chamil Wijesinghe, Media Secretary of the Government Medical Officers’ Association (GMOA), noted that the health workforce plays a vital role in maintaining the system despite its numerous shortcomings and drawbacks. The collective efforts of nurses, attendants, midwives, technicians, and minor personnel significantly enhance the accessibility and efficiency of the state’s health services, he noted.
To keep them motivated at work and improve public service, all of them should ideally receive substantially higher pay with additional amenities than they already receive, he said.
“Yet, considering the state of the nation’s economy, requesting a rise comparable to that of doctors is unrealistic and inappropriate,” Dr. Wijesinghe added.
Sri Lanka’s healthcare sector is confronting a dearth of skilled workers, with 1,500 doctors and specialists having already crossed borders.
There are 20,000 government doctors, and about 5,000 doctors have completed the medical licensing examinations of developed countries, mainly the United Kingdom (UK), Australia, and West Asia countries. Their departure will only worsen the crisis the health sector faces due to the shortage of
doctors, Dr. Wijesinghe said.
"These remaining doctors and specialists should be kept from leaving the country to avert the impending disaster by offering effective solutions," he said.
According to the 2024 budget, all state sector employees will receive an additional Rs. 5,000 in cost-of-living allowance from January and a total of Rs. 10,000 from April. This increased allowance will also benefit workers in the health industry, he said.
“Although it would not amount to much, given the sharp increase in the cost of essentials, it is absurd to anticipate much more at this point just because doctors’ DAT allowance has been granted. The supplementary medicine professions should focus on their own set of problems, like better uniforms and transportation benefits, instead of requesting a DAT. This is the GMOA's stand," he added.
Furthermore, GMOA also believed that the whole trade union action was driven by political objectives.
The Government Medical Officers’ Forum president, Dr. Rukshan Bellana, told the Sunday Times that the strike action carried out by healthcare workers raised a range of ethical issues. "Most fundamentally, as a strike action is designed to disrupt, it has the potential to affect healthcare delivery.”
Strikes on Thursday and Friday
(February 1 and 2) prolonged the agony of patients. There have also been disturbing reports that hospital staff did not even attend to patients in intensive care units at Gampaha General Hospital.
Besides, it is rather ironic that the union representing radiographers declared in their letter that they would determine what constitutes an emergency, he said.
Tri-force personnel were deployed at state hospitals nationwide to ensure uninterrupted essential medical services during the strikes. As a result, Dr. Bellana said many hospitals reported that services continued without a hitch, though a few patients had trouble receiving their medications. Patients who could not obtain their medication from the hospital were directed to State Pharmaceutical Corporation (SPC) outlets.
“This should serve as a wake-up call for the government to outsource paramedic services to the private sector,” Dr. Bellana said. "Those who are considering future strikes need to prioritise the needs of the poor and spare them more agony."
Any trade union movement needs public support to be impactful, but by severely undermining the healthcare system, demonstrators will gain minimal empathy because their actions primarily affect the average person and have little bearing on lawmakers and their families, he said.