Intl. accreditation guidelines ignored by private hospitals : SLMA President
The international accreditations that Sri Lankan private hospitals have, in their pronouncements, include obligations to patients, such as patient waiting times to see doctors, etc.
Thus patients who feel they are not being treated properly should not only complain to private hospitals but also to the accreditation bodies themselves, whose inherent duty is to ensure that those they accredit follow their guidelines, according to Sri Lanka Medical Association President Prof. Vajira Dissanayake.
Making this comment at this week’s Sunday Times Business Club discussion on ‘Private channelled practice’ where he was a panellist along with Additional Secretary (Medical Services) for the Ministry of Health Dr. Palitha Mahipala and Sunday Times Deputy Editor Kumudini Hettiarachchi, Prof. Dissanayake also opined that a further reason for a lot of negative experiences by patients visiting private hospitals, such as long waiting times, too many expensive tests, etc, was the lack of contracts between private hospitals and visiting medical consultants. This led to a grey area in terms of the private hospitals responsibilities regarding the conduct of visiting consultants and their treatment protocols, etc.
Another issue with regard to proper treatment protocols at private hospitals that Prof. Dissanayake highlighted was the fact that many private hospitals did not have departments specifically for specialities so there were no department heads to ensure proper treatment protocols were followed.
He also stated that there was ample evidence that, based on the criteria of safety alone, Sri Lanka's government hospitals were far better than private hospitals. He also added that it was "suicidal" to seek treatment at certain places, such as private Accident and Emergency (A&E) departments.
Prof. Dissanayake also indicated that another factor contributing to a decline in the quality of patient care at private hospitals was the lack of specialists, which led to some specialists seeing, sometimes, more than a 100 patients a day. Further, he suggested that this was also because only 10% of Sri Lankan doctors became specialists, mainly due to a lack of places at the country's Postgraduate Institute of Medicine.
Meanwhile, speaking about government hospitals, Dr. Mahipala noted that there were over 60,000 beds available island-wide, in just over a thousand institutions, and that there was one doctor for every 1,500 plus patients. He said Sri Lanka's was the only healthcare that was unique in that, not only was there a government health facility within 3 km of any citizen, there were also field personnel who came to homes to treat people.
He further indicated that healthcare was the third largest expenditure in the national budget and that Rs. 100 billion would be spent this year alone, while Sri Lankans would spend the equivalent of 3.2% of per capita GDP on healthcare. A number which was very low compared to the 17% spent in the US and 14% spent in Japan. As such, the local healthcare system was a highly lauded model worldwide showing upwards of 400% efficiency for every dollar spent. He also added that only 44% of healthcare costs are paid out of pocket by Sri Lankans, with the remaining 45% absorbed by services provided for by their taxes.
Commenting on government healthcare, Prof. Dissanayake said that, while the government hospitals' services were commendable, there was room for improvement and cost cutting. He noted two examples: Rs. 500 million was being spent annually on rabies vaccinations with less than 50 cases of dog bites a year and 3% of the annual national drug budget allocated for the 2,000 patients suffering from Thalassemia, a relatively rare blood disorder.
He also opined that the government health authorities had to be less democratic and institute referral systems, etc unilaterally. He also added that the government should take steps to put in place manufacturing facilities for essential drugs, saying " we can't depend on the private sector for these."
Ms Hettiarachchi spoke on the issues concerning patients about waiting time at private hospitals as specialists often get late, hospital- hopping by doctors in private practice and the debate over generic and branded drugs. But she pointed out that the government sector provided the best service and state doctors and others in the system were a dedicated lot.
The club is hosted by the Taj Samudra Hotel, sponsored by Etisalat and co-sponsored by Hameedia.