“If you stay in your electorate hospitals, schools and roads will improve”

The interactive discussion moderated by Prof. Janaka de Silva that followed the presentations, brought to the fore many serious issues.

MP Vasudeva Nanayakkara let off the first volley by casting doubts on the efficacy of the generic drugs being given to parliamentarians by the Medical Supplies Division and also requesting that a survey be done on malnutrition among the lower income groups. “National figures on malnutrition are deceptive and there is a need to deconstruct these figures at electoral level,” he said.

In reply, Health Minister Dr. Rajitha Senaratne said that there is a campaign that ‘branded’ drugs are better, but assured that generics are selected by Technical Evaluation Committees headed by medical specialists.

While there was much discussion on the pros and cons of a referral system, MP Eran Wickramaratne raised concerns about doctors becoming managers of state hospitals, while adding that private insurance is the wrong way to go about to improve the healthcare system.

Gently disagreeing with Mr. Wickramaratne, Dr. Ravi Rannan-Eliya defended doctors who are administrators.

MP Susil Premajayantha pointed out that the health system comes with a lot of dissatisfaction, with Prof. de Silva explaining that the country has quantity but needs to improve quality.

It may not have been the last word but it was a strong censure from Prof. Sanath Lamabadusuriya, who when referring to inequities in Sri Lanka, pointed out that if MPs, the moment they are elected do not come to Colombo and set up homes here, but remain in their electorates, development will go to those areas.

“Send your children to the schools in your electorates, use the hospitals in your areas and go about on pot-holed roads in your areas, then development would quickly percolate to the grassroots,” he said.

The last word was from WHO Representative to Sri Lanka, Dr. Razia Pendse, who pointed the way forward by reiterating that health is a human right. Many laurels have Sri Lanka gained, but without resting on them, the country needs to move towards a paradigm shift – re-think, re-design and reform the health system to meet the new challenges of non-communicable diseases (“once a diabetic, always a diabetic”) and a rapidly ageing population.

“More investments are imperative, it’s not a choice any more. Where will the money come from? Collective action is needed to decide how the future will be – to live, age in a healthy manner and if sick to have access to resources deployed equally, equitably and with equity. There should be universality of health, leaving no one behind,” urged Dr. Pendse.