The debate about private medical education has been revived again with the Kotelawala Defence University’s (KDU) Medical Faculty being approved to provide paid medical training. Many have revived the criticism that private higher education, particularly of the medical stream will lead to disaster.The Government and proponents of private education dismiss the claims. 

However, while the KDU has begun to advertise for the MBBS Medical Education programme already, and a decision regarding the establishment of another a Medical Faculty at the National School of Business Management (NSBM) around the bend, the question of who will actually pay of the ‘private education’ remains unclear, as the KDU lists in its annual report, two Treasury-guaranteed loans amounting to Rs. 35.5 billion from the State-owned National Savings Bank (NSB) obtained to build the teaching hospital. The loan is to be repaid by the end of 2031, which given the current progress makes the prospects of repayment on time, uncertain. Even if the interest for the loan is to be borne by the Treasury (tax payers), the monthly repayment which KDU will have to honour is unlikely to be covered by the income from the private-funded medical students or that of foreign students.  The fiscal discipline regime brought in with consultation of the IMF will also make such loan sustainment with Treasury assistance difficult.  

It is true that Sri Lanka’s experience with private medical faculties (SAITM) has not been a very successful one. It is also noteworthy that in Sri Lanka, this is not just a matter about higher education, but also a topic of discussion in political and social spheres. In the present context where doctors are leaving the country seeking better employment opportunities and students are doing the same seeking education at foreign higher educational institutes, this is also an economic concern. In this context, to make the proposed initiative a success that benefits all, Sri Lanka should look at the matter of private medical faculties in a logical manner without succumbing to political agenda surrounding the matter. There are both pros and cons of establishing private medical faculties.

While it is true that the private education sector has fulfilled a massive lacuna created by the lack of resources and attention given to the State-owned education sector, looking at the establishment of more private institutes as the best solution, would be unwise. Firstly, with more private education institutes and sudden projects such as the proposed NSBM Medical Faculty, Sri Lanka will have to improve its regulatory frameworks concerning such institutes. Secondly, as a country that has faced a number of issues due to private medical faculties in the past, to prevent the recurrence of such issues, Sri Lanka should also carefully restructure and improve the existing legal and regulatory systems within which the proposed medical faculty would be established. At the same time, the authorities should pay attention to the potential impacts of such an initiative on the state education sector, because there is a possibility of lecturers ‘migrating’ to the private sector for higher pay or other perks. It is imperative that the Government improves the funding, quality compliance and the resources committed to the existing state medical faculties. Thereby improving expert staff retention, improving the quality of trained doctors and also increasing output volume.

At the same time, it is crucial to not overlook the larger, real issue here. The biggest factor that has created a necessity of private education institutes is the present state of state sector education institutes. Excessive competition for enrollment, inadequate resources, and brain drain of teachers have weakened the state education sector for decades, and it has become a bigger issue with the economic crisis. Therefore, while acknowledging that such inadequacies have led to an excessive demand for private educational institutes, the authorities should take steps keeping in mind that the present socioeconomic situation calls for more scientific, effective and sustainable efforts. Above all, the authorities’ steps need to be genuine and not politically driven. In essence, while a private medical faculty could be beneficial in many ways, it needs to be done in the right manner at the right time. It is important to understand that the necessity of more education institutes is merely the beginning, and that to make private medical faculties a success, much more needs to be done and learnt. Instead of state funded institutions which run private medical faculties, which as experience has shown ends up, at least if they follow the existing system, being a burden on the taxpayer, Sri Lanka should seek to attract foreign direct investment (FDI’s) to establish private medical faculties, which are linked to private hospitals.