Sri Lanka’s healthcare sector is grappling with a critical shortage of radiographers, jeopardising the delivery of essential diagnostic services across the country.
Radiographers play a vital role in modern medicine, operating advanced imaging technologies such as X-rays and Magnetic Resonance Imaging (MRI), Computed Tomography (CT), and Positron Emission Tomography (PET) scans, which are indispensable for accurate diagnosis and treatment.
However, the nation faces a significant 40% workforce deficit in this crucial field, raising concerns about the future of radiological services.
A severe shortage
Speaking to The Sunday Morning, Government Radiological Technologists’ Association (GRTA) President Chanaka Dharmawickrama said there was a 40% deficit in the required workforce, with only 620 radiographers available out of the required 1,150.
This shortfall has placed immense strain on hospitals across the island, particularly provincial, Central Government, and teaching hospitals, where services like X-rays; MRI, CT, and PET scans; and mammograms are essential for patient care.
According to Dharmawickrama, the issue is further compounded by a two-year recruitment freeze imposed by the Government, which has limited the intake of new professionals.
While 110 graduates have applied for internships this January, opportunities remain scarce. Moreover, 80 radiographers have migrated abroad over the past two years, seeking better career prospects and working conditions, further exacerbating the workforce crisis.
Dharmawickrama pointed out that many professionals were attracted to countries like the UK, where the curriculum and certification process were more accessible compared to other regions, with one radiographer often covering the workload of two or three.
“The severe shortage has led to service disruptions in some areas, with certain clinics and imaging departments unable to operate effectively. Smaller facilities, such as chest clinics in Galle, are struggling with just one or two radiographers managing all operations. Larger institutions like the National Hospital of Sri Lanka (NHSL), Teaching Hospital Peradeniya, and Galle National Hospital are also under significant pressure to meet patient demands,” he said.
Dharmawickrama stressed the need for urgent action to address this issue, calling for the immediate lifting of the recruitment freeze, the creation of more internship opportunities for graduates, and the implementation of policies to retain trained professionals.
Without these measures, he warned, the quality and availability of radiological services across Sri Lanka would continue to deteriorate, affecting patient outcomes and healthcare efficiency nationwide.
Radiologists vs. radiographers
Radiology is a specialised field of medicine that utilises ionising and non-ionising radiation to diagnose and treat diseases through advanced imaging techniques. These techniques include X-ray radiography, MRI, CT, ultrasound, PET, and nuclear medicine. A medical consultant specialising in this branch of medicine is known as a radiologist.
Radiology encompasses several subspecialties, each focusing on specific body systems or conditions, such as neuroradiology (central nervous system imaging), paediatric radiology (imaging in children), breast imaging, cardiovascular radiology, musculoskeletal radiology, and interventional radiology, which uses minimally invasive techniques for diagnosis and treatment.
Radiographers, also known as medical imaging technologists, are allied health professionals who perform X-rays and other medical imaging procedures, including MRI scans and CT scans. Their work plays a critical role in assisting medical doctors with the diagnosis, monitoring, and treatment of illnesses and injuries.
Admitting the current shortages of radiographers, Association of Medical Specialists (AMS) President Consultant Paediatrician Dr. LakKumar Fernando said the shortage affected only radiographers and not radiologists.
“We have sufficient radiologists in Sri Lanka. They are medical doctors. Radiographers are technologists who are not medical doctors, but are specialised in the technical aspects of the area.”
Dr. Fernando further said that the shortages were primarily due to migration, noting: “Many radiographers are migrating to Middle Eastern countries.”
NAO revelations
Meanwhile, the National Audit Office (NAO) has highlighted severe staffing shortages and discrepancies within the Ministry of Health, calling for urgent reforms to address these issues and ensure efficient healthcare delivery.
In its latest report, the NAO has revealed that as of June 2023, the ministry faced a shortfall of over 14,000 staff, significantly impacting hospitals and health institutions across the country. Out of an approved workforce of 95,948, only 81,915 positions were filled, leaving a gap of 14,033 staff.
The report also uncovered discrepancies in staffing records, with some hospitals reporting fewer staff than reflected in ministry data, pointing to inefficiencies in tracking and maintaining accurate information.
One key finding was the shortage of specialist doctors. Although the Cabinet had approved 2,837 specialist positions across 58 fields, only 2,740 specialists were employed as of June 2023, leaving 97 posts vacant.
Furthermore, the audit found that 972 positions in 35 fields were underfilled, while 113 specialists were employed in excess in 12 areas. Alarmingly, 141 specialists were hired for fields without Cabinet approval, raising concerns about irregular hiring practices.
The audit has also highlighted imbalances in staff deployment. For example, while some hospitals lacked 226 specialists, others had 123 specialists employed beyond their approved quotas. This misallocation reflects poor planning and coordination between the ministry and health institutions, leading to inefficiencies in addressing critical staffing needs.
Contractual employment practices were another area of concern. For instance, 1,103 mosquito control assistants hired since 2017 for dengue control activities were not formally recognised in ministry records, exposing gaps in employment processes and record-keeping. The NAO has recommended formalising such positions to ensure transparency and proper oversight.
Additionally, staffing shortages hindered the functionality of upgraded facilities like the Kalutara Teaching Hospital. Despite Cabinet approval in 2018 to increase its staff, no action had been taken by the end of the review period. The report has also found contradictions in staffing data from different ministry divisions, further complicating assessments of the healthcare system’s needs.
The NAO has urged the ministry to address these issues by hiring additional staff, reallocating excess personnel to underserved areas, and improving record-keeping. The audit has stressed the need for a systematic approach to staffing, better planning, and enhanced coordination to ensure the healthcare system meets the country’s growing demands.