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Paid services at Govt hospitals needs planning

01 Nov 2022

Minister of Health Keheliya Rambukwella’s plan to introduce paid services at selected public hospitals has attracted criticism from various parties, including health sector trade unions, which claim that the Minister’s plan is an attempt to gradually privatise the health sector. However, according to the Minister, this is aimed at providing better services for a minimal fee, in a context where the number of persons that seek services from the public health sector has increased owing to the increased fees of the private health sector. While the idea of free services, including free healthcare, has been a source of relief to countless citizens for decades, it is understandable that the manner in which these free services are funded and maintained should be revisited, given the nature of the economic crisis, which calls for long-term cost-cutting measures. As has been noted, on the one hand, charging a minimal fee could support the maintenance of the health sector to a certain extent, and on other hand, it would enable the health sector to provide improved services to those who cannot pay. However, making money through a service that is largely provided for free, while ensuring that citizens who cannot afford to pay are not negatively affected by the same, is a challenging, long-term task, and at this moment, the Government should focus on devising a way to kick this endeavour off with small steps.  The Minister has noted that one of the objectives of the aforementioned plan is to give the people the opportunity to obtain services at a lower rate than that charged by the private health sector. However, first and foremost, the Government should identify the capacities of various institutions that come under the public health sector, such as hospitals and laboratories, and also the requirements of those seeking their services. If the public health sector is to compete with the private health sector, before declaring paid services even in a limited number of public hospitals, the Government should conduct a study into the prospect. The study should look into a number of matters, with a focus on identifying capacities and requirements that are important for short- and long-term steps. It should delve into how the public health sector could provide the services that are currently primarily provided by the private health sector, and what services are being provided by the private health sector mainly or solely due to the lack of resources in the public health sector. At the same time, the study needs to look into what new or improved services could be provided by the public sector immediately, even at a minimal rate.  At the same time, since this is a matter that has national-level importance and influence, it is crucial that this plan is implemented gradually. While the people and health sector professionals need time to fully understand the nature of such programmes, the Government should take the time to initiate a meaningful dialogue about these programmes with the people and the health authorities. Most importantly, the Government should work only according to its capacity, because establishing paid sections in public hospitals, only to hand these operations to the private sector later due to an inability to maintain them, is not something that the country would want to experience.


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