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Taking healthy decisions

Aug 23, 2011 3:26:46 PM - www.ft.lk

STATE-funded healthcare is both a boon and a curse for the public. On Tuesday the Health Minister decided to ban all Government hospitals from referring patients to get tests done at private medical centres, creating another stage for controversy.According to reports, the decision was announced to the media after Health Minister Maithripala Sirisena did a tour of the Colombo National Hospital’s laboratories.

The premise this order was based on is that it is unfair for patients to be referred to private laboratories since they are more expensive. This is far from sound, as even a cursory examination of laboratories in public hospitals will show.
Government hospitals, particularly in rural areas, are notorious for being ill-equipped and below standards. The tests are at times inaccurate and laboratories are not able to provide the required variety of tests. Unless tests are done quickly, it is difficult for an accurate diagnosis to be obtained, thereby delaying treatment.
In addition, Government hospitals are notorious for being underfunded and mismanaged. This is not to say that they do not serve the public to the best of their capacity, but there is definite room for improvement. Moreover, subsidised healthcare should be targeted towards the poor and if there are patients with the financial means to resort to private testing services, then they would create more room for the poor to get faster results. In such a scenario it is difficult to justify the stance of the Health Minister that banning referrals to private laboratories serves everyone.
Since the Ministry has not yet issued the gazette notification for this move, it is likely that there will be more discussions on this subject in the next few days. It makes little sense to enforce this measure as few Government laboratories have the necessary infrastructure to efficiently carry out the Minister’s wishes. Getting the right diagnosis can make the difference between life and death. Finding out what is wrong with the patient as early as possible can save a lot of money in treatment and not giving patients the option of going to private laboratories simply because they are more expensive is totally counterproductive.
In a country that spends more on defence than on per capita healthcare, there are many other steps that can be taken to improve efficiency and standards. Regular drug shortages, doctors and nurses going on strike, grossly inadequate funding and lack of access to latest procedures and technology are just a few problems that the health sector faces. There has also been a long need to clean up mismanagement and corruption within the field. These make for a long ‘to do’ list that would better occupy the Minister.
Touring one hospital and deciding on something that will affect millions of patients countrywide is not wise, to say the least. As a powerful public official, the Minister has to be more broadminded and consider all aspects of a problem before he puts out an order. Discussion with the people and relevant experts would be one way of understanding the consequences of decisions. There must also be a framework to enforce the good decisions and ensure that they are implemented. Random declarations cause more wounds in an already-bleeding healthcare system.

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