In an era where individuals try to cling on to positions of power, come what may, it was refreshing but at the same time frustrating to hear of the resignation of Prof Colvin Gunaratne as Chairman of the Sri Lanka Medical Council (SLMC), last week.
Gunaratne’s tenure as head of the apex body that purportedly regulates the medical profession was short, barely ten months. He took over from Prof Carlo Fonseka, his predecessor both at the SLMC and at the Colombo Medical Faculty, where they both served as Professors of Physiology.
Fonseka presided over the SLMC until the ripe old age of eighty-four. He was instrumental in opposing the registration of graduates of the South Asian Institute of Technology and Medicine (SAITM). When he retired, the doctors’ trade union, the Government Medical Officers’ Association (GMOA) first pleaded with him to stay on and then warned of dire consequences if Gunaratne was appointed SLMC Chairman.
Of course, appointing the Chairman of the SLMC is the prerogative of the Minister of Health, and the GMOA should not be whingeing about it, but then, complaining about matters that are outside its purview- such as, the free trade agreement with Singapore, for instance- is now the norm for the GMOA. Prof Gunaratne is no stranger to controversy. He authored a book on Sri Lanka’s first case of alleged medical negligence, ‘A Doctor’s Quest for Justice’.
At the time, rightly or wrongly, many accused him of being partisan towards the doctor concerned. So, as Chairman of the SLMC, when he says that the SLMC is a body where patients’ rights are not heard because it is dominated by doctors, one must sit up and take notice.What is significant is what Gunaratne revealed, in offering his resignation. He noted that, given the manner in which the SLMC is constituted, 16 of its 25 members are from the GMOA. No wonder that he said, it was impossible for him to function independently.
Recently, when elections to the SLMC were held, the GMOA took a leaf out of the book of our politicians. They hired buses to bring doctors to the SLMC Colombo Office at Norris Canal Road, to vote. They came in their dozens, they voted and they conquered the SLMC. Now, as Prof Gunaratne points out, the SLMC is but an extension of the GMOA. They might as well call it the GMOA (SLMC branch)!
The SLMC is supposed to be an independent body comprising eminent persons that regulate the medical profession.
That is what medical councils worldwide do. Most medical councils in the developed world comprise not only medical professionals but other individuals relevant to the profession. Therefore, they have representatives from among lawyers, patients, and members of the general public in their councils. It is to ensure that such a council is not skewed in favour of doctors alone.
Instead, what we have is an SLMC dominated by the GMOA. By the very nature of how it has been constituted, the GMOA gets a virtual ‘two-thirds majority’ to run the affairs of the SLMC as it pleases. That is why Prof Gunaratne first tried to have the rules governing the SLMC changed and that is why he resigned when he was unable to do so. All this wouldn’t matter if the GMOA too was a principled body that diligently self regulates and maintained lofty standards. Instead, it has become an institution of doctors, run by doctors, for doctors. The voice of patients- and anyone else, as we saw during the SAITM dispute- has been drowned by their strident cacophony.
Of course, doctors have rights too and as the trade union representing its interests, the GMOA is entitled to its fair share of shouting. There is nothing wrong with that. However, what we have seen is strike after strike after strike by doctors who want their interests served at whatever cost, even at the cost of patients’ lives. We have seen the GMOA stage strikes demanding duty-free permits and privileged schools for their children. The latter is both hilarious and ridiculous. Obviously, the GMOA feels that their members are a different kind of privileged and endangered species by virtue of getting a high ‘Z score’ and gaining entrance to a medical faculty where they adorned themselves with a medical degree. As such, they must be treated like royalty and be entitled to special privileges, such as ‘good’ schools for their children.
That concept is comical and it is surprising that no one has challenged it in a court of law. To accord the children of a certain category of professionals special access over and above others for a fundamental right such as education could even constitute a breach of law. What if engineers, lawyers and accountants all demand the same privilege?
The hypocrisy of the GMOA was exposed during the SAITM issue. SAITM, it appears had its fair share of deficiencies, and maintaining the standards of medical education is a noble ideal, but the GMOA was opposed to all forms of private medical education- even if it was properly regulated- while it was demanding special privileges when it came to the education of their own children. What next? Reserve a few places in state medical faculties for doctors’ children, perhaps?
This week saw a railway strike that crippled public transport in the country. At the height of the strike, we saw members of the public turn against railway workers, booing them, denouncing them and then trying to take them on, physically.
The public resentment that was witnessed appeared spontaneous and not engineered by political manipulation. If the GMOA continues to act in the manner it has done until now, the day that it will be set upon by the public will not be far off.
Whether Prof Colvin Gunaratne did the right thing by resigning is debatable. Maybe he should have stayed on and fought to reform the SLMC and the rules that govern it. However, he has now confirmed what many have suspected for the past few years: without any kind of proper self-regulation or ethical framework to adhere to, the medical profession is no longer the dignified calling it once was; it is now yet another job where anything can be done for just a few rupees more.