Recording another judicial victory against the Sri Lanka Medical Council (SLMC), the graduates of the South Asian Institute of Technology & Medicine (SAITM), Sri Lanka’s only private medical college, left the Supreme Court complex last Tuesday (30), with fresh hopes for their future. Some 40 graduates and their parents had gathered both inside and outside Courtroom No. 404, where the case was heard by Justices Buwaneka Aluwihare, L.T.B. Dehideniya and Preethi Padman Surasena.
The legal battle that began in March this year, ended last week with the Court’s ruling that directed the SLMC to provisionally register the petitioners, the SAITM medical graduates, as medical practitioners in Sri Lanka in terms of Section 29 (2) of the Medical Ordinance. The Court ruling also required the health authorities to lift all barriers to the SAITM graduates being granted internships as medical officers. Furthermore, the Supreme Court bench ordered the SLMC to compensate each petitioner with a Rs. 200,000 grant.
The momentous judgement by the Court opens up the way for privately educated medical graduates, having obtained the relevant qualifications, to enter the healthcare system as medical professionals. The Supreme Court bench also directed all relevant respondents, including the SLMC and Health Ministry, to take necessary steps to instate due seniority of the SAITM graduates in the posts they take up.The Court, cognizant of the considerable time lapsed since these medicos graduated, has stipulated that all measures to restore their rights should be taken and completed, with just three weeks allocated to follow these measures.
A swim against the tide
The strivings of the 84 SAITM medical graduates for justice was a journey that contained many challenges, sometimes pitting these aspiring young professionals against powerful political forces and hostile professional interest groups. Mostly unaware of the intricacies of medical professionalism, the larger society remained unsympathetic.
Even though SAITM was later recognized by the University Grants Commission (UGC) and later recognized by the Ministry of Higher Education in 2013 as a Degree Awarding Institute, SAITM’s medical students became victims of the haphazard, often tempestuous, governing of the country. During successive governments, they struggled to win their professional recognition, but it was a lonely endeavour.
Neither the politicians who originally facilitated the establishment of SAITM’s private medical college nor the succeeding politicians in power - who pretended to be even more liberal in economic policy – chose to listen to the grievance of SAITM’s 900 plus students. It is likely that these aspiring, but hapless, young people were too small in number to be considered a valuable vote bank.
However, much of the persistent uncertainty over their professional future was created by the arbitrary behaviour of the SLMC, its bureaucractism and resistance to change and, efforts to demonstrate an institutional power it did not possess.
Prof. Colvin Gunaratne, currently Chancellor of the Open University, stepped down from his previous position as President SLMC an year ago claiming that the SLMC should come out of the captivity of trade unions and instead, serve its ultimate purpose, the safeguarding of the public from wayward medical practitioners. Prof. Gunaratneblamed the GMOA, for being the controlling hand of the SLMC which ‘used to’ be a well-recognized and respected institution.
Trade union attack on SLMC
The SLMC is the apex controlling body of the country’s medical profession, supposed to ensure its professionalism as well as the calibre of its contribution to society. Currently the SLMC’s membership of 24, comprises of deans of the faculties of medicine in state universities (8), members elected by medical practitioners (8), members appointed by the Health Minister (4), Dean of the faculty of dental sciences, a dental practitioner, a member of RMO and the Director-General of Health Services.
“When I was the President at SLMC, I remember how those GMOA fellows faced the Council elections. They had hired buses and brought doctors from many outstation areas.
Finally, the election ended with contenders and supporters beating up each other. Such disgraceful behaviour…” Prof. Gunaratne recalled in an interview with the Sunday Observer.
Eight SLMC members represent the GMOA, while another eight represent the Faculty of Medicine Teachers Association (FMTA) (deans), thus making two-thirds of the SLMC a place for trade unions. Eventually, the SLMC came to be made up100 per cent of doctors and began to display a bias towards the interests of the doctors alone.
During the time Prof. Gunaratne was active in the SLMC as a member and, later, as its President (a span of three and a half years), only four cases against doctors were taken to the trial stage at SLMC. “It is a biased place as it represents the doctor community.
It does not serve the public, which was the goal of establishing the SLMC under the provisions of the Medical Ordinance,” Prof.Gunaratnesaid.
Challenging SLMC
Chinks in the armour of the mighty SLMC began to show with its legal appeal against SAITM medical graduate Malshani Suriyarachchi, who was the first to go to courts to obtain her provisional registration with the SLMC. After considering her petition, the Court of Appeal (CoA) ordered the SLMC to grant her the due registration in January 2017. But the SLMC refused to adhere to the court order and appealed it at the Supreme Court.
SLMC sources revealed to the Sunday Observer that the meeting held at SLMC soon after the CoA verdict, had been stormy with much angry rant about the wealth and income statements of SAITM founder Dr Neville Fernando.
While the SLMC bureaucrats of the time were focusing on someone else’s wealth (and perhaps making some of their decisions based on that) the Council’s appeal against the CoA order was rejected and the Supreme Court upheld the previous decision in September last year.
Meanwhile, citing the SLMC’s failure to date to implement court directives to register SAITM graduates, a separate case of contempt of court is also now underway against the Council. The next hearing of that case will be taken up in September 2019. However, there have been even greater challenges to the SLMC’s intransigency in its engagement with SAITM.
In July 2015, following an invitation by SAITM, a special inspection team consisting of Professors Rezvi Sherrif, Nilanthi De Silva, Ranil Fernando, Ranjani Gamage, Wasantha Gunathunga, K. Sivapalan, Doctors L.B.L. De Alwis, B.J.C. Perera, Hemantha Perera and H.M.S.S.D. Herath who were appointed by the SLMC, went to SAITM and the Neville Fernando Teaching Hospital for a thorough evaluation.
However, the final report of this inspection which was handed over to Health Minister Dr Rajitha Senaratne on September 4, 2015, was a fraudulent document as highlighted in the Supreme Courts’verdict last September.
The report prepared by the committee had endorsed the provisional registration of SAITM graduates following the fulfillment of certain recommendations, while the report sent to the minister stated the complete opposite. It stated that SAITM graduates are not suitable for provisional registration with the SLMC. However, it came to light in the judicial proceedings that the SLMC had acted scandalously by removing five principle recommendations and four additional recommendations submitted by the inspection committee.
Conception to abortion
Even earlier, in September 2014, a fundamental rights case was filed in the Supreme Court by SAITM students against the Minister of Health. This was, however, settled out of court, on the grounds that then Minister of Health (Maithripala Sirisena) had agreed to cooperate with SAITM to facilitate the required clinical training at a designated state hospital.
This was a time when, despite isolated protests against SAITM from the Inter University Students Federation and some other leftist parties, there was no major controversy about the private medical college.
Primarily it was because SAITM was established with the complete support of the government of the time. Ex-President Mahinda Rajapaksa participated in certain events of SAITM. Moreover, it was the then Minister of Higher Education S.B. Dissanayake who issued Gazette No. 1721/19 of September 30, 2011, recognizing SAITM as a degree awarding institute under Section 70C of the Universities Act, with power to award MBBS degrees, subject to fulfillment of several conditions specified in the Gazette including the establishment of its own teaching hospital and professorial unit. This was followed by another supplementary gazette on September 26, 2013.
But SAITM, the baby of the previous regime became orphaned after the power shift in 2015 as no one was there to listen to its issues.
Thus, on hearing the historic court ruling last Tuesday, graduates who had completed their MBBS degree in 2016 and later, had burst into tears of joy. Those were not just tears of happiness. The celebrating graduates still could not but feel betrayed by a society that largely just stood by as this small group of determined young people who had invested much in terms of money and studying, struggled for recognition with due return on investment.
For too long have they been the ‘imposters’. And all they had wanted was to be recognised by society so that they too could contribute towards the health of the nation.