Putting the State health sector in order

The recent arrest of the former Health Ministry Secretary Janaka Sri Chandraguptha by the CID over the importation of substandard immunoglobulin is likely to lead to several other high-profile arrests. Chandraguptha was remanded until 27 December by the Maligakanda Magistrate last Monday with a directive from Court to seal his office so that the investigating officers can inspect the documents relating to medical purchases. 

Trade unions representing the health sector have been alleging for months that substandard medicines are being imported into the country, particularly after the economic crisis began last year. Several deaths have been reported due to allergic reactions caused by such medicines with the import of substandard immunoglobulin injections, one of the main malpractices exposed by opposition politicians, trade unions as well as the media.

Fingers have been pointed at the former Health Minister Keheliya Rambukwella too but so far the CID has not recorded a statement from him. Rambukwella was removed from the health ministry portfolios by President Ranil Wickremesinghe in October amidst allegations of worsening fraud, malpractices and inefficiency in the health sector.

Though faced with many shortcomings, Sri Lanka’s free health system is a lifeline to millions providing people with access to the best doctors in the country as well as nursing and other healthcare facilities. There are 555 Government hospitals with more than 95% of inpatient care provided by these hospitals. These hospitals also provide primary healthcare which offer curative, preventive, and rehabilitation services and is accessible for anyone who wishes to use such services. With private health services reaching exorbitant rates, more and more people have turned to the State sector for their health needs.

The country’s economic crisis impacted the health sector badly and medicine shortages became a major problem. Most patients attending hospitals were forced to buy their medicines privately, but that situation has slowly eased but there is still a long way to go to get the State health sector back to where it was.

It’s while the public were facing the worst of times that details of corruption among officials in the health sector came to light. These include the purchase of medicine bypassing the Government approved tender procedures with emergency purchases used as an excuse to do so. With little thought for their fellow citizens who were facing dire medical needs, these corrupt officials compromised on the quality of the medicines to fatten their purses and put the lives of patients at serious risk. For months, even after the details of the malpractices became public, there was little action taken to stop those engaged in such practices and Rambukwella, who was the minister, proved unable to put an end to the worsening problems in the sector and was himself accused of being party to such illegal practices.

Since the new Health Minister Dr. Ramesh Pathirana took over, there has been some attempt to inquire into the allegations levelled at senior officials in the sector. Some arrests have been made and cases filed in court. How these cases will be carried forward will be seen in the weeks and months ahead. Even if those arrested are found guilty and punished by law, it will be too late for the families of those who lost their loved ones due to the use of substandard medicines or due to shortages but leaving such persons unpunished would be worse and a green light for corruption to continue among those in the officialdom.

Such arrests are likely the tip of the iceberg in a sector that is rampant with corruption. Hence a lot more will need to be done to make the country’s free healthcare system truly meaningful and eliminating corruption is crucial.