BY SURESH PERERA
The Government Medical Officers’ Association (GMOA) last week urged the government to acquire the Sri Jayewardenepura General Hospital (SJGH), which has been tainted by allegations of corruption, waste, mismanagement and financial irregularities.
"There is no alternative option left now but to take over this medical facility and convert it into a government-run general hospital", says Dr. Sankalpa Marasinghe, the GMOA’s Assistant Secretary.
It has taken 26 years to realize that SJGH is a failure — a white elephant, he pointed out. "We have always made it clear that the ‘board management system’ of this semi-government hospital was not viable and has led to irregularities and allegations".
Apart from the prospect of acquisition by the government, there seems to be no way out for this 1,001-bed hospital, Dr. Marasinghe underscored. "As a key medical facility and a postgraduate medical training center, it is equipped with modern equipment ideal for a government general hospital".
SJGH has also come under heavy flak for exploiting patients under a system of unregularized charges, which, as revealed in last Sunday’s edition, had caused concern over a surgeon charging 45,000 rupees and 50,000 rupees, respectively for two simple colonoscopy and hemorrhoids procedures.
The All Ceylon Health Services Union (ACHSU), which protested over this "shocking exploitation of patients", said last week that moves are afoot to refund these excessive charges following The Sunday Island exposure.
"They are now trying to reimburse the money after the damage is done", says Chandana Jayalath, the trade union’s Secretary. "The crux of the matter is the absence of an acceptable, regularized system of charges".
"That’s right, we have decided to refund the money and have already asked the family of the young girl who underwent the colonoscopy procedure to submit an appeal", said Nimal Bandara, the hospital’s Chairman. "These exorbitant charges are unacceptable".
"Apart from the reimbursement, we will be calling for the explanation of the surgeon concerned", he assured. "We will not tolerate such behavior".
Jayalath asserted that SJGH generated 300 million rupees in revenue in 2010, of which 166 million rupees had to be allocated to pay consultant surgeons and other medical practitioners. "Paying salaries of other staff, utility bills and the day-to-day expenses had to be met with the balance money".
Bandara said that surgeons are permitted private practice within the hospital before 8 am and after 4 pm on week days. They can charge 1,000 - 1,200 rupees per visit from in-house patients and what some of them do is lump all these charges together and claim as ‘surgery’.
SJGH is entitled to a share of 30% of these charges, but as a whole, these medical practitioners take the lion’s share, the Chairman explained. "But, on the other hand, if they didn’t do it, neither party will get anything".
He said that SJGH is now in the process of introducing medical packages so that patients would know the cost of each operation, be it a caesarean section or bypass surgery. "This will help regularize the charges".
A ‘package system’ for surgery categorized under four different headings was proposed on the perseverance of Kiran Atapattu, a then director to regularize and control charges, but with his recent removal, it was back to square one, hospital sources said. was accountability at that time".
Under this system, the charges levied for surgery were as follows: Normal Ward – minor - 1,000 rupees, intermediate – 2,000 rupees, major – 5,000 rupees and special major 7,000 rupees, Class 2 (Paying Ward) minor – 1,500 rupees, intermediate – 3,500 rupees, major – 7,500 rupees and special major - 10,000 rupees and Class 1 (Paying Ward) minor – 2,000 rupees, intermediate - 4,000 rupees, major 7,500 rupees and special major - 12,500 rupees.
There are some medical consultants at SJGH who earn an incredible three million rupees per month, the trade union leader said. "It is a big rip off".
Amongst other debts, SJGH is in arrears of 275 million rupees to the National Water Supply and Drainage Board and 300 million rupees to medical suppliers, Jayalath claimed. "This is unbelievable".
He said the trade union has been invited for a meeting with the hospital’s Chairman on Tuesday (15) to discuss the critical issues confronting this key medical facility. "We are deeply concerned over ongoing developments".
The appointment and the all-inclusive 250,000 rupee monthly salary paid to Dr. Shavendra Gamage, SJGH’s director has also come under the searchlight with the trade union describing it as "highly irregular".
The special board meeting called to sanction the director’s appointment and allowances didn’t have the required quorum of five members and as a result Dr. Gamage himself had sat on the board to make up the quorum and ratify it, Jayalath charged. "That’s why the minutes of this board meeting do not have a board meeting number".
"This board meeting was in order in terms of the law, but admittedly it may not be ethical as the director himself had sat on it", the Chairman explained. "The appointment had been done before my time".
"I know it doesn’t look nice when a person sits on the board to approve his own salary/allowances, but that is what had happened", he pointed out. "Anyway, the meeting itself was legal and well within the SJGH Act".
On the director’s salary, he said the board approved an additional 60,000 rupees to him by way of a 2,000 rupee daily allowance. "At the Castle Maternity Hospital, where he served earlier as director, Dr. Gamage was paid around 160,000 rupees as remuneration which included all his allowances".
The minutes of this board meeting lists the participants as N. W. E. Wijewantha (then Chairman), Dr. Ajith Mendis, Mahinda Samarasekera, Ms. Hiransa Kaluthanthri and Dr. S. A. K. Gamage (the director-aspirant).
Kiran Atapattu had strongly protested against the appointments and declined to sit at this board meeting on the basis that it was "not in order", hospital sources said.
On the trade union’s assertion that deputy director, Dr. (Mrs) Chamila Ariyananda, is not registered with the Sri Lanka Medical Council (SLMC) and that she had applied for the position giving an address in Surrey, United Kingdom, the Chairman replied, "She had been interviewed by the Health Ministry and her appointment was approved by the SJGH board. The address given in her application was in the UK as she had lived there for 16 years".
Bandara said the deputy director has a dental degree but she did not possess postgraduate qualifications and was ‘not less than 45 years’ as the criteria demanded.
When insisted whether she had SLMC registration, the Chairman said, "That had not been part of the criteria for the appointment".
"The deputy director has no postgraduate qualifications, is less than the required age and is not registered with the SLMC, but she continues to hold that position", Jayalath shot back. "The appointments of both the director and his deputy are irregular".
SLMC registration was an absolute requirement just as much and any previous experience in hospital administration for this job, he insisted. "Both criteria had not been met".
Questions have also been raised over the appointment of an MBBS doctor as the director and a dental surgeon as the deputy of SJGH, a significantly large hospital with 1,000 plus beds.
"We are now looking afresh at the deputy director’s appointment", Bandara assured. "What needs to be done will be decided after that".
"The lesson we can draw now — after nearly three decades since SJGH was created – is to take over this medical facility, appoint a director and run it as a government general hospital", the GMOA official advocated.
http://www.island.lk/index.php?page_cat=article-details&page=article-details&code_title=38953
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