Improving workforce, re-opening health facilities

By Sarah Hannan

About 600 graduates of the paramedical degree programme in the University of Peradeniya of the 2009 intake had not been given employment after their graduation, The Sunday Morning learnt. Meanwhile, there was a shortage of healthcare staff reported in the Northern and Eastern Provinces and many people from the areas volunteered to work during and after the civil war.

We spoke to the Ministry of Health Nutrition and Indigenous Medicines Public Relations Officer Dr. Upul Gunasekara to clarify: “While there are over 15,000 vacancies for nurses, there weren’t qualified individuals that we could recruit.

Moreover, these volunteer staff had not been acknowledged for their contribution and therefore, the Ministry of Health decided to absorb all who met the minimum educational qualifications as full-time staff members in 2015.”

Since 2015, all paramedical graduates were given jobs as radiographers, physiotherapist, and nurses.

“The trade unions can say what they presume, but we were determined to give due recognition to these voluntary staff contributions and offered them letters of appointment. We also observed that there have been some anomalies in the recruitment process and for some of the posts, people have not been recruited after 2009, creating a shortage in paramedical staff,” he added.

For a country that has 21 million people, once there had only been 15 neurosurgeons and around 15 cardiothoracic surgeons, which is insufficient for the country.

Considering the patient needs, the Ministry had then convened all the medical colleges and informed them to increase the intake for postgraduate medical studies to increase the amount of specialists that are produced per intake.

In order to improve the country’s health services, more specialists are required. Dr. Gunasekara further noted that Sri Lanka is still lacking in various facilities. “Though we won the Cricket World Cup in 1996, Sri Lanka did not have a sports therapy unit. Even though we talk about our health system with high regard and have infrastructure in place, it means nothing if there are insufficient specialists at hand.”

Specialists to graduate

At present, there is only one Post Graduate Institute of Medicine (PGIM) for the entire country at the University of Colombo, and Dr. Gunasekara informed that Health Minister Dr. Rajitha Senaratne had proposed to establish PGIMs in the Peradeniya and Jaffna Universities as well.

Furthermore, there had been over 40 hospitals that were closed down due to non-availability of staff and doctors in the Northern and Eastern Provinces.

Though many previous health ministers had attempted to transfer doctors and staff to these hospitals, it had failed, depriving the people from the area of access to healthcare facilities. “We decided to re-establish these hospitals after 2015.

For the past four years, we have recruited 4,205 medical officers. As requested by the Education Minister Akila Viraj Kariyawasam, the Ministry enrolled medical students at the Sabaragamuwa University and established the Sabaragamuwa Medical Faculty in Ratnapura and the Wayamba Medical Faculty in Kuliyapitiya.

The Eastern Medical Faculty has launched a huge project at the Batticaloa Hospital where they have all the latest equipment to treat patients in an efficient manner.

Increasing workforce

Between 2007 and 2014, the Ministry of Health trained 7,009 paramedical staff. A nursing faculty is to be established attached to the Jayewardenepura Teaching Hospital in the coming years as well.

From 2015 to 2019, the Ministry appointed 8,478 nurses, which included the paramedical staff that was trained between 2007 and 2014, thereby increasing the overall workforce of the Ministry of Health.

Each year, a batch of 1,500 doctors are recruited from the foreign graduates, yet the Government could not assign them to hospitals as some of the stations could not be opened due to the lack of specialist doctors who could head the ICUs, neuro-trauma units, and cardiothoracic surgery units.

A clear mal-distribution of skills and workforce was identified.

“There are over 100,000 employees working at the Ministry of Health. But for all these years, we did not have an HR department. This led to recruitment anomalies and mal-distribution of staff, and left the staff with no point of referral to attend to their employment needs.

The minister presented a cabinet paper requesting to establish an HR department for the Ministry of Health after he was appointed in 2015.”

With the establishment of the HR department, the Ministry of Health has forecasted the workforce needs for the next five to 10 years. Dr. Gunasekara assured that even the recruitment process is now streamlined and will take place in an orderly manner.

Emergency services improved

With the introduction of the “Suwa Seriya” emergency ambulance services, even the ambulance drivers had to be trained to provide paramedic care in times of need.

Dr. Gunasekara opined that it is important to provide them with proper training so they could assist in providing preliminary healthcare as they rescue lives. “We are also looking at sending them for international training sessions so they could observe how other countries handle emergency situations.”

He also revealed that provisions are being made to establish a SAARC medical faculty in Sri Lanka which will greatly benefit the enrichment of Sri Lanka’s health sector.

Meanwhile, the Ministry has opened up opportunities to various grades from the health sector to take part in foreign training programmes from time to time, and the Minister has instructed that opportunities are to be equally distributed to avoid favouritism. Emergency Treatment Unit (ETU) staff including doctors, nurses, and paramedics is sent to Singapore for training and over 30 individuals have undergone training so far.

Minor staff not in excess

Responding to the article that was published in The Sunday Morning on 21 April titled “Overstaffed and under qualified”, Dr. Gunasekara, refuting the allegations, stated that at present, many hospitals are in fact short of minor services staff.

“Various trade unions would present their analysis that we are haphazardly recruiting individuals, but in reality, we have received requests to recruit minor services staff from Kandy Teaching Hospital and National Institute of Mental Health as they are finding it difficult to function.

The Minister is in discussions with the provincial councils to understand their workforce needs for area hospitals and have requested them to directly send in their requirements for minor staff.”

When inquired as to what the minimum criteria to join the healthcare minor staff were, Dr. Gunasekara stated that any individual under the age of 35 who has passed six subjects of the G.C.E. O/L examination with a minimum of two credit passes are eligible to apply.

He also noted that the Ministry encourages individuals from the respective areas to apply for these positions through the provincial councils, and the recruitment process will take place as per the requirements.

With the restructuring of the recruitment process, all new recruits are now assigned to the hospitals that are closest to their home town. “However, we still have staff that come and request for transfers to their home town. Some of them have been working in distant areas for over five years.

With employing a scientific method of managing the human resources for the Ministry, we are hoping that the health sector workforce requirements can be fulfilled in the next four-five years,” Dr. Gunasekara noted.