•  Health Ministry mulls cadre increase

The Government needs to recruit around 20,000 more nurses just to meet the minimum cadre required to maintain the country’s health services, while a further 40,000 nurses are needed to bring the nursing workforce to an adequate level, according to the All Ceylon Nurses Union (ACNU).

Speaking to The Daily Morning, ACNU General Secretary H M S B Mediwatta said the nursing service currently had around 45,000 nurses, but irregular recruitment over several years had created a major gap in the intake of new nurses. Retirements and nurses leaving the country had further worsened the shortage, he said.

“There has been no regular recruitment to the nursing service from around 2021. A group that had completed three years of nursing training had to wait around nine months for appointments before receiving them in 2025. The 2019 Advanced Level (A/L) batch was also recruited only in 2025,” Mediwatta said.

He added that interviews were currently being conducted for around 3,000 students who had passed the A/L examination between 2021 and 2024 and were seeking admission to nursing training.

Mediwatta said around 2,800 nurses who had already completed their training were expected to receive appointments in November. He added that the shortage had become more serious as new hospital units, operating theatres and clinics were being opened without enough nurses to staff them. "The Hambantota District General Hospital is an example. There, two operating theatres and several specialised units cannot be fully started because of the shortage. The hospital has requested at least 50 to 75 nurses to operate those units," he said.

He also said nurses were also being transferred from existing hospitals to fill vacancies elsewhere, creating shortages at the hospitals they left. "The problem was particularly visible at hospitals such as Talangama and Athurugiriya Divisional Hospitals. Talangama Hospital, which previously had 22 nurses, now has 15 despite an increase in services, and Athurugiriya Hospital has around 11 nurses compared to about 30 previously."

Mediwatta said the nursing cadre itself also needed to be updated because the existing cadre was based on figures from around 2015 or 2017, despite an increase in the number of wards, operating theatres, clinics and other units in recent years. He said the Government was now working to increase the cadre by around 20,000, which he identified as the minimum requirement for maintaining services, but estimated that around 40,000 more nurses would be needed to bring the service to a proper level.

Meanwhile, Government Medical Officers’ Association (GMOA) Secretary Dr Ubaya Bandara Warakagoda said the Public Service Commission, the Ministry of Finance’s Department of Management Services, the Ministry of Public Administration and the Ministry of Health should work together to address the shortage as an urgent matter. He said newly established hospital units were also facing serious staff shortages, with some wards having only one specialist and one MBBS-qualified doctor and some having only a specialist doctor. “The shortage of human resources is not something that can be looked at by shortlisting one particular area. The problem exists from the National Hospital down to the smallest estate hospital,” he said, adding that the shortages were not limited to doctors and also affected nurses and field officers. He said a number of district hospitals, including hospitals in the Northern Province, needed nurses but did not have even a single nurse. 

Deputy Health Minister Dr Hansaka Wijemuni, speaking to The Daily Morning, said the Health Ministry had requested increases to the nursing and other health service cadres and had also made requests through Provincial Councils for cadres at provincial hospitals. Those requests would then be sent to the Management Services Department for approval. “Once it approves the cadre, we can increase it. But at present, the bigger issue is not the cadre. We have a limit on the number of nurses we can recruit, and that limit is currently insufficient,” he said. He also said newly recruited nurses could not be sent directly to hospitals because they had to complete the required training first.

He said the Ministry was also taking steps to ensure that new hospital units were opened in a planned manner instead of simply being opened after construction was completed. “We have introduced guidelines for starting new units. Hospitals should recruit the required staff through the Ministry before starting a new unit. We have to plan this properly,” he said. The Ministry was also reviewing the distribution of health workers to ensure that nurses and other staff were deployed to places where they were needed. “We are looking at all these areas to ensure that there is no further unplanned development of the health sector,” Dr Wijemuni said.