Sri Lanka’s free healthcare system has long been one of the few institutions this country could genuinely be proud of. While politicians argued, governments changed, and the economy stumbled from one crisis to another, ordinary people still had something precious to rely on: the ability to walk into a State hospital and receive treatment regardless of wealth, class, ethnicity, or political connection.

That did not happen by chance. It was built over decades through political vision, public investment, and the dedication of generations of doctors, nurses, attendants, and health workers who kept the system alive even under impossible circumstances.

This is the same health service that functioned through a brutal war. The same system that responded after the 2004 tsunami when entire communities were wiped away in a matter of hours. The same system that held together during the Covid-19 pandemic when far richer countries struggled to cope. Our healthcare service survived because the people inside it carried it on their backs.

But today, the warning signs are everywhere. The system is beginning to crack.

The country’s economic collapse did not only empty the Treasury. It devastated the public sector workforce, and nowhere is that damage more dangerous than in healthcare.

The Government continues to speak about reforms and recovery, but there is very little honesty about the scale of the crisis inside public hospitals. Wards are understaffed. Clinics are overcrowded. Essential equipment goes unrepaired. Patients wait months for surgeries. Families are increasingly forced to buy medicines and surgical items from private pharmacies because hospitals simply do not have them.

This is the reality ordinary Sri Lankans are now facing.

The tragedy is that Sri Lanka trained many of these professionals at enormous public expense. Taxpayers funded their education. State universities produced highly skilled doctors who are now being welcomed by countries such as Australia, Britain, and Canada. Those governments are benefiting from Sri Lanka’s investment while this country struggles to retain even the minimum staff needed to maintain its healthcare system.

Even now, the political class seems incapable of understanding the urgency of the situation. 

Then comes the issue that has shattered public confidence more than anything else: corruption.

For years, there have been allegations surrounding medicine procurement, inflated tenders, and substandard drugs entering the system. What was once dismissed as rumour is now openly discussed in Parliament, investigated by committees, and exposed by journalists. The public has heard enough to understand that this is not a few isolated mistakes. There is something deeply rotten in the system of procurement and accountability.

And this is not ordinary corruption. Corruption in healthcare has consequences measured in suffering and death.

When a patient takes medicine from a government hospital, there is an unspoken trust that the drug is safe. That it has been properly tested. That somebody in authority did their job honestly. Once that trust disappears, the damage goes far beyond politics. It destroys faith in one of the few institutions that still binds this country together.

This is where the Government must stop treating the crisis as a public relations problem and start treating it as a national emergency.

Sri Lanka does not need grand speeches about “developing healthcare excellence” while basic hospital services are deteriorating. What is needed is straightforward political action.

First, medicine procurement must be taken out of the hands of political influence and subjected to full independent oversight. Every major tender should be transparent and publicly scrutinised. Those responsible for corruption must face consequences, regardless of rank or connections.

Second, healthcare workers must be retained through realistic salaries, safer working conditions, and proper incentives. It is impossible to save a public health service while the people running it are desperate to leave. Third, rural hospitals and clinics must be prioritised. 

Most importantly, the Government must finally tell the public the truth. People can tolerate hardship when they are treated honestly. What destroys public confidence is denial, spin, and political theatre while the system visibly deteriorates around them.

Sri Lanka’s healthcare system remains one of the country’s greatest achievements. But achievements can be destroyed through neglect, corruption, and political incompetence.

A country that cannot protect its public health service is a country that is abandoning its people. And right now, that is exactly what many Sri Lankans fear is happening.