• JCPSM Secy. Chanaka Dharmawickrama notes that the same practice leads to delays in important decisions, weak planning, poor health service mgt., lack of coordination, misuse of resources   
• Adds that the Health Min. has been requested to act against hosp. admins. violating circulars on tech. evaluation comms. by not including professionals from the supplementary med. services in the decision-making process for their knowhow/experience   

The supplementary medical services play a vital role in Sri Lanka’s healthcare system, providing essential support in diagnostics, treatment, and rehabilitation. This diverse sector includes professionals such as radiographers, pharmacists, physiotherapists, and speech and language therapists, whose work is critical to the functioning of modern medical care. Despite their importance, these professionals face numerous challenges, from salary anomalies and poor recruitment policies to a lack of representation in decision-making.

Speaking to The Daily Morning, the Joint Council for Professions Supplementary to Medicine (JCPSM) Secretary, radiologic technologist/radiographer Chanaka Dharmawickrama discussed the ongoing struggles within the sector, their demands, and the actions being taken to address these pressing issues.

Following are excerpts from the interview:

What are the primary professional challenges and demands currently encountered by professionals in the supplementary medical services in light of matters such as salaries, recruitment, and staffing policies?

This is a widespread service comprised of many professionals, including radiographers, radiotherapists, pharmacists, occupational therapists, speech and language therapists, physiotherapists, audiology therapists, and others. They have separate trade unions (TUs), and the JCPSM is a collective of those TUs. These professions are involved in the diagnostic process and the technical side of medical services.

These days, we are particularly focused on issues related to the recruitment of allied health graduates to these supplementary services, which is both crucial and problematic. In addition to that, there have been long-standing salary anomalies within the professions, especially when compared to other similar Government services. Promotions are also carried out very slowly. Also, the extra duty allowance has not been increased or reviewed for 22 years. Although successive Governments have provided various benefits to other professions, including doctors, those engaged in these professions have not received the benefits that they deserve. For example, almost all of those who join these services are graduates, yet, they receive salaries meant for diploma holders. This example highlights the seriousness of the issue. As a result, graduates with degrees related to these professions are somewhat reluctant to join the local services. Also these professionals don’t take part in the decision-making process or any other technical evaluation where it is very important to have their knowledge and experience.

What proposals or strategies do you suggest for addressing these challenges effectively?

We sent a proposal to the Public Service Commission (PSC) regarding the changes that need to be made to the scheme of recruitment (SOR) four years ago. The SOR should be amended to address these issues. Usually, it takes five to six years at most to finalise such an amendment, and it requires collaboration between the Ministry of Health and the PSC. The PSC does not work directly with TUs. Therefore, we submitted our proposals regarding the recruitment policy to the PSC.

We see a serious lack of intervention from the ministry, which is slowing down the process. Regarding the salary anomalies, we have requested the ministry to appoint a committee to review the proposals and reach a decision. However, it is yet to be appointed. If a committee is appointed for this purpose, we will be able to submit our proposals and have meaningful discussions with them.

As for the allowances, several committee reports have already been submitted to various governments, yet, no action has been taken so far. The issues related to promotions are entirely in the hands of the ministry. They should carry out the promotion process regularly; otherwise, the backlog will only increase. We have also requested the ministry to take action against hospital administrations that violate circulars on technical evaluation committees by failing to include professionals from the supplementary services.

How do you respond to the suspension of JCPSM President Ravi Kumudesh and the broader issue of TU suppression within the health sector?

This issue is part of an organised campaign. In society, there is no positive image of TUs, and governments are creating a bad impression of them. This Government is also doing the same to control TUs and their leaders.

Regarding this particular incident, the authorities claim that he (Kumudesh) contested the last Parliamentary Election without informing the Health Ministry. However, he had informed the ministry on several occasions in writing that he was going to contest the said election. If we set aside his political affiliations, it was he who exposed a number of major frauds and scandals that took place within the health sector. He was one of the few people who revealed the controversial human intravenous immunoglobulin scandal. There are many inquiries against him for exposing such sensitive public matters. In fact, the Government should pay attention to the issues raised by such individuals, instead of misinterpreting the message and suppressing him. This is more like shooting the messenger. Therefore, we urge the ministry not to make such arbitrary decisions based on personal rivalries.

The ongoing shortages of essential medicines and the inoperability of essential medical equipment — such as computed tomography scanners — have raised serious concerns. What has been the practical impact of these deficiencies on the sector, and do you believe that the Government’s response has been sufficient?

There are certain machines that are still not operational. Even the machines and equipment that are in use are not properly maintained. Most of the technical faults are not rectified or repaired in a timely manner. Most of the time, companies are hired to repair and maintain these machines, and they can be penalised if they don’t do it properly. However, this system also does not work.

There are 10 linear accelerators set up in cancer hospitals across the country, and the majority of them are not functional. These machines are very important and have a great impact on treatments. Sometimes, treatments cannot be carried out properly without them. Also, issues in the procurement policy, the lack of proper technology, and other factors such as the electricity supply could damage or hinder the functioning of these machines and equipment. When it comes to medicines, several essential drugs are still unavailable, although the situation is not as bad as it was in the past few years. That is why we say that the authorities must properly utilise the talent of our people to maintain these machines.

What is your perspective on the current issues surrounding the General Sir John Kotelawala Defence University (KDU) and the broader concerns affecting medical and health education in Sri Lanka?

We notice that the Government is following double standards when it comes to medical education and allied health education at the KDU. They are accommodating only foreign and military individuals for medicine, while anyone can enrol in allied health degrees. This is not acceptable, as there are serious issues with the quality of the enrolment process. Therefore, we urge the Government to treat both degrees in the same way, without selling the degrees just for money.

What is your assessment of the Government’s policy on the recruitment of allied health graduates, and how has this policy influenced the operational capacity and morale within the sector?

When recruiting people for medical services, there is a policy of giving priority to graduates from Government universities over those from private and foreign universities. The recruitments are carried out based on merit, determined by an examination conducted by the University Grants Commission (UGC). However, this time, the Government has deviated from the usual recruitment policy. If recruitments for all other medical services are done according to one system, why is a different system being used for our services? Since the Allied Health Science degree was introduced in 2005, the medical community and medical administrators have not accepted these graduates well.

Therefore, we urge the Government to directly recruit graduates from Government universities based on the merit system. Otherwise, there is a risk of this process being politicised.

In recent times, the Government has reportedly entered into memoranda of understanding (MoUs) with India, particularly relating to the health and pharmaceutical sectors, without adequate public disclosure. What are your thoughts on the potential implications and consequences of such agreements?

We are not aware of the content of those agreements. We are ambiguous about whether the Government is going to import drugs or professionals. Even when importing drugs, we have serious issues regarding the conduct of the National Medicines Regulatory Authority (NMRA). It is not about with whom they signed the particular MoU, but the impact of those agreements on the country’s health sector. The Government should disclose what is included in these MoUs. 

Allegations have surfaced regarding numerous administrative inefficiencies within the Ministry of Health. In your view, how are such administrative shortcomings affecting the advancement and functionality of the sector?

The Ministry of Health is facing serious problems due to administrative issues. One main problem is that the Ministry Secretary is handling two ministries at the same time. This means that he does not have enough time to properly focus on the health sector, which is a large and important area that needs full attention. As a result, important decisions are delayed, planning becomes weak, and health services are poorly managed. There are also other problems like the lack of coordination and the misuse of resources. These issues make it hard for the ministry to function well and improve the country’s healthcare system.

What are the future plans and initiatives your TU or professional organisation intends to undertake in response to these ongoing issues?

Our professional organisation is actively pressuring the Ministry of Health to take immediate action. We have submitted our demands in writing to all the relevant authorities and continue to raise our concerns through discussions and media engagement. Our main goal is to ensure that the health sector receives proper leadership and attention. We are also calling for an end to the practice of assigning dual roles to key officials, which weakens the system. If the ministry fails to respond positively, we are prepared to take stronger action to protect both the rights of health workers and the quality of healthcare.