Quo Vadis? Private sector medicine in Sri Lanka

Quo Vadis? Private sector medicine in Sri Lanka

The question of where private medicine is headed in Sri Lanka has been a perplexing one for the author, who has spent decades working in both the Ministry of Health and the private health sector. While many private practitioners continue to provide dedicated and compassionate care, there are concerns about the operational structures within which they work.

The author argues that a healthcare system cannot be judged solely by the integrity of its individual practitioners, but must also be evaluated by the structures in which they operate.

The author acknowledges the dedication and hard work of many private healthcare professionals who continue to serve patients with empathy and professionalism. However, the reality is that some patients turn to private medicine due to long waiting times, limited availability of services in government hospitals, and the convenience of seeing a specialist at a more convenient time.

While this may seem like a valid reason, the author emphasizes that when patients enter a private hospital, they are not only seeking healing, but also engaging with a commercial environment.

The author expresses concern that when treatment is viewed primarily as a business transaction, patients may be at risk. When treatment becomes a business transaction, there is a fundamental difference between reasonable remuneration for providing a service and extracting excessive amounts from vulnerable patients who have little or no ability to question the bill.

The author cites an example of private hospitals in Colombo increasing their hospital charges for Channelled Consultations to the same level or even higher than the consultation fee charged by the consultant. This practice of charging prohibitive fees for air-conditioned waiting areas, chairs, washroom facilities, and other services that are ostensibly provided by hospital staff is a troubling development.

The author contrasts this with the situation in the distant past, when the consultant's channelling fee was much lower and the hospital charges were significantly less. This disparity in charges seems to be blurring the line between reasonable fees and excessive charges. Patients often complain about excessively high laboratory charges, radiological investigations, and inpatient bills, which can be difficult to understand and may contain various institutional fees.

The author questions whether these fees actually reach the intended service providers, such as medical officers or nurses. The terminology used in hospital bills deserves scrutiny, as it can create confusion about where the charges are going.

The author concludes by reiterating that no patient should be subjected to surprise charges or non-justifiable fees in healthcare. In Sri Lanka, there are many excellent doctors, nurses, technicians, and other healthcare workers who work in the state sector under difficult circumstances, providing remarkable and magnificent services.

The question remains: why do some patients still choose private medicine despite the concerns raised? The author urges for transparency and fairness in the charges imposed on patients, so that the healthcare system can remain a place of healing rather than a commercial enterprise.