Mar 03, 2017

SLMC needs overhaul

The SLMC by law mandated to enter and make inquiries at recognised universities and institutions to ascertain if such universities and institutions conformed to prescribed standards.

The Ceylon Medical Council, instituted under colonial rule and later renamed and improved as Sri Lanka Medical Council (SLMC), is legally mandated to take care of the community’s and the people’s health.

Legally it can sue and be sued. Sadly the SLMC official website does not say what its vision and mission are. It has a tab in the toolbar for FAQs but no FAQs. The SLMC has to maintain registers of practising medical doctors, dentists, nurses, and other allied professionals, but they are not posted on the website.

Information like the number of registered medical practitioners, specialists, dental surgeons, foreign graduates, who sat the Act 16 examination are all missing.

Prescribed standards for medical faculties and reports of quality evaluations of medical faculties are not available either.

Even short profiles of academic and professional achievements of the members of the SLMC are not given. In short, the official website of the SLMC is a primitive and pathetic presence on the world wide web. (Accessed on 26 February, 2017 at )

It would be interesting to know what information they could provide if requested under the RTI Act now in force.

The SLMC by law is mandated to enter and make inquiries at recognised universities and institutions to ascertain if such universities and institutions conform to prescribed standards.

If they fail to conform to prescribed standards, the SLMC can recommend to the Minister to withdraw such recognition. And it also means, recognition of medical faculties at the end, is a political decision.

The SLMC stands exposed on this mandate as a political tool, incapable of honouring its own professional and independent presence.

The story of the SAITM controversy begins with its management applying to the UGC in 2011 for approval and acceptance of the medical faculty as a degree awarding institute.

It was then a University Grants Commission (UGC) headed by a Chairperson personally picked by President Rajapaksa.

The UGC recognised SAITM as a medical degree awarding institute and in its annual report of 2011 on Page 02 says

“Another major important task in 2011 has been the recognition of South Asian Institute of Technology and Medicine (Pvt.) Limited (SAITM) and Institute of Information Technology (Guarantee) Limited (SLIIT), as Degree Awarding Institutes for specific degree programmes with a view to developing higher education in the country.”

What is more important in the context of mass agitations against SAITM fuelled by SLMC decisions, is the fact that Prof. Carlo Fonseka was a member of the UGC in 2011 that recognised SAITM as a medical degree awarding institute. A few months later in  January 2012, handpicked by President Rajapaksa, Professor Carlo Fonseka was appointed Chairman of the SLMC by the then Health Minister Maithripala Sirisena.

Chaired by Prof. Carlo Fonseka the SLMC had legal powers under Section 19A of the “Medical (Amendment) Act No. 30 of 1987 to investigate SAITM “After giving not less than two week’s notice in writing, enter a recognised university or institution and make such examination and investigations thereon and such inquiries of the members of the relevant faculty, as may be necessary for the purpose of ascertaining whether,

(a) Courses of study provided by such university or institution leading to the grant or conferment of a medical qualification

(b) The degree proficiency required at examinations held by such university or institution for the purpose of granting or conferring any such qualifications and (c) the staff, equipment, accommodation and facilities provided by such university or institution for such course of study.”
If that responsibility was duly carried out by the SLMC in 2012, it would have denied all reasons and space for any protests and controversy over SAITM we see now.

As a member of the UGC that recognised SAITM as a medical degree awarding institute, Prof. Carlo Fonseka had the extra responsibility as Chairman of SLMC to ensure “quality” or refuse registration of its medical students till quality was adequately matched.

It is quite obvious the SLMC and Prof Carlo Fonseka as Chairman never wanted to examine and investigate SAITM during the Rajapaksa regime. Nor was the GMOA threatened to go on strike “Till SAITM is abolished”.

Exposing their political nudity 09 months later with the defeat of Rajapaksa in January 2015, Prof. Carlo Fonseka with GMOA backing, manipulated the fact finding report of the SLMC in September to oppose SAITM. He then wrote to the Minister of Health to say the SLMC could not recognise the SAITM medical degree.

Meanwhile, the 2010 Annual Report of the SLMC the last to be posted in their website says, the Council had accepted a medical graduate from the Kazan State Medical University of Russia, on a “Personal to the holder basis” as that university was not accepted by the SLMC.

Reason given is that the graduate had filed an FR Petition (SC/FR 405/2009) against the Council. Surprisingly the GMOA had seen no wrong in that proving there were no proper standards adhered to, when the SLMC and the GMOA did not want to.

This irresponsibility, this muddling of issues, and political subordination by the SLMC, is not due to political stooging alone. It is the very procedure of constituting the Council that leaves it open to political intrusions and thus for corruption.

It is the very sectarian, undemocratic procedure that makes it possible to appoint political stooges and allow the Council to be totally controlled by State sector medical professionals with GMOA domination.

That is made possible as the Act leaves no representation for any other profession and for the community. It is taken for granted that the medical profession is the only qualified profession that could decide on everything related to health and therefore its exclusive presence is enough to decide on people’s health.

That is how the whole Council of 23 members came to be medical practitioners with all eight medical faculties in State universities, and another representing the Dental Faculty included.
Under 12 (1)(a) of the Act, the Chair of the Council is decided by the President. The Health Minister appoints four more of his choice under 12(1)(f) of the Act.

This does not make the Medical Council take care of community and people’s health and wellbeing, but makes it jealously guard the interests of the medical profession.

The GMOA on the strength of the Government medical practitioners are only fighting for “free” education and never for “Free Health “.

Their logic is plain and selfish.

They demand “free” education to become medical doctors at the expense of taxpayers and then the right to continue “selling” healthcare at prices they determine to the very taxpayers, who paid for their “free” education.

They work for private medical care at the expense of free health. It is therefore hard to believe and there is no necessity to believe the medical profession and the GMOA is interested in the health and wellbeing of the community and the people.

Sri Lankan people are therefore at crossroads.

They need serious reforms in education from pre-school to higher education including universities and tertiary/vocational education to turn out better professionals and skilled and educated youth.

But SAITM has virtually blindfolded that need with political campaigning on sectarian slogans of the GMOA and petty political interests of the JVP and other splinter “Left” groups. The SAITM nevertheless now brings to the fore, the necessity to completely change the purpose and how the SLMC should be constituted to address the needs of society.

In our culture of professional selfishness and arrogance, the SLMC to be left at the hands of the medical profession alone would be too dangerous to the health of the nation.

The way out would be to include other professions as “community” representations. It has to provide provincial community representation as well, to make it a nationally representative body.

The Medical Board of Australia (MBA) in fact has Federal State Medical Boards supporting it.

There’s federal representation brought through Federal State boards. They have highly reputed professionals including community representation with seven women out of the 13 in the elected board.

Their election procedure is democratic and transparent, unlike here in Sri Lanka.

The Medical Council of Canada (MCC) also has federal and provincial representation in a Council of 52 members. The public elect up to five members and the medical undergraduates through their Canadian Federation of Medical Students elect two representatives.

The Council elects its Executive Board at its annual meeting for regular deliberations on routine matters.

The General Medical Council (GMC) of Britain has 12 elected members with six elected to represent the community, called “lay members”. Lay members are not from the medical profession and represent other disciplines. Interestingly in the present GMC, five of the six lay members are women.

Health of the nation cannot and should not be a monopoly of the medical profession. The foremost regulating body therefore should include a wide representation both in terms of professions and
geographical provinces.

In terms of other social segmentations it is necessary to ensure representation from women to youth, from ethnic and religious representation and the private sector. Such broad representation to be brought in, we need an electoral system that can be transparent and democratic. In short, the present SLMC has to be completely overhauled for the benefit of society. That remains the “lesson learnt” from the SAITM controversy.

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