Curing health sector ills

Tuesday 31st October, 2023

New Health Minister Dr. Ramesh Pathirana has reportedly decided to give some key institutions under his purview a radical shake-up. They are to get new heads, we are told. The National Medicines Regulatory Authority (NMRA) and the State Pharmaceutical Corporation (SPC) are said to be among those outfits. This is something long overdue.

The task of straightening up the state health sector, however, requires a multifactorial approach, and a vital prong thereof is finding the right persons for the key slots in the institutions characterised by waste and corruption. If Dr. Pathirana plucks up the courage to get rid of the high-ranking officials under a cloud, that will be half the battle in breaking the back of most problems in the health sector.

No Health Minister has so far been equal to the task of cleansing the health sector of corruption, which is a hydra-headed problem. All of them vowed to throw the corrupt behind bars and revitalise the state health service, but nothing of the sort happened. Instead, they became conformist and some of them even benefited from the corrupt. The situation took a turn for the worse during the past few years, with some crooks making the most of the current economic crisis to dump inferior-quality medicines and equipment here and enrich themselves. Obviously, they could not have done so unbeknownst to the political authority.

Corruption however is not the only cause of the deterioration of the public health sector, which has been starved of resources under successive governments. It is poorly funded, as is obvious, and deserves more financial allocations. But there is reason to believe that it may be able to provide a better service to the public by utilising the available resources if rampant waste and corruption are eliminated urgently. Health workers’ professional associations and trade unions have exposed numerous crooked deals involving the procurement of pharmaceutical drugs, and medical and surgical equipment for government hospitals, and the resultant staggering losses to the state coffers.

The corrupt have plunged the health sector into such an unholy mess that public trust therein has been ebbing rapidly. There have been many much-advertised anti-corruption drives in this country, but none of them succeeded. What basically caused them to fall through was the failure of successive governments to put in place a robust mechanism to install transparency in the state sector procurement process.

Transparency is a prerequisite for the fight against corruption and the promotion of efficiency. When government actions, corporate dealings, and public processes are made open and accountable, corruption finds it harder to thrive in the shadows. Transparency fosters public trust, allowing citizens to scrutinise decisions and expenditures, holding institutions accountable. Moreover, it encourages healthy competition, reduces bureaucratic red tape, and enhances the allocation of resources, ultimately boosting efficiency. In both public and private sectors, transparency acts as a powerful disinfectant, as it were, deterring corrupt practices, promoting fairness, and enabling a more effective, accountable, and equitable society.

Parliamentary watchdog committees, especially the COPE (Committee on Public Enterprises) and COPA (Committee on Public Accounts), trade unions and campaigners for good governance have shed ample light on the health sector corruption. Minister Pathirana has to ensure that various allegations against the Health Ministry mandarins, including some doctors who have cut Faustian deals with shady suppliers, etc., are probed, and action taken against the culprits expeditiously.

Powerful crooks who are thriving at the expense of the sick are not likely to accept defeat without a fight. They have immense lobbying power, and huge slush funds with which they bankroll election campaigns. They are sure to put up stiff resistance. But if Dr. Pathirana is really keen to take the bull of health sector corruption by the horns, so to speak, he can rest assured that the public and workers’ associations including trade unions will be on his side, and the government’s approval rating will go through the roof.