BY ROHANA R. WASALA

The landmark appeal court ruling delivered  on January 31, 2017 upholding the right of a graduate of the South Asian Institute of Technology and Medicine (SAITM) to be granted provisional registration with the Sri Lanka Medical Council (SLMC) was thought by many to have put an end to the private medical college crisis. However, there still appears to be a question mark over the issue, since the finality of the appellate court decision does not seem to have been yet accepted by the SLMC. The apex body itself is apparently in a quandary. The thing is that the problem has been so insensitively politicized that few people other than their parents appear to be concerned about the unenviable fate of the SAITM students. In spite of the appeal court decision, uncertainty still prevails regarding the students’ future. Whatever final solution is implemented, their welfare must be fully guaranteed by the government, because the future of these innocent students is synonymous with the future of the innocent youth of the whole country.

The irrational demand for the abolition of SAITM is likely to be met neither by the present nor by a future government. If continuing SAITM as a private medical college is not acceptable, then it is possible to nationalize the institute and the associated teaching hospital, the same way as the North Colombo Medical College (NCMC) started in 1980 was turned into the medical faculty of the Kelaniya University in 1989 during late Mr R. Premadasa’s presidency. The call to nationalize SAITM is one of the three key demands of the Government Medical Officers’Association (GMOA) that held a token strike on  May 05, 2017. However, the government seems determined to continue SAITM as a private institute.

About three weeks ago, it was reported in the media that, in answer to continued protests led by GMOA, the government was initiating a process to list SAITM in the Colombo Stock Exchange (CSE). It had also asked Dr Neville Fernando, the SAITM chairman, to bring the institute under a broad-based administration by appointing a board of directors. Along with the claim that steps were being taken to turn SAITM into a CSE-listed corporate firm, it was reported that the government made several proposals regarding the future of the institute: (1) that MBBS graduates from SAITM receive additional clinical training in relevant subjects, of one month’s duration for each subject, at the Homagama and Avissawella base hospitals, (2) that candidates sit an examination that must be taken for qualifying for provisional registration under the supervision of the SLMC and the UGC, (3) that the Ministry of Health (MoH) gazette the minimum standards for medical education submitted by the SLMC with the approval of the Attorney General, and (4) that the MoH bring the Neville Fernando Teaching Hospital under it (the MoH) and continue it as a teaching hospital.

What the government is offering seems to be something close to (but not identical with) what is available in the Kotalawala Defence University (KDU), that is, a combination of free and paid medical education. Now the General Sir John Kotalawala Defence Academy (KDA) was inaugurated on October 11, 1980, and established as a statutory institution by act of parliament in 1981 during the UNP government of  Mr J.R. Jayawardane. It was originally meant for the pre-commission training of officer cadets of the three wings of the Sri Lanka Armed Forces: Army, Navy, and Air Force. Its principal objective today is educating males and females to be commissioned officers of the armed forces of Sri Lanka. From 1980 to 1986, under UNP rule, a temporary arrangement was made for service officer cadets to follow courses in engineering and physical science at the universities of Colombo and Moratuwa. Later the KDA was raised to university status. It began offering degree courses in Defence Studies. Based on an amendment bill passed on March 18, 2007, the institute was renamed General Sir John Kotalawala Defence University” on October 11 the same year. The KDU is governed by a board of management with the Secretary of Defence as chairman. The board of management includes the commanders of the tri-forces and representatives of the University Grants Commission and the General Treasury, among others. It was Mr Gotabhaya Rajapaksa, former Secretary of Defence who was instrumental in inaugurating a medical faculty in the KDU as an ad hoc measure to meet a shortage of doctors in the defence forces at the time. Since 2012, the KDU has been open for non-military students on a payment basis. The KDU is now a fully fledged state university, which is a member of the Association of Commonwealth Universities, United Kingdom. It has evolved as such in response to an important national need, surviving and flourishing through a number of governments committed to different political ideologies. Under the new government, the KDU began enrolling paying students including from foreign countries in October 2015. Why can’t the SAITM be nationalized, but remain a fee-levying state university somewhat on the lines of the KDU, that is, as a state university that accommodates an optimum number (as determined by authorities depending on the  amount of resources it possesses) of prospective medical students from among those who get left out of medical faculties of state universities and are denied access to free education every year simply because of the paucity of vacancies in them?

The current controversy over the fate of the medical faculty of SAITM has arisen from the basic perception prevalent among university students, government doctors, trade unionists, politicians and the general public that privatizing medical education would invariably mean the production of low quality doctors through the possible compromising of standards as a result of prioritizing the profit motive on the part of the entrepreneurs behind the private institution, while at the same time threatening to undermine the free education system of the state. Of course, it is not wise to entrust medical education entirely to private entrepreneurs; the state must introduce strict regulatory measures to ensure that standards are maintained at any cost. Both the aforementioned dangers can be averted by bringing SAITM under proper state oversight as implied in the above proposals of the goverment. As we know, the medical graduates of the KDU are not challenged in this regard.

In reality, the SAITM case is now a nonissue. It may be characterized thus not in the usual sense of ‘a subject of little or no importance’, but in the sense that, in the context of a more or less informal, unregulated private education sector having evolved with the connivance or the tacit approval of successive governments over the past forty years (parallel to the state’s free education system), we are obliged to accept private education, including private medical colleges, as a fait accompli. All that we can now do is to introduce the necessary improvements to make the best of it in the general national interest. The government’s proposals are a step in that direction.

Unfortunately, among the three main demands of the GMOA, the SAITM nonissue has become the most prominent in the public eye. Though the doctors conduct their strike action as humanely as possible, few among the patients sympathize with their cause. But some are intelligent or knowledgeable enough to blame the government for all the inconveniences caused. Actually, the whole point of a strike is to bring pressure on a government and force it to listen to workers’ complaints and take action to resolve them. We can all see what is happening now. All the public anger, or much of it, is turned on the doctors by the wily politicians who, ironically, have their exclusive claim to it. My humble opinion as a concerned ordinary citizen is that the SAITM problem be shelved for the time being if not abandoned altogether in the interest of the other more important demands.

These centre on such things as forced constitutional reforms, Economic and Technical Cooperation Agreement (ETCA) with India, ‘foreignization’ of state assets, deteriorating national security, and a plethora of other similar really substantive issues, which should be resolved for us to survive as a nation/country. The late veteran trade unionist and SLFP stalwart Mr Alawi Maulana used to say, thaellata issarawela bella paressam karaganta onae” when talking about the subject of strategies for overcoming the separatist terrorism. The words literally mean: Protect your neck before you protect your necklace”. Mr Mahinda Rajapaksa remembered the late patriotic labour leaders words in his speech at the recent May Day rally of the Joint Opposition in the Galle Face Green. I too remember Mr Maulana uttering those words during the August 2015 parliamentary election campaigning. What he wanted to stress was that we needed to focus on the really important issues rather than on the ephemeral that could safely wait. It’s time that the doctors and all other patriots heeded Mr Alawi Maulana’s words of wisdom.