Rajith Keerthi Tennakoon Former Governor of Southern Province

Sri Lanka is a leading country that generates Graduates for Europe, North America, Australia and the Middle East region since the decade of 1970. Even after the 1971 insurrection, the Black July 1983 and the 1987–89 dark era (deadly era) intensified the said situation. Higher salaries, better employment opportunities, higher studies, children’s education and the issues of the Heads of Institutions are the main factors that influence the migration of scholars. Medical Officers, Engineers and Graduates in other demanding fields have continued to migrate since the decade of 1970.

Dr. Chamil Wijesinghe, the Spokesperson of the Government Medical Officers’ Association had stated that 274 Specialist Medical Officers had resigned for their service since 01^st of June 2022 to 31^st of May 2023, and left the country.  This statement is a falsehood!  

Brain Drain: Over 200 doctors left without notice within a year, says GMOA

The reality is that the number of medical officers, in categories of who have received foreign & local leave with no pay under Pub Ad Circular No. 14/2022 and the general procedure, who have permanently released from the Ministry of Health and who have taken leave with no pay and not reported to work during the period from 2021 to up to now in 2023 is 289. Simply, it is bullshit that the number of Specialist Medical Officers who received leave for three years is mentioned as they have left the country in a single year.

      Specialist Medical Officers

Details	2021	2022	23.08.2023	Total
Officers who have received foreign leave with no pay	22	74	91	187
Officers who have received local leave with no pay	–	–	05	05
Those who have taken leave with no pay and not reported to work (considered as vacation of post)	7	29	14	50
Medical Specialist who have been permanently released from the Ministry of Health (They are working in Kotalawala Medical Faculty, Universities and Ministries)	15	19	13	47

From the year 2021 to August 2023, the number of specialists who have obtained leave with no pay and did not report to duty is 50. In figure, 14 no.s until August 2023, 29 no.s in 2022 and 7 no.s in 2021 have left the service. According to the Establishment Code, Specialist Medical Officers as well as every Public Official have the right to migrate with no pay. Most of them will be back.

Approximately 25 Specialists Medical Officers hold government and other administrative positions aside their expertise. It should be immediately suspend the appointment of Specialist Medical Officers to administrative positions instead of treating.

According to the statement of Dr. Chamil Wijesinghe, 842 Grade Medical Officers (Senior Medical Officers) have resigned and migrated. This is also a falsehood. The truth is that the number of medical officers who have permanently left or been terminated for the last 3 years is 586. It is a bullshit that if someone claims as more scram in one year than they scram in a period of 3 years.

      Medical Officers

Details	2021	2022	23.08. 2023	Total
Officers who have received foreign leave with no pay	146	396	392	934
Officers who have left the service	113	203	121	437
Officers who have resigned	10	61	78	149

The actual number of medical officers who have left the service from the year 2021 to up to now in 2023 is 437.  The number of medical officers who have given resignation is 149.  In figure, 934 (total of 3 years) have received foreign leave with no pay under the procedure mentioned in the Establishment Code and Pub Ad Circular No. 14/2022. It is thus clear that the figures presented by the Government Medical Officers’ Association are more than the sum of numbers in three years.

They said that they are making their statements based on the data obtained from the Ministry of Health under the Right to Information Act. According to the data given by Dr. G. Wijesuriya on 03^rd August 2023, it is very clear that the number of Grade Medical Officers who left the service from 01^st of June 2022 to 31^st May 2023 is 197, and the number of Medical Officers who have resigned is 109.  Ranjith Madduma Bandara, MP (Opposition Party) had also stated in a Parliamentary Debate that thousands of medical officers have left the country within a year. These people are exaggerating their figures by placing all those who have migrated on formal leave as medical officers who have left the country.

      Dental Surgeons

21 Dental Surgeons have left the service in the last 3 years. The number of resignations is 12.  Another 39 Dental Surgeons have migrated on formal leave with no pay.

      Nursing Officers

Currently, the approved cadre of Nursing Officers is 45,367. Out of which 42,253 numbers are employed. During the period from 2021 to 31.08.2023, 557 Nursing Officers have been informed as vacation of post (VOP). 05 Nursing Officers have resigned. 434 Nursing Officers have taken foreign leave with no pay, under a formal procedure.

      Other Officials in the Health Sector

The situation of other officials in the health sector is also collateral to this condition. There are 20 resignations and 54 vacation of posts in the last 3 years. The number of people who have received formal foreign leave with no pay is 71.  The total number of employees who have migrated after obtaining leave for more than 6 months is 43 and 15 of the total number have migrated during the period till the end of August 2023.

This does not mean that there is no shortage of human resources in the health sector of the country. In figure, 2,574 (90.3%) out of the approved cadre of 2,851 Specialist Medical Officers are currently in service.  20,907 (92.8%) out 22,535 of Medical Officers to be, are existing.  1,585 (89.6%) out of 1,769 Dental Surgeons to be, are existing. Clearly 10% of vacancies are available in the Health Sector. However, leaving the country in bulk is a falsehood!

#	Cadre	Cadre approved as at 31.12.2022	Cadre presently assigned in Service	%
1.	Specialist Medical Officers	2,851	2,574	90.3
2.	Medical Officers	22,535	20,907	92.8
3.	Dental Surgeons	1,769	1,585	89.6
4.	Pharmacists	2,306	2,022	87.7
5.	Medical Laboratory Technician	2,392	2,132	89.1
6.	Physiotherapist	847	733	86.5
7.	Occupational Therapist	276	166	60.1
8.	Radiologist	1,103	694	62.9
9.	Speech Therapist	144	119	82.6
10.	Audiologist	58	35	60.3
11.	Nursing Officers	45,367	42,253	93.1

The highest number of vacancies in the health sector exists in Allied Health Services. There should be 1,103 Radiologists; however there are 694 (62.9%). There should be 58 Audiologists; however only 35 (60%) are employed. There should be 2,306 Pharmacists; however there are 2,022 (87.7%). This is the real crisis in the health sector that needs immediate responses.

After the 1971 insurrection, 37%, 36% and 45% of the Medical Graduates produced in Sri Lanka in 1972, 1973 and 1974 migrated to United Kingdom and settled permanently. In 1971, 75 out of 165 Engineers produced in Sri Lanka migrated to United Kingdom.  (Source: A study by the Colombo Institute for UNCTAD. Scientist’s migration – Article written by Mr. V. K. Samaranayake) There is no such trend in migration of Medical Officers today. Between three decades 1980 and 2009, 11% of the Specialist Medical Officers produced in Sri Lanka have migrated permanently.                 

No. of Medical Officers and Engineers migrated to United Kingdom from Sri Lanka during the Period of 1968-1974

Medical Officers						Engineers
Year		Migration to United Kingdom	No. of Graduates	(2) as a Percentage of  (3)		Migration to United Kingdom	No. of Graduates	(5) as a percentage of  (6)
(1)		(2)	(3)	(4)		(5)	(6)	(7)
1968	–	27	318	8.5		7	113	6.2
1969	–	14	243	5.8		26	135	19.3
1970	–	28	307	9.1		48	206	23.3
1971	–	43	288	14.9		75	165	45.5
1972	–	101	272	37.1		71	222	32.0
1973	–	99	271	36.5		25	231	10.8
1974	–	118	257	45.9		8	270	3.0

Medical Officers migrated for a period of one year for their higher studies must serve in Sri Lanka for 4 years, and Medical Officers migrated for a period of 2 years must serve in Sri Lanka for 8 years. From January 2022 to date, 343 Medical Officers who migrated for Postgraduate studies have reported back. However, approximately 110 among them violated the Terms of Service and did not report to work.

In every year, our medical collages produce approximately 2,000 new Medical Officers. During the period of 2020 to 2022, 1,239 Medical Graduates who have completed their studies in foreign universities have passed the examination conducted by the Medical Council and have had the opportunity to engage in the medical profession in this country. In the year 2023, approximately 600 new Medical Officers are waiting for the registration of the Medical Council. From the year 2020 to 2022, 421, 229 and 589 Medical Officers who completed their studies abroad have been received the registration of the Medical Council respectively.

The attention of the health authorities should be expeditiously referred to find practical solutions not only to the shortage of Medical Officers, but also to the shortage of other professions in the Health Sector. Prompt recruitment of retired medical officers and Specialists Medical Officers to medical services on contract basis is a solution to the current shortage of Medical Officers. Approval has been granted by the Cabinet of Ministers for the establishment of 3 private medical universities. It is essential to increase the number of Medical Officers newly appointed to the Health Sector in every year.

The Ministry of Health should take immediate action to blacklist medical officers who resign the service without prior notice. Further, the already existing laws should be put in place to allow medical officers who migrate to practice only in professions that are suitable for the medical profession. It is essential to recover compensation from officials who leave the service and violate contracts of the Ministry of Health, based on the Terms of Service

The Health Sector is currently suffering due to shortage of drugs and equipment. Meanwhile, the data and statistics of medical officers leaving the country are presenting in an exaggerated manner. Unfortunately, the responsible officials and political leadership have failed to convey the true and accurate information related to any of these facts. Therefore the real issues in the Health Sector are being hidden without concern.