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Country heading towards severe shortage of specialist doctors

By Dilanthi Jayamanne in Ceylon Today, June 22, 2023
With 4,000 consultant specialists being required by 2025 and only around 2,050 specialist doctors in place by 2023, the country would face a more serious situation in the near future, due to the retirement of a total 250 specialist doctors by 31 December 2023, in accordance with a Government Gazette, warned the health services.

Countering a news report, published in the Ceylon Today on 13 June 2023, in which the Government Medical Officers’ Forum (GMOF) accused over 200 consultants of remaining in service beyond retirement age, informed medical sources yesterday (21) accused the Forum and certain parties with vested interests of blowing the issue out of context.

“The situation has nothing to do with highly popular posting, it is about viewing the bigger picture and seeing the plight of the country, should M.B.B.S. qualified doctors opt to go abroad while the existing consultants, with experience, are sent on retirement. Special units will collapse without specialists, leading to closure of hospitals, especially in the peripheries of the island due to shortage of qualified medical professionals for them to function,” they explained.

Further explaining, sources said that the retirement of about 250 specialist doctors, who had reached the age of 60 by30 June, 30 and 31 December 2023, would take place in accordance with this Gazette Notification. What the union failed to enumerate was the collapse of several services which would occur as a result. While the currently available number of consultants would further reduce with their forced retirement from service, the shortage created may result in the closure of several medical units in countrywide hospitals. Citing an example sources noted that currently there were 18 Cardio Thoracic consultants while the cadre requirement for the speciality was 27. Of them the National Hospital, Colombo has six Cardio Thoracic consultants, Kandy four ,Teaching Hospital Karapitiya three, Lady Ridgeway Hospital has three and Teaching Hospital Jaffna has two. While one consultant would be retiring on reaching the age of 63 the remaining five affiliated to the NHSL would be forced to retire if the gazetted regulations were implemented with regard to the medical profession as well.

Sources said that this would jeopardise cardiac procedures such as stenting at the NHSL, Colombo while in order to rectify the situation a consultant would have to be transferred from one of the other stations to Colombo. They said that the situation was prevalent in the other specialties as well. While those being forced to retire earlier, the expected age of 60 would include paediatricians, physicians and anaesthetists.

Of the 302 cadre projection for Paediatric consultants, Sri Lanka had only 146. Of them 28 were scheduled to retire on reaching the age of 60 by 31 December 2023. Five would retire on reaching the age of 63 by the end of this year while those lost to the State health service, other than by retirement, (by migrating or joining the private sector or universities) numbered 23. They said that 12 board certified paediatric consultants, had returned to Sri Lanka in 2022. There were already 63 vacant paediatric posts in the 2023 annual transfer list. While in 2020, 2021 and 2022 only about 400 to 500 medical practitioners left the country or joined the private sector, this year the number had topped 700.

Sources noted that the 2023 annual transfer list had been “strategically delayed by the State health authorities for about six months and had been released on the Health Ministry’s website recently.”

Currently, there was a shortage of about 750 specialists in the country according to the 2023 transfer list. About 350 have left the country by December last year, while the numbers that had completed training abroad and returned to the island according to the data of the Post Graduate Institute Medicine (PGIM) was about 250 while, of them about 120 have returned to the island after completing their staffing requirements only to leave the island once more, they explained.

However it should be considered unfortunate if health authorities and the government imagine that the 150 will be adequate to fill in the 750 vacancies. In addition, while forcing retirement on those who complete 60 years by the end of 2023, about 50 specialist doctors over the age of 63 have been verbally asked to continue working on a temporary contract basis, they charged.

While State health officials and the government could point out with evidence that the vacancy of specialist doctors in the island may exceed 1,000 by next year, they would not be able to increase the number to even the existing 2,500 with the loss of consultant doctors who were to be forced into retirement at the end of this year. Of the required 4,000 by 2025 the country would have only about 1,750 in service by 01 January 2024, they lamented. https://ceylontoday.lk/2023/06/22/country-heading-towards-severe-shortage-of-specialist-doctors/