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Whoever is against SAITM should also be opposed to fee-levying institutions such as private nurseries, tuition classes, outfits that offer all kinds of certification and practices such as channeling services.\u00a0 This is an argument that is widely tossed around by those opposing opposition to SAITM.\u00a0 The flak that Dr Anuruddha Padeniya of the GMOA has got over the past few days has been liberally padded with such logic.\u00a0 His detractors have roundly castigated him for offering consultancy services in private hospitals even as he spearheads the agitation against SAITM.<\/div>\n
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The cause of the GMOA has not been helped by the fact that some of its fellow-travelers have waved the anti-privatization flag.\u00a0 In other words, the \u2018SAITM issue\u2019 for them is but an expression of a process or even an economic policy preference they oppose, namely privatization. \u00a0<\/span><\/div>\n![](\"https:\/\/4.bp.blogspot.com\/-j2zf2SU5bCc\/WRSlSZaj5CI\/AAAAAAAAHfs\/Js4E3U4GWl8VqKvHCSFDdnnNDn22T1SyACLcB\/s640\/SAITM.jpg\")
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| AITM: Means different things to different people on both sides of the divide<\/em><\/span><\/td>\n<\/tr>\n<\/tbody>\n<\/table>\n<\/div>\n \u00a0<\/i><\/div>\n All causes have to deal with different stakeholders who have diverse outcome preferences.\u00a0 The opponents have the option of picking out one or more of the claims or parties and target these.\u00a0 That\u2019s politics.\u00a0 Misidentification, mislabeling, misrepresentation and such are part of the game.<\/i> \u00a0<\/span><\/div>\n <\/div>\n There are therefore people who are calling for the blood of the movers and shakers of GMOA, especially Dr Padeniya.\u00a0 Naturally \u2018the sick\u2019 are used as grist.\u00a0 The pro-SAITM or let\u2019s say the anti-GMOA lobby would have us believe that no one cares more about the poor and the sickly of this country than them.\u00a0 That again is politics.\u00a0 It is useful, after all, to have the key issues shoved out of the debate.\u00a0 Indeed, part of the story is to define \u2018key issue\u2019 in ways that make for easy engagement.\u00a0 Everyone involved in this drama does this.<\/span><\/div>\n <\/div>\n What all this helps displace is the important (let\u2019s not say \u2018THE key issue\u2019) matter of a coherent policy with respect to education in general. \u00a0 It is easy to say \u2018we need more doctors\u2019.\u00a0 Of course we need more doctors, there\u2019s no question there.\u00a0 It\u2019s easy to ask \u2018if you are raising concerns about quality, can you give any guarantees about the quality of doctors produced by the state universities?\u2019\u00a0 It\u2019s a valid question of course.\u00a0\u00a0<\/span><\/div>\n \u00a0<\/span><\/div>\n It\u2019s easy to take medical mishaps, inflate them, display them, throw them in the face of those who bring up the issue of standards (pertaining to SAITM) and scream \u2018you don\u2019t have a case, hoo-hoo\u2019.\u00a0\u00a0<\/span><\/div>\n \u00a0<\/span><\/div>\n It\u2019s easy to say such things and raise such questions as long as you desist from talking about the realities in our hospitals \u2014 the congestion, the financial constraints, under-staffing across all categories, the consequent stress and say nothing about the incredible services rendered therein.\u00a0 Easy and irresponsible.\u00a0<\/i><\/span><\/div>\n <\/div>\n The SAITM issue\u201d is a book that has not yet been written, or rather is a book whose pages are all over the media, including Facebook, Twitter, the blogsphere and elsewhere on the internet.\u00a0 This is not an abridged version of that book and neither is it a review.\u00a0 What\u2019s written above is preface and what follows will be a short note on the seeming contradiction of GMOA members engaging in \u2018private practice\u2019 with a view to separate the issue of privatization or private income-earning practices from that of regulation and accreditation. \u00a0<\/span><\/div>\n <\/div>\n One of the most sober comments on this element of the debate was offered on Facebook by Dr Waruna Jayasinghe.\u00a0 It is worth translation.\u00a0 He called it \u2018From nurseries through SAITM to channeling\u2026.\u201d<\/span><\/div>\n <\/div>\n Montessori Schools: Whether or not a child has attended a Montessori is irrelevant when being enrolled in a school. The particular child is not required to have obtained instruction on any elements of the primary curriculum.<\/i><\/div>\n <\/div>\n Tuition: Tuition gives students preparing for exams a boost.\u00a0 However it is not the tutor who sets and conducts the exam, but the state.\u00a0 Those who attend tuition classes and those who do not are assessed by a single institution and process.\u00a0 (We can define the SAITM situation as one where the tuition master himself conducts an exam and produces doctors according to a Montessori system). \u00a0<\/i><\/span><\/div>\n <\/div>\n Private degrees (e.g. IT) and private medical colleges: Since many don\u2019t see a difference, let me use an example.\u00a0 I obtain an IT degree of forgettable quality.\u00a0 You give me a job.\u00a0 I write software programmes at a rate.\u00a0 You realize that they are useless.\u00a0 You sack me.\u00a0 In other words, the consumer, the quality controller and the boss are all one person and someone who knows the subject well.\u00a0 Now assume I get a degree from SAITM.\u00a0 Even if the quality controller, the Sri Lanka Medical Council, says \u2018poor quality,\u2019 the law forces recognition. Accordingly I am recruited and sent to serve in Wanathavilluva.\u00a0 I prescribe medicines like crazy.\u00a0 I also engage in private practice.\u00a0 The patients\u2019 conditions get worse courtesy my treatment and prescription, but they wouldn\u2019t know I am the cause.\u00a0 Since there are very few senior doctors in such facilities they too wouldn\u2019t notice my idiocy.\u00a0 So I will remain secure and happy.\u00a0 Here the consumer, the quality-controller and the boss are independent of one another.\u00a0 The quality controller has been crippled.\u00a0 The consumer has no knowledge of quality and no authority either.\u00a0 The boss doesn\u2019t have the means nor the mechanisms to assess the work of junior physicians.\u00a0 I continue to practice.\u00a0 One day you come to me for treatment.\u00a0 I prescribe. You die.\u00a0 Your loved ones complain to the SLMC and my registration is cancelled.\u00a0 This is of no use to you, since you are dead.\u00a0 My friends will continue to treat and prescribe medicine to their patients.\u00a0 \u00a0<\/i><\/span><\/div>\n <\/div>\n Channeling: I work in a government hospital.\u00a0 After I clock-out, I have the freedom to make koththu or engage in channeling.\u00a0 Since I am a doctor, I choose private practice.\u00a0 I have knowledge and training to offer for a price.\u00a0 You come to purchase these because you find it more convenient or of greater value to obtain these in this manner rather than getting it free at a government hospital.\u00a0 You have the complete freedom to obtain treatment from a government hospital or from some other individual should you feel that I am expensive or that you would not get value for money from me.\u00a0<\/i><\/span><\/div>\n <\/div>\n What this shows is that although people try to put everything in one heap, it is SAITM that disempowers people from choices and that if the quality of medical degrees is not strictly monitored the outcomes could be disastrous.\u00a0<\/i><\/span><\/div>\n <\/div>\n Now some may argue that (say in the USA) universities offer their own degrees.\u00a0 The issue there however is that there is assessment, there are ratings, there are minimum standards that have to be met for purposes of accreditation.<\/span><\/div>\n <\/div>\n \u2018The SAITM issue\u2019 is about accreditation.\u00a0 It\u2019s about quality control.\u00a0 One can vilify the SLMC and argue about the quality of doctors produced by state universities, but one cannot shove under the carpet the issue of coherent and comprehensive assessment.\u00a0 There has to be a single authority in the business of regulation or else a coherent and comprehensive process of evaluation.\u00a0\u00a0<\/span><\/div>\n \u00a0<\/span><\/div>\n Someone can claim that the SLMC is not perfect.\u00a0 That\u2019s fine.\u00a0 The solution would be to improve the institution and the processes therein.\u00a0 The Government, as of now, appears to be ill-equipped intellectually and politically to sort out the mess to which it has contributed (as did the previous regime) by being frivolous and arrogant.\u00a0\u00a0<\/span><\/div>\n \u00a0<\/span><\/div>\n What\u2019s evident is a scandalous disregard for regulation and a bastardization of accreditation. \u00a0 The Government should rise about the politics of\u00a0 misidentification, mislabeling and misrepresentation because a) it is unhealthy, and b) as things stand it could maim or kill a lot of things, including the Government itself.<\/span><\/div>\n <\/div>\n This cannot be healthy.\u00a0<\/span><\/div>\n <\/div>\n Malinda Seneviratne is a freelance writer.\u00a0 Email: <\/i>malindasenevi@gmail.com<\/i><\/span><\/a>.\u00a0 Twitter: malindasene.\u00a0 Blog:<\/i>malindawords.blogspot.com<\/i><\/span><\/a><\/span><\/div>\n<\/div>\n<\/div>\n<\/div>\n<\/div>\n<\/div>\n<\/div>\n <\/div>\n<\/div>\n","protected":false},"excerpt":{"rendered":" \u00a0BY MALINDA SENEVIRATNE Whoever is against SAITM should also be opposed to fee-levying institutions such as private nurseries, tuition classes, outfits that offer all kinds of certification and practices such as channeling services.\u00a0 This is an argument that is widely tossed around by those opposing opposition to SAITM.\u00a0 The flak that Dr Anuruddha Padeniya of […]<\/p>\n","protected":false},"author":1,"featured_media":0,"comment_status":"open","ping_status":"closed","sticky":false,"template":"","format":"standard","meta":{"footnotes":""},"categories":[75],"tags":[],"class_list":["post-66022","post","type-post","status-publish","format-standard","hentry","category-malinda-seneviratne"],"_links":{"self":[{"href":"https:\/\/www.lankaweb.com\/news\/items\/wp-json\/wp\/v2\/posts\/66022","targetHints":{"allow":["GET"]}}],"collection":[{"href":"https:\/\/www.lankaweb.com\/news\/items\/wp-json\/wp\/v2\/posts"}],"about":[{"href":"https:\/\/www.lankaweb.com\/news\/items\/wp-json\/wp\/v2\/types\/post"}],"author":[{"embeddable":true,"href":"https:\/\/www.lankaweb.com\/news\/items\/wp-json\/wp\/v2\/users\/1"}],"replies":[{"embeddable":true,"href":"https:\/\/www.lankaweb.com\/news\/items\/wp-json\/wp\/v2\/comments?post=66022"}],"version-history":[{"count":0,"href":"https:\/\/www.lankaweb.com\/news\/items\/wp-json\/wp\/v2\/posts\/66022\/revisions"}],"wp:attachment":[{"href":"https:\/\/www.lankaweb.com\/news\/items\/wp-json\/wp\/v2\/media?parent=66022"}],"wp:term":[{"taxonomy":"category","embeddable":true,"href":"https:\/\/www.lankaweb.com\/news\/items\/wp-json\/wp\/v2\/categories?post=66022"},{"taxonomy":"post_tag","embeddable":true,"href":"https:\/\/www.lankaweb.com\/news\/items\/wp-json\/wp\/v2\/tags?post=66022"}],"curies":[{"name":"wp","href":"https:\/\/api.w.org\/{rel}","templated":true}]}} |