Medical Administrators have done well to steer SL’s health services to a coveted global position
The College of Medical Administrators of Sri Lanka (CMASL) is the main body responsible for academic and professional development of medical administrators in the country.
Founded 26 years ago as a professional and academic body, the CMASL’s primary interest is to raise excellent medical administrators to efficiently and effectively manage Sri Lanka’s healthcare services, says Dr. Hemantha Beneragama, the newly-elected president of the College.
"It is also our duty is also to provide inputs to develop the healthcare system, polices and planning", he outlined in an interview.
Q: Can you initially outline the reason behind forming the College of Medical Administrators of Sri Lanka (CMASL) and spell out its objectives?
The CMASL was formed 26 years ago as a professional and academic body with the primary interest of enabling the country to have excellent medical administrators to efficiently and effectively manage healthcare services.
It is with great pride I say that since the inception of the Department of Health Services, which was, at first termed Civil Medical Department by the British colonial rulers in 1858, it has been managed by medical administrators, and the Director-General of Health Services has always been a qualified medical administrator. The achievements of our health sector, which are on par with most developing countries, have been attributed to the excellent leadership given by them.
The objectives for which the College was established are to guide health development in Sri Lanka, assist in the implementation of national health policies and strategies, to regularly review the status of medical administration in the country, and analyze problems in the field, to guide the Ministry of Health and the private sector in addition to promoting postgraduate studies and continuous professional development in the field of medical administration.
Apart from that, the CMASL also promotes/undertakes health policy and health systems research, promotes and foster professional advancement of medical administrators, foster fellowship among professionals in the field of medical administration, publish the Sri Lanka Journal of Medical Administration and regular news bulletins and develop partnerships and links with similar professional bodies in other countries.
Q: What’s the criteria to be eligible to be members of the College?
All medical administrators of the government and private health sectors, including those in the armed services and police, holding a recognized administrative post with appropriate qualifications, are eligible to be members.
Young officers aspiring to be medical administrators can join as associate members until they become full members by getting into medical administrative positions.
In fact, I am a founder member of the College, and it took 26 years for me to climb up the ladder and be its president. I now serve as Deputy Director-General of Laboratory Services in the Ministry of Health. Earlier, I was the head of the then National Medical Drugs Authority, and Head of the Medical Supplies Division. I have over 30 years’ service in the profession. Members of this prestigious body are those who led or are leading the management of health services in the country.
Q: As the newly-elected president of CMASL, what are your priorities?
I would like to see the younger generation of medical professionals taking up to medical administration and securing specialist qualifications in this sphere so that they will be able to give leadership to healthcare services in the most efficient and effective manner. We need to develop medical leaders with solid character. Since Independence, our services have been managed by many such personalities, who did wonderfully well to steer Sri Lanka’s health services to a coveted position globally. This was achieved at a very low cost to the government. We need to now convert our previous successes to improve quality and responsiveness in service delivery to be on par with the most developed nations.
Q: What are your future plans to steer this key body of medical professionals to a new high?
We have to blend academic qualifications and personality development with a mindset to be task-oriented. It should not be mere administration but to be excellent leaders in managing healthcare. We need a younger generation coming up as all-round leaders. Though we are the main body responsible for academic and professional development of medical administrators, our duty is also to provide inputs to develop the healthcare system, polices and planning.
Q: How would you describe the challenges medical administrators may have to face in carrying out their duties and responsibilities in the future?
We need to clearly demarcate the difference between lay administrators and medical administrators. The NHSL, for example, has 273 categories of staff and the human resources needs to be managed. You need to also look into personality management. You have to deal with planning hospital services, political bureaucracy as well as media handling. In addition, there are some other key aspects such as managing supplies, trade unions, diversity and funds, apart from providing medical services. So I feel that a manager of a hospital can run any organization with the exposure and experience gained.
There is also a misconception that doctors should not do administration as they are trained to look after patients, and this task should be left to lay administrators.
This argument is not valid because a doctor trained in administration is better equipped to manage health institutions as they know all about healthcare needs, epidemiology, health team responsibilities and the best management that’s required to run the services. Further, doctors are looked up to by the rest of the health staff and they respond better to us than to lay persons. This was proven sometime back when they tried to replace medical administrators with lay administrators and had to revert to us as the experiment was a failure.
This is a challenge we have to continuously face as some politicians also tend to think in terms of lay administrators.
In the best interest of the health sector, we need to convince everybody that we can manage the health services better than anyone else.
Q: As a professional body with no recourse to trade union action, how successful has CMASL been in terms of redressing the grievances of its members?
Yes, we are not a trade union. But whenever our members bring to our notice any grievances, which we think are justifiable, we intervene on their behalf not through trade union action, but through effective negotiations and creating a win-win situation. Through this approach, we have been successful in our endeavors. With no recourse to trade union action, our modus operandi has been to negotiate with respect and patience. Hence, our College is more acceptable to the public and the bureaucracy.
Q: Many medical administrative vacancies remain unfilled in the government health sector with ‘acting’ appointments continuing for years even in key hospitals. Has the CMASL intervened to sort out this longstanding issue through discussions with the Health Ministry?
Yes, this situation is to be understood in an overrule context. This specialty is relatively young. In the past, MBBS qualification with postgraduate qualifications in some fields were the basic requirements for taking up administration. We decided to create this specialty in 1994. Now, we have 1,100 government facilities but only 200-250 qualified medical administrators. Hence, this is a transitional period. We need to have patience in filling these vacancies. But we are doing our best to accelerate the processes.
Q: There are allegations of politically favored ‘acting’ medical administrative appointments. Is the CMASL concerned over this development as it has denied opportunities to the deserving?
It’s an absolute misconception as no person is appointed in an ‘acting’ capacity without basic academic and professional qualifications in the government medical administrative service unlike other sectors. Apart from having a basic MBBS qualification, one has to acquire postgraduate qualifications to hold such acting positions, even though it’s the lack of qualified administrators that has led to this situation.
We had continuous negotiations with the ministry hierarchy, including with the Minister of Health, and has finally been able to get some of these anomalies rectified.
BY SURESH PERERA
The Island, November 2, 2019,