Sri Lankan doctors defy government strikebreaking

Twelve leaders of the striking doctors union in Sri Lanka—the Government Medical Officers Association (GMOA)—surrendered to Colombo police June 26 after a district court ordered their arrest. The union leaders were freed after posting bail of Rs. 200,000 (US$2,850).

The GMOA held a press conference on June 27 and denounced the arrests as an attack on the democratic rights of trade unions. They also said striking doctors were pressing them not to retreat from their demands. “Before calling off the strike we need an interview with the President and a solution to our problem” the union leaders said.

When the doctors' strike began June 17 Peoples' Alliance (PA) government President Chandrika Kumaratunga used wartime emergency regulations to effectively ban the strike. Doctors defied the government and continued their walkout. Then a person posing as a “concerned citizen” filed a case against the GMOA charging that it was damaging public interests by striking an essential service. After hearing the complaint, the district judge issued the “return to work” order which was also defied by the doctors' union.

On June 23, a large number of doctors from all parts of the country gathered at a meeting in Colombo to denounce the government repression and demand the union continue the strike. The court responded by issuing the arrest order for the union leaders.

A government sponsored terror campaign

Last week President Kumaratunga called off talks with doctors' union, saying negotiations would not resume until they returned to work. Along with the state repression, the PA government has unleashed a terror campaign against doctors. Talking to WSWS correspondent on Friday and Sunday, doctors and GMOA leaders gave details of physical attacks by persons believed to be government thugs.

Grave concern was expressed about the abduction of a gynecologist, Dr. S.M. Mohideen, who served in government hospital in the wartorn Northern Province border town of Vavuniya. GMOA rejected the government-sponsored speculations that this abduction was the work of the separatist guerrilla group, Liberation Tigers of Tamil Eelam (LTTE), and said: “It was an act against the strike.” Dr. Mohideen was abducted when he was returning home from the hospital. Later his car was found near a lake. In Anuradhapura, the capital of the North-Central Province, PA politicians called a picket in front of the hospital, threatening doctors with physical violence. Doctors had to call the police and the army for protection. The next day, June 27, all the workers of this hospital held a picket to support the doctors. In various parts of the country, PA politicians have organized pickets by goons who have denounced the doctors as “murderers.”

“Organized groups in unnumbered vehicles follow doctors to find out their residences and later in the night stoned them,” doctors said. In the southern town of Hambantota a gang came in a state vehicle and attacked a doctor's car, damaging the windscreen. A pediatric surgeon from the country's leading children's hospital in Colombo was followed by two persons on a motorcycle after he left GMOA headquarters. During the night his car, which was parked outside of his residence, was set on fire. The government is openly encouraging the terror campaign, describing it as a “public protest” against the strike.

Not only the government-owned media, but also private media outlets, including the self-styled “alternative press,” have engaged in a virulent campaign against the doctors' strike. During the media conference on June 27, GMOA officials asked these media personal “not to engage in media prostitution”.

More than 4,000 doctors from 400 hospitals on the island are striking to halt the government's plans to decentralize the administration of the medical service, and shift it to Provincial Councils (PCs). These councils, established in 1987 under Indo-Sri Lanka Agreement, have taken over many central government functions, including the health sector. Because of opposition by doctors, however, their services remain under the control of the central government. The current strike was provoked when the PC Chief Minister of Northwestern Province went to court to demand the administration of medical professionals in his area be attached to his PC. Doctors fear that the government and the provincial councils want to decentralize health care in order to dismantle free medical care.

The Sri Lankan government set up the PCs as a supposed solution to Tamil national question. But the irony is there are no provincial councils in the north and east, where Tamil majorities reside. Councils in other provinces are controlled by the ruling party which dominates each area and have been used to undermine free education, health service and other rights.

Consequences of the decentralization

Striking doctors told the WSWS, “When decentralization is complete there will be no national policy for health. Free health service will be killed. The private hospitals will get the upper hand as recommended by the Presidential Task Force (PTF) Proposals for Health Sector Reforms. We can tell this from our own experience. Nurses and other staff are already demanding that they be taken back to central government because they have seen the cutbacks. PCs have no money to make overtime payments. Sometimes they delay even paying wages. Quality of the medical service is going down rapidly.”

The doctors cited a report compiled by the World Health Organization (WHO) on 38 countries including Philippines and Papua New Guinea where the health services deteriorated after decentralization. One said, “In those countries, efficiency of the health service has gone down, staff training is inadequate, management skills have been downgraded and decision-making is influenced by politicians. The staff is not paid on time and medical supplies are cut. These things, and even worse, will happen in Sri Lanka.

“When the Presidential Task Force (PTF) reforms are implemented Outdoor Patients Departments (OPDs) will be separated from the main hospitals. State hospital services could be shared with private hospitals. The government will encourage foreign investment in the sector and public hospitals will start billing. This will mean the systematic wiping out of free health service,” he said.

Over the last two decades successive Sri Lankan governments have undermined the right to free health and education at the direction of the IMF and World Bank. The PTF report admits that during this period there was “little investment in health” and “any favorable indices in health” were due to previous investments. The ongoing attack on health care in Sri Lanka is part of a worldwide phenomena where health and education services are privatized and transformed into profit-making enterprises.

Political questions

Major political questions have been posed by the doctors' strike. The statement of the Presidential Secretarial issued on June 23 noted: “The GMOA is attempting to wrest the powers of this government in policy formulation and implementation.” Indeed the struggle does raise the issue of who controls political power and decides how society's resources are allocated. The question is whether the needs of masses take priority or whether health care, education and other services are sacrificed to repay the international lending agencies.

However, the GMOA has no intention of wresting political power from the PA government. Instead its entire strategy is based on the demand that doctors' services remain under the authority of the central government, the very agency that has carried out the IMF's austerity demands. Any settlement between the PA regime and the GMOA, even if central authority over doctors' services is wholly or partially retained, will come at the cost of free health service.

The doctors struggle has the potential of encouraging far wider layers of working people to fight the attacks on social programs and defend their living standards. That is why President Kumaratunga has reportedly advised ministers to prevent other strikes while the regime seeks to isolate and crush the doctors' walkout. Last week a strike erupted at government controlled newspaper center—Lake House—but within a day it was quickly settled.

The trade union bureaucracy is also concerned about social protest spreading. It has refused to mobilize the working class throughout the island against the government strike-breaking operation. At a health sector union federation meeting in Colombo on June 27 union officials did nothing more than issue a statement expressing their “concern” over the state attack on the doctors.

Members of the Socialist Equality Party at the meeting, from the Central Bank Employees Union and Plantation and Industrial Workers Union, raised the political questions posed by the strike. They explained the need to build an independent political party of the working class and oppressed masses to oppose privatization and fight for a socialist program to defend free health care and other services. The SEP members opposed a resolution presented by the union officials calling on President Kumaratunga to intervene in the strike, explaining instead that the working class needed to conduct an independent struggle against the PA government.

One of the PA government's coalition partners, the Lanka Sama Samaja Party (LSSP) has issued a statement instructing the GMOA stop the strike and give in to the government's demands. The statement issued by the general secretary of the LSSP, Batty Weerakoon, said: “The ongoing strike in the medical sector cannot be condoned. . . . It is unfortunate that trade union actions developed to a point at which the government has had to enforce the essential service order under emergency regulations in order to maintain medical services needed in the North and the East, specifically for purposes connected with military operations.”

For over a year the LSSP parliamentary members have been engaged in a bogus protest against the extension of emergency rule. Now when emergency regulations threaten to crush a struggle for the defense of free health, the LSSP shamelessly defends the regime. The most cynical aspect of the LSSP's position is that it attacks the doctors' strike in the name of the PA government's bloody war against the oppressed Tamil masses, when the doctors are seeking to protect health care and save lives. This only underscores the fact that the LSSP, once a mass socialist party, is a party of capitalist law-and-order and racist war.

The Socialist Equality Party has organized several discussions with health care workers and doctors, including one held June 26 at the Colombo National Hospital, where 150 nurses, doctors and other staff participated. The SEP published a statement explaining the political issues involved in the doctors' strike and a socialist perspective to defend health care. The statement, initially published in Kamkaru Mawatha, the SEP's newspaper, was distributed to thousands of workers throughout the country.