Sri Lankan Health Workers’ Action Committee initiates fight against “paying wards” in government hospitals

The Health Workers’ Action Committee (HWAC) in Sri Lanka has launched a campaign against the Wickremesinghe government’s move to introduce paying wards in public sector hospitals. The HWAC was formed on the political initiative of the Socialist Equality Party (SEP).

Kandy Hospital workers protest against the Rajapakse government on 28 April 2022. The placard calls for the formation of workers' action committees

Last week HWAC members campaigned among workers at the Colombo and Kandy national hospitals, the Sirimavo Bandaranaike Children’s Hospital and the Peradeniya Teaching Hospital. Campaigners distributed copies of the HWAC statement, “Defeat the plan to create paid wards in government hospitals,” and the SEP statement “Sri Lankan workers need action committees to fight IMF austerity measures.”

The Wickremesinghe government officially proposed the introduction of paying wards in its harsh 2023 budget. The budget involves widespread privatisation of public sector enterprises in line with International Monetary Fund (IMF) austerity demands, in return for an emergency loan to deal with the impact of the global economic crisis on Sri Lanka.

The HWAC has called on health staff to come forward and fight for the mobilisation of workers to defeat the government’s budget cutting program, which is aimed at wiping out Sri Lanka’s public health system, a fundamental gain won by the working class.

The health sector unions have kept their mouths shut about the privatisation attack, indicating their tacit support.

When Health Minister Keheliya Rambukwella announced that paying wards would be introduced last October, S.B. Meddawaththa, president of the All Ceylon Nurses Union (ACNU), claimed that his organisation would block the move. But this is hot air.

Meddawaththa’s statement has nothing to do with preparing a genuine struggle against privatisation but is an attempt to contain growing opposition in the working class. The ACNU is controlled by the Janatha Vimukthi Peramuna (JVP), which is fully committed to the IMF’s program, including privatisation. It is currently fighting for general elections with the aim of winning more parliamentary seats and implementing the same austerity measures.

Many health workers that HWAC members spoke with identified the introduction of paying wards as an attack, not just on all health employees, but patients and the working class as a whole.

Tharaka, a junior staff member at Colombo National Hospital said, “The creation of paying wards is like pushing patients into a frying pan. I’m against it. Even now, patients have to bear a lot of expenses for tests and buying medicines while getting treatment at government hospitals. Half of the required medicines are not available in government hospitals, and there are waiting lists for months for examinations and surgeries. After paying wards are created, even the existing free facilities will be withdrawn.”

Tharaka said that the paying ward system was “a major step towards the privatisation of healthcare. Its purpose is profit and, in the process, a large number of existing employees will be thrown out.

“The administration is already working to demoralise and arbitrarily fire employees. Warning letters are even being issued in response to minor mistakes. Just yesterday, hundreds of workers were sent letters saying that they should not come to work. Overtime allowances are going to be cut further but our wages are already too low. You need at least five times the current salary just to live,” he added.

Asked to comment on the role being played by the health sector trade unions, he said: “There are a large number of trade unions in this hospital but when a problem arises, the unions appear and then they disappear. There is a tug of war going on between them as well, which means that members like us are isolated. Because of this problem, the workers do not have the confidence to fight. The majority of workers are against privatisation but are hesitant to fight without their own political organisation.”

When HWAC campaigners explained the need for health workers to form an independent action committee, Tharaka readily agreed.

Nayana, a Gampola Base Hospital nurse, said: “If paying wards are created in hospitals then we will have to work like slaves. Because the unions are silent and the media is not publishing any information about it, patients and health workers are confused about the privatisation of the public health service.”

Nayana pointed out that there were not enough doctors and nurses because they had left and found work overseas, and also explained that there were shortages of medicines and medical equipment. She said that if paying wards are introduced “the limited resources available will not go to the non-paying patients. And if that happens, the poor patients will lose the services they currently get.

“Patients and health service employees are not fully aware of these issues, which is dangerous for both parties. This means there could be possible clashes between patients and health workers for limited resources. Finally, the patients who receive free care would feel that there is no need for them to come to the hospital because they would receive no proper treatment and so the public healthcare system will die.”

A junior staff worker at Kandy National Hospital said, “Not one trade union is taking responsibility to fight for the rights of health workers who are under unprecedented pressure. I’ve not seen any trade union express its opposition about the paying wards. Nothing has been won by trade unions during the last decades while governments have been attacking the rights of the workers.”

Referring to the April–July mass uprising against then President Gotabhaya Rajapakse, he said, “I think that the JVP and the trade unions planned from the beginning to mislead and betray the workers who came out during the protests against Rajapakse. Apart from driving out Rajapakse, they did not present any program then, or now, and must bear responsibility for bringing President Ranil Wickremesinghe to power. Similarly, the trade union leaders support this or that government but they are betraying workers’ struggles and gaining benefits, such as higher positions, from the different administrations. They are all friends.”

Jayantha, a health worker from Colombo National Hospital, said that he was “shocked” about the government’s plans. He commented on his experience with the union bureaucracy and its tacit support for paying wards.

“I’m retiring shortly but over the past few years, I’ve come to understand the nature of trade unions very well. We have big problems. There’s a lack of staff because new employees are not being recruited, overtime has been cut, and those who have retired after many years have not received the retirement bonus [gratuity].

“We went to the health ministry as trade union members one day to talk about this and I learnt that the son of someone who used to work here [at the hospital] as a trade union leader was given work in the ministry,” he said.

“We have no objection to people getting jobs, but even as many people don’t have work, the trade union leaders are in a privileged position. They have been appointed to the leadership, saying that their work is to talk about our problems. We understood very well that they have betrayed us. The workers are worried,” Jayantha added.

HWAC campaigners also spoke with people coming to Colombo National Hospital for treatment.

Ganesh, a hotel employee, said: “Establishing paying wards in government hospitals has far-reaching consequences. It will not be easy for workers like us to get medicines in paying wards. These governments don’t care if people die.

“I’m an employee of the Kingsbury Hotel and understand the difficulty of spending on health. Although the cost of goods has skyrocketed, our wages have not increased. Hotel management say that they are losing because tourists are not coming but they use that excuse to fire employees. This situation exists everywhere and workers are stressed, that is part of the reason why there are more diseases.”