The Government Medical Officers’ Association (GMOA) convened a meeting of health sector unions on January 29. It was announced as the launch of a “new broad alliance” of health unions, supposedly to defend free public health care and address the deepening crisis in the sector. In reality, the purpose of this alliance is to stifle mounting opposition among health employees while begging the government for negotiations.
Those present—the Health Professionals Federation (HPF), Government Nursing Officers’ Association (GNOA), Sri Lanka Free Health Services Association (SLFHSA), Government Family Health Service Officers’ Association (GFHSOA) and several others—did not even pretend to formulate a serious plan of struggle.
When pressed by a reporter, one union leader bluntly admitted the meeting discussed “no strike plans or decisions” and added: “Instead, we hope to engage the health minister and authorities without resorting to strikes.”
HPF president Ravi Kumudesh asserted that the discussions were “not against the government at all” and “not politically motivated,” a line promptly endorsed by the others. This new alliance is being formed not to lead a genuine fight, but to block one.
The alliance emerged directly after the GMOA’s 48‑hour strike on January 23–25 over five demands concerning the Disturbance, Availability and Transport (DAT) allowance, additional duty allowances, research and postgraduate training, and a unified Sri Lanka Medical Service. These demands were summarily rejected by the Janatha Vimukthi Peramuna–led National People’s Power (JVP/NPP) government, leaving the GMOA with no option but to continue strike action.
Health Minister Nalinda Jayatissa flatly declared that doctors’ demands could not be met “given the current economic situation,” accusing health workers of “holding patients hostage” while citing a paltry salary increase that has already been eroded by inflation and the country’s deepening social crisis.
Confronted with the government’s rejection and mounting anger among doctors and other health workers, the GMOA sought to wind down the strike instead of extending it to other sections of the working class. It called for limited protest measures, urging doctors to defy ministry directives and refrain from prescribing medicines or medical tests from private pharmacies and laboratories.
The GMOA leaders then moved rapidly to convene the January 29 meeting to press for talks with the minister and at the same time form an alliance of bureaucrats to contain and suppress the anger of health workers.
This is entirely in line with the health unions’ record. In March 2025, GMOA president Saman Ratnapriya and the Joint Federation of Paramedic Professionals called off a strike by 30,000 health workers—including nurses, midwives, laboratory technicians and pharmacists—on the basis of an empty pledge by the health minister to discuss demands with the Treasury secretary.
In the same month, Kumudesh suspended a planned HPF strike over cuts to allowances after another empty promise from the minister. Nothing has been resolved to this day.
The GMOA has repeatedly used limited or threatened industrial action as a safety valve for the mounting anger of workers. In August 2025 it announced an island-wide token strike over shortages of medicines and equipment, only to abruptly call it off after late-night talks and a vague ministerial assurance.
The “new alliance” is being assembled under conditions where the JVP/NPP government is pressing ahead with IMF‑dictated austerity and the privatisation of key public health functions. Amid a severe economic crisis deepened by Cyclone Ditwah, which destroyed major hospitals and medical facilities, real public health spending has been slashed to levels dictated by the IMF.
On January 6, the cabinet approved the expansion of public‑private partnership (PPP) schemes in government hospitals for high‑tech diagnostic services and blood products, an explicit fulfilment of IMF conditions. Patients will be increasingly forced to obtain medicines and tests from private providers at their own expense, condemning the poor and working class to untreated illness or debt.
Kumudesh acknowledged that, under IMF dictates, laboratory testing services are being handed to the private sector, “undermining” free healthcare. Ratnapriya likewise warned that free health services face “serious threats” and “injustices” to patients and workers. But neither advanced any plan to defeat these attacks.
In fact, these leaders are defenders of the IMF program. Kumudesh told the World Socialist Web Site in June 2022 that he had “no fundamental disagreement with the IMF agenda” and would “personally” support turning to the IMF for emergency funding regardless of the harsh conditions imposed.
Ratnapriya served as a labour adviser to former president Ranil Wickremesinghe and is an open advocate of IMF restructuring. In June 2022, he boasted that nurses were being sent abroad “to bring dollars,” even though “there is a shortage of workers in hospitals here.”
The GMOA is no different. Its interventions over the past decade—time‑limited protests, retreats into negotiations, and actions tied to the pro-capitalist parties of the political establishment—have all been compatible with, and often directly supportive of, the austerity and privatisation framework laid down by the IMF and successive governments.
The JVP/NPP government’s response to the January health protests has been repression, not “dialogue.” From January 28, it imposed sweeping Essential Public Services orders covering 15 state institutions, including hospitals, effectively outlawing strikes. The law permits dismissals, fines, jail terms, and the deployment of police and military. Invoked about 100 times since 1979 to crush workers’ struggles, it has already been used four times by the JVP/NPP government since November 2025, including against Ceylon Electricity Board workers opposing privatisation.
Yet the health union leaders uttered not one word against the essential services order at their January 29 press conference. Their silence is not accidental. Any genuine fight against these repressive laws would immediately place them in direct conflict with the government and the IMF.
Kumudesh, Ratnapriya and other union leaders are deeply integrated into the political establishment while posturing as “independents.” Kumudesh stood in the October 2024 general election for the United Democratic Voice, a right-wing capitalist party led by former UNP minister Ranjan Ramanayake. After serving as a labour adviser to former president Ranil Wickremesinghe, Ratnapriya was rewarded with a UNP parliamentary seat in 2020.
The unions function not to lead workers, but to police them. The government and the union leaders fear that mounting anger among workers—including health workers—could develop into a mass anti‑government struggle, as erupted in 2022 forcing President Gotabhaya Rajapakse to flee the country and resign.
The defence of jobs, conditions, and free public healthcare is inseparable from a struggle against the IMF program and capitalism. Workers must take matters into their own hands by forming democratically controlled rank-and-file action committees in every hospital, clinic, and health institution, totally independent of the unions and all capitalist parties.
These committees should fight for immediate demands—restoration of real wages and allowances, adequate staffing and resources, an end to PPPs and all forms of privatisation, and the abolition of essential services and “anti‑terror” laws. The struggle should be linked to demands for the repudiation of foreign debt, expropriation of the banks, major corporations and private health chains, and placing the entire health system under workers’ control as part of a planned economy based on social need, not profit.
Such a perspective requires uniting health workers with teachers, electricity and postal workers, plantation labourers and the rural poor in Sri Lanka, and with the international working class confronting similar IMF‑dictated attacks. It must be animated by the fight for a workers’ and peasants’ government to refashion society from top to bottom on socialist lines.