Authorise local area MOH officers to Supervise
Ensure better, just service with fare pricing formula
The National Audit Office has recommended placing private health medical institutions under the coordination of an officer working in the regional offices of the Medical Officer of Health (MOH) to regulate private health medical institutions at the local level.
In a report titled “Evaluation of the Performance of the Private Health Service Regulatory Process in Sri Lanka” issued by the Auditor General in 2024 the department states that private medical institutions have been established all over the country at present, and they provide a high contribution to the health sector, but there is an urgent need to regulate their activities and have a fare pricing formula in order to ensure a better and just service to the public.
The Auditor General also highlights the importance of displaying the fees charged for the services provided by the private medical institutions in line with terms of the Private Medical Institutions (Registration) Act No.21 of 2006.
At the local level the report recommends to utilise the services of an officer who serves in Office of Medical Officer of Health in order to regionally regulate the private medical institutions and appoint the Field Officers in Regional Medical Officer of Health level and collect quarterly the data on human resources, worker qualifications and fees of the private medical institutions through them.
Also, the report recommends establishing a separate office with staff including necessary powers for implementation the regulatory activities and registration in Private Health Services Regulatory Council in all the Provincial Health Services Director Office. Also, the report recommends the participation of the Provincial Health Services Directors in Private Health Services Regulatory Council meetings.
In cases where they cannot participate for the committee meetings due to unavoidable circumstances, to make the legal provisions enabling to participate for the meetings by an officer in the level of District Health Services Director or an authorised representative.
The Parliament had passed the Private Medical Institutions (Registration) Act, No. 21 of 2006 as an Act to provide for the registration, regulation, monitoring and inspection of Private Medical Institutions; and to foster the development of, Private Medical Institutions; and to provide for matters connected therewith or incidental thereto. The Private Health Services Regulatory Council had been established for its purposes in the year 2007.
It was observed among the major audit observations identified that although the problems regarding the regulation of the private health sector and the proposed strategies to mitigate them had been identified in the National Strategic Framework for Development of Health Services 2016-2025, the Health Ministry has not achieved positive progress by following those strategies.
Also 16 members out of the total of 28 members of the Regulatory Council or 57 per cent of the total number of members have been appointed by the minister in charge and the quorum of a meeting of the Regulatory Council is 07 and therefore, 07 members, out of the 16 members have the ability to hold a council meeting and take decisions. Also this amounts to a conflict of interest due to the fact that the owners of the private health institutions that are subject to the regulation of the regulatory council are members of the regulatory council.
Even though the number of private hospitals registered in the Private Health Services Regulatory Council was 171 in the year 2023, it was also observed that members only to represent a few hospitals were continuously appointed in the appointment of members to the Governing Council.
Among complaints, there were 51 complaints, viz. 52 per cent out of the total No. of complaints, were received in relation to nine leading private hospitals of the island representing the governing body of the Private Health Services Regulatory Council out of the complaints submitted in 99 occasions to the Sub-Committee on Complaints, held from 2017 to 30 June 2023.
The Ministry of Health had received 72 complaints in the period of four years from 2019 to 2022 regarding the professionals working in private medical centres instead of working in government hospitals during duty hours.
Although it has been stated in the Act that one of the tasks of the Private Health Services Regulatory Council is to collect and publish relevant health information and statistics, the data related to private health services had not been included in the National Data System. In order to minimise these deficiencies related to private medical institutions established in Sri Lanka, the Parliament should pass a new regulatory act solely for the regulation of private health services, the National Audit office observed.
