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by Dr. T. G. D. Chandra Perera

The primary object of a trade union is to bring about an improvement in the welfare of its members and the protection of their rights pertaining to their employment.

The government on its part, allows several concessions such as collection of membership subscriptions on the pay abstract release of office-bearers for full-time trade union work etc. for the organization and maintenance of trade unions. It in return, expects a better dedication to the duties by the public officers.

For a responsible trade union, the strike is not at all the first option but the last, and it is resorted to only when all other options such as representation, discussion, lobbying, and resolution across the negotiating table have totally failed. For a trade union of medical officers, who are of an intellectual class, and who are on a holy missions of saving people dying of curable diseases, the strike should not only be the last, but should be a measure resorted to under extremely excruciating circumstances, that could be put above the loss of the life of a patient.

In Sri Lanka the rate of unionization and the impact of unions have fallen sharply since of late. The number of industrial disputes and strikes also have declined markedly. This is considered to be the ultimate out-come of the general strike of 1980, which brought about the loss of jobs of as much as 80,000 strikers.

In the health sector, I believe, there had been no strike by any workers for a long period other than medical officers who have not failed to have at least one strike every month, if not islandwide, at least confined to a hospital.

The ethical contract between the doctor and patient is such that it will not allow any doctor, whether involved in a dispute with his employer or not, to turn away a helpless patient who seeks his help, fee or no fee. If the government doctor think that the state health service is substitute for this ethical contract, it is totally a wrong notion. Whether in government service or not a doctor is there to treat the patient. The physician needs a clear head and a kind heart.

He may be threatened by an ruly person but it cannot be a valid reason to desert a hospital full of innocent patients, like in the case of the recent lightning strike at the National Hospital, Colombo, where a doctor faced such an unfortunate situation. These are incidents that commonly occur in the society, and only the arm of the law has a role in them and not trade unions. For instance if a farmer or a clerk is assaulted by a member of the public, he does seek a general stoppage of work but legal remedies.

Never has the outlook for the medical profession been brighter. Everywhere the physician is better trained, and better equipped than he was few decades ago. Disease is understood more thoroughly, studied more intensively and treated more skilfully. The doctor is, today, able to reduce human suffering both with the help of his knowledge and technology. Diseases familiar to our fathers and grandfathers have disappeared and death rate due to curable disease is falling to the vanishing point.

Today, in addition to advance medical knowledge and medical technology, we also have sophisticated medical buildings and facilities. All these advancements are made not for the benefit of the doctor or the administrator but for the benefit of the patient. The doctor's duty is to pass these benefits to the patient without interruption or denial.

Furthermore, all health workers, including doctors, nurses and others, have a variety of organisations which protect their interests and which are also able to paralyse the medical services, leaving the authorities with no options but to give whatever they demand, because failure to do so means death for some of their patients. But the poor patient has no organisation or law to protect his rights and if the doctor has no mercy on him or is not prepared to leave aside his interest for the good of the patient, he can only die for want of medical care.

It is indeed that strong medical ethic, which is more powerful than a law, which alone can and should ensure the patient all he needs to protect himself in his time of helplessness. In view of this professional ethic and nobility of the profession, the weapon of strike was anathema to it until recently. In view of the fact that doctors, today, brandish the weapon of strike on any flimsy grounds and more often than any downtrodden works in the country, there is a serious crisis in the state health sector. The crisis is seen and felt in the inability of patients to receive treatment when needed, due to lightning strikes and desertion of hospitals by doctors, because when doctors go on strike, all services come to a standstill and almost all the workers of the hospital have nothing to do but idle until doctors resume work.

However, the tax-payer does not see any reason why doctors should desert the hospital, leaving the patients to face the horrors of disappointment, despair, hopelessness and finally death. They also wonder how doctors could be so cruel as to take the lives of their patients to ransom to gain solutions to their minor problems.

Today, the grievances of the patient are manyfold. Apart from the impact of endless strikes, the patient is also faced with the torments of lonely waits in hospital clinics, slipshod examinations by busy doctors, and absence of access for the poor masses, to advanced medical facilities and so on. Further he feels that while he could receive very personal attention at private clinics of government doctors, the attention he receives from the same doctors at government medical institutions is very often quite impersonal and brief.

A person who is very ill and who finds that he cannot carry on any longer by himself is looked upon as patient. This illness and helplessness are the materials the doctor works with. These materials, unfortunately, have become commodities, with which some doctors seem to be building up lucrative business.

Further a doctor can do business with illness or can devote his time in bargaining with the state by means of strikes only while he himself is healthy. But when he too is sick he has no alternative but to seek medical treatment from another doctor. This also points to the fact that doctors too have to experience illness some day and have to share death with their patients, one day. Thus the death is the common platform where doctors and patients meet in equal terms. So no doctor who is true to his profession, should allow a patient to die due to his inattention, whatever the circumstances may be.

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Copyright 2001 The Associated Newspapers of Ceylon Ltd.
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