Interview: Ashok Pathirage

Which areas hold the best opportunities for private hospitals and clinics in Sri Lanka?

ASHOK PATHIRAGE: Several opportunities exist for the private sector, particularly in insurance, where penetration rates remain especially low. Per capita incomes are rising in Sri Lanka and are set to reach $4000 by 2016. That said, insurance is a very capital-intensive business, which is one of the largest challenges for market players at present. We are growing in size but must also remain profitable in order to sustain the business as well as look after shareholders.

This is why it is important for Sri Lanka to focus on developing capital markets. With a market share of around 40% among private institutions, we enjoy a strong advantage in that we are setting standards and prices. For instance, we opened up 250 beds about three years ago and are almost full, operating at a capacity of around 85%. All three hospitals in Colombo are in a similar situation.

However, while public health care in Colombo is excellent by regional standards, people also face a lack of capacity, including very long waiting periods. Perhaps the greatest opportunity lies in geriatric care as the country prepares to deal with an ageing population. We will require new, specialised medical centres to deal with their needs adequately. Moreover, services such as cyberknife, robotics and laser surgery are not readily available in Sri Lanka, so people seek them abroad.

Are levels of expenditure on health sufficient to meet demand in Sri Lanka?

PATHIRAGE: The current allocation for health in the federal budget is around 1.8% of GDP, which is certainly not sufficient. That said, the current administration has increased this figure in order to preserve free health care and improve its quality. In the long run, the sector needs a more efficient distribution of resources, as well as better planning to meet the demands of provinces for health care. While access to health care remains fairly high, the uniformity of quality standards could be improved in various ways. For example, many health care businesses remain family-owned and lack solid ownership structures. Less than 5% of the current health budget is funded by donor agencies. While funding from foreign aid has been put forward for the development of public hospitals, we will still need to come up with a long-term plan to maintain this progress.

What measures can be taken to develop Sri Lanka as a destination for medical tourism?

PATHIRAGE: Many countries in the region are popular destinations for medical tourism, such as Thailand, Malaysia and Singapore. While Sri Lanka also has potential in this regard, we must cater to local demand first, which will require investing in advanced technology. Only then can we invest in a global marketing campaign. Costs in Sri Lanka are lower than in other destinations worldwide, which will help in creating holiday packages to match the country’s offerings.

How would you assess the development of human capital for the health sector?

PATHIRAGE: Our human capital is improving and on par with many countries, but it is still incapable of meeting demand. The government has a training degree in place for nursing, as well as postgraduate training for doctors along with diplomas for allied care services. On the private sector side, major hospitals offer three-year programmes for nurses.

However, more investment must go into this area. The country also faces a significant challenge in retaining qualified professionals, as many may leave for better international opportunities rather than staying to work here. This challenge can only be addressed by re-evaluating the salary packages offered in Sri Lanka compared to other countries.