The National Audit Office has issued a stark warning regarding significant staffing shortages and discrepancies within Sri Lanka’s health sector. As of June 2023, over 14,000 vacancies in the Ministry of Health are crippling the delivery of essential services across the country.
The audit revealed that the Ministry, with an approved staffing level of 95,948 positions, had only 81,915 posts filled, leaving a gap of 14,033 across hospitals and health institutions. The shortfall includes critical medical specialties, where 97 positions remain vacant out of the 2,837 approved specialist posts. Notably, 66 specialist roles are unfilled in eight essential medical fields, highlighting a severe imbalance in the allocation of resources.
Adding to the concern, the report uncovered irregularities in staffing practices. While 972 specialist positions in 35 fields were underfilled, there were 113 specialists employed in excess of the approved posts in 12 other fields. Furthermore, 141 specialists were hired in unapproved roles, undermining the Ministry’s credibility and planning processes.
In addition to shortages, discrepancies in record-keeping have emerged as a major issue. Staffing levels reported by various departments within the Ministry were inconsistent, complicating efforts to accurately assess the situation. For instance, the Planning Division cited 81,915 staff as of June 2023, while other records presented conflicting numbers.
The report also highlighted long-standing issues, such as the failure to address staffing needs for expanded facilities like the upgraded Kalutara Teaching Hospital. Although Cabinet approval to increase staff was granted in 2018, no concrete action had been taken by the end of the reviewed period.
The audit raised concerns over the informal employment of health workers. Since 2017, 1,103 mosquito control assistants have been engaged under contracts for dengue control activities, yet only five of these positions are officially recorded. This gap in formal recognition and record-keeping undermines the Ministry’s ability to effectively manage human resources.
Moreover, staffing imbalances were evident at the institutional level. While some hospitals reported excess specialists, others faced acute shortages. For example, 226 specialists were missing in 50 hospitals, leaving critical areas underserved despite surplus staff elsewhere.
The National Audit Office attributed these issues to poor planning and coordination between the Ministry and health institutions. The lack of a systematic approach to updating and maintaining accurate staff records further exacerbates the problem.
The report called for immediate action to address these challenges. Recommendations include recruiting additional specialist doctors to fill vacant positions, reallocating surplus staff to underserved areas, and improving record-keeping systems. The Ministry has also been urged to develop a transparent and efficient staffing plan to meet future healthcare demands and ensure equitable distribution of resources across the country.
This alarming situation underscores the urgent need for reforms in the health sector to safeguard the well-being of the population and ensure the effective delivery of healthcare services.
