A shocking National Audit Office report reveals how financial mismanagement, negligence, and systemic failures in Sri Lanka’s Ministry of Health have cost the nation more than Rs. 1.27 billion, raising urgent questions about accountability and governance.
Sri Lanka’s Ministry of Health has come under fire after a damning National Audit Office report exposed staggering financial irregularities and negligence that led to the loss of over Rs. 1.27 billion in public funds. The report highlights systemic weaknesses, a lack of internal controls, and widespread inefficiency in managing medical officers’ contractual obligations, foreign employment, and postgraduate studies abroad. The revelations underscore a crisis in accountability within one of the nation’s most vital ministries.
The audit reveals that hundreds of medical officers have abandoned their posts to pursue higher education or lucrative jobs overseas without settling their financial obligations. Many failed to repay bond money, fines, or salary overpayments, leaving the ministry unable to recover funds owed despite legal frameworks clearly mandating repayment. The losses are not only financial but also reflect a severe brain drain of trained professionals at a time when Sri Lanka’s health sector is already struggling with shortages.
According to the audit, as of October 31, 2024, a total of 705 medical officers had defaulted on Rs. 1,156,562,119 after breaching their contracts. An additional 116 medical officers, who did not even submit their personal files for audit inspection, owed a combined Rs. 119,404,239. In another shocking instance, Rs. 1,041,215 in salaries, allowances, and loan balances paid to five doctors who left service without bonds has still not been recovered. Altogether, the Ministry has failed to collect funds that could have bolstered the public healthcare system.
The auditors found gross negligence by ministry officers tasked with recovering these arrears. Files went missing, follow-up was either minimal or non-existent, and correspondence was incomplete. In many instances, officials failed to act “efficiently and responsibly” as required by law, leading to years of delays and making some recoveries practically irrecoverable. In addition, provincial council hospitals and other health institutions were found to have acted outside their legal authority, overriding the Public Service Commission, which is the sole constitutional body empowered to appoint and discipline medical officers.
The report points to a culture of disregard for rules and procedure. While the Public Service Commission’s Institutional Code and Procedure Rules—introduced in 2009 and updated in 2023—clearly outline how foreign travel and related matters should be managed, the Ministry repeatedly ignored these frameworks. The result is a chaotic system where financial discipline has collapsed, and billions of rupees in taxpayer money are at risk.
One of the most concerning findings relates to specialist medical officer appointments. Despite Cabinet approval for 2,837 specialist posts across 58 medical fields, the Ministry only reported 2,740 posts across 50 fields. No appointments were made for 66 posts in eight key fields, leaving critical shortages. As of November 2023, there was a shortage of 972 specialists across 35 fields, while 113 surplus specialists were found in 12 fields. Even more alarming, 141 specialists had been deployed in 12 fields that were never formally approved by Cabinet, a clear violation of official authorization.
Central government hospitals reflected the damage of this mismanagement. Data as of June 30, 2023, showed a shortage of 226 specialists across 50 central hospitals and other institutions, while 123 specialists were in surplus across 23 hospitals. This imbalance left critical gaps in healthcare provision, undermining patient care and exposing deep flaws in workforce planning.
The report further highlighted how 71 medical officers who went abroad on full-pay study leave to obtain board certification failed to complete their training and never returned to service. This represents a double blow: public funds were wasted on salaries for absentees, and the country lost the expertise of doctors it had invested heavily in training.
Adding to the crisis, the audit exposed structural problems dating back to a Cabinet memorandum that sought to increase specialist numbers from 971 to 2,837 by 2015. Instead of adhering to this structured plan, the Ministry treated the total number as a blanket authorization and deployed specialists arbitrarily, ignoring both expertise and institutional needs. This arbitrary deployment has had long-term consequences, including mismatches between hospital requirements and available skills, compounding the difficulties faced by an already overstretched public health system.
The National Audit Office report concludes with strong recommendations. It urges the Ministry to establish a centralized database of all medical officers, from appointment to resignation, to ensure proper monitoring and accountability. It also calls for strict adherence to procedural rules, timely recovery of government payments, and disciplinary action against officers who have neglected their duties. Strengthening internal controls is identified as a key step to prevent recurrence of such financial mismanagement.
The findings of the audit paint a grim picture of how negligence and inefficiency in one of the most crucial ministries have cost Sri Lanka both financially and professionally. The Rs. 1.27 billion loss could have funded hospitals, procured vital medicines, or trained new healthcare workers. Instead, it was squandered through poor management and a lack of oversight.
The revelations are likely to fuel public anger, as the country continues to face economic challenges and rising demands on its healthcare system. The loss of funds and the shortage of medical professionals highlight a crisis that extends beyond balance sheets—it is a crisis that affects the lives and wellbeing of ordinary Sri Lankans.
If decisive action is not taken, the Ministry of Health risks repeating the same mistakes, leading to further losses of public funds and continued deterioration of healthcare services. For Sri Lanka, the scandal is a reminder of the urgent need for accountability, stronger governance, and a renewed commitment to safeguarding the nation’s resources for the benefit of its people.
