COLOMBO — Questions have emerged over the procurement of five CT simulator machines intended to support cancer treatment at major government hospitals in Sri Lanka, with medical professionals calling for greater transparency over delays and their potential consequences for patients awaiting radiotherapy.
The equipment was included in a procurement programme supported by Asian Development Bank (ADB) financing to strengthen cancer treatment facilities.
The five CT simulators were intended to support radiotherapy services at hospitals in Anuradhapura, Badulla, Kurunegala, Ratnapura and Hambantota.
Concerns have been raised that delays in obtaining the specialised machines could prevent expensive radiation treatment infrastructure from being used to its full capacity.
Consultant physician Dr. Chamal Sanjeewa, President of the Medical and Civil Rights Professional Association of Doctors, has questioned the handling of cancer equipment procurement and called for investigations into alleged administrative irregularities.
The concerns place renewed pressure on the Ministry of Health to clarify the status of the procurement process, explain any outstanding obstacles and disclose when the equipment is expected to become available for clinical use.
Why CT Simulators Are Essential for Radiotherapy
CT simulators are specialised medical imaging systems used in planning radiation treatment for cancer patients.
They produce detailed images that allow medical specialists to identify the location of tumours and surrounding healthy tissues before treatment begins.
The information is used to develop treatment plans that determine how radiation should be delivered accurately while minimising unnecessary exposure to healthy organs.
Linear accelerators, commonly known as LINAC machines, are used to deliver precisely controlled radiation to cancerous tissue.
CT simulation and treatment planning are important components of modern external-beam radiotherapy.
Without suitable imaging and an approved treatment plan, patients cannot safely proceed with particular forms of radiation treatment.
However, the absence of a dedicated CT simulator at an individual hospital does not necessarily establish that every linear accelerator installed there is unusable. The actual position depends on available equipment, treatment-planning arrangements and the clinical services being provided.
The distinction is important when assessing the operational condition of Sri Lanka’s radiotherapy facilities.
Five Regional Hospitals Identified for Equipment
The procurement concerns involve hospitals serving five provinces:
- Anuradhapura: North Central Province
- Badulla: Uva Province
- Kurunegala: North Western Province
- Ratnapura: Sabaragamuwa Province
- Hambantota: Southern Province
These facilities are important to the government’s efforts to expand specialist cancer treatment beyond the Western Province.
Sri Lanka’s national cancer control planning documents identify the development of radiotherapy facilities and the provision of suitable CT simulation equipment as priorities for strengthening regional treatment services.
Expanding these services would allow more patients to obtain specialised treatment closer to their homes.
For cancer patients living in distant districts, the availability of regional radiotherapy facilities can make a substantial difference to treatment accessibility.
Travel to Colombo or Maharagama may involve transport costs, accommodation expenses, loss of income and considerable physical strain.
Such difficulties can be particularly severe for patients requiring repeated hospital visits over several weeks.
The successful introduction of regional radiotherapy services is therefore an important matter of healthcare access and equitable distribution of public resources.
Questions Over the ADB-Funded Procurement Process
The Ministry of Health previously advertised the procurement of five CT simulators under the Health System Enhancement Project’s additional financing arrangements.
Official procurement documentation identifies the tender as HSEP(AF)/PMU/PRO/G35.19/63/2025.
The original procurement notice was published in September 2025, and the deadline for submitting bids was subsequently extended to November 24, 2025.
The existence of this procurement process is documented.
However, the allegation that the tender has been indefinitely cancelled or abandoned requires further confirmation from the Ministry of Health or the project authorities.
The available documentation does not, by itself, establish that the procurement has been terminated.
Nevertheless, questions remain concerning its present status and the timeframe for supplying the equipment.
The Ministry should clarify:
- Whether the tender evaluation process has been completed.
- Whether a supplier has been selected or a contract awarded.
- Whether any administrative, technical or financial objections remain unresolved.
- Whether the ADB financing remains available for the procurement.
- When the machines are expected to be delivered, installed and commissioned.
- Whether interim arrangements are available for patients requiring treatment planning.
Clear answers would help establish whether the procurement is progressing normally or has encountered delays requiring intervention.
Concerns Over Expensive Radiation Treatment Infrastructure
Sri Lanka has invested substantial public resources in expanding cancer treatment infrastructure, including the acquisition and installation of sophisticated radiation treatment equipment.
Such investments involve more than the initial purchase of machines.
Effective radiotherapy services also depend on properly equipped treatment facilities, trained specialists, medical physicists, radiographers, maintenance arrangements and compatible treatment-planning systems.
A delay affecting one essential component can therefore reduce the effectiveness of the wider investment.
Medical professionals have raised concerns that expensive equipment may remain underutilised if the supporting systems required for treatment are unavailable.
However, the supplied allegations do not independently establish that all five hospitals currently have fully installed but entirely unusable linear accelerators.
A hospital-by-hospital technical assessment would be necessary to determine the operational condition of the equipment and the services presently available.
The Ministry of Health should publish accurate information on the installation, commissioning and clinical use of radiotherapy equipment at the five facilities.
Such disclosure would help establish whether public investment is delivering the intended benefits.
Regional Patients Face Additional Difficulties
The consequences of inadequate regional cancer treatment facilities extend beyond equipment procurement.
Patients who cannot obtain specialised services near their homes may be required to travel considerable distances to larger treatment centres.
Maharagama’s Apeksha Cancer Hospital remains one of Sri Lanka’s principal institutions providing specialist cancer care.
High demand for its services places pressure on patients and healthcare professionals.
Recent reports have also highlighted technical problems affecting a CT simulator at Apeksha Hospital, with medical associations warning that the disruption has delayed treatment planning for patients awaiting radiotherapy.
These concerns underline the importance of strengthening regional cancer services and ensuring that essential equipment is properly integrated into existing treatment systems.
For patients undergoing cancer treatment, delays can create considerable anxiety and additional financial hardship.
Depending on the diagnosis and individual treatment requirements, delays may also affect clinical outcomes.
The precise consequences must be assessed by treating specialists rather than assumed from the existence of a procurement delay alone.
Dr. Chamal Sanjeewa Calls for Greater Accountability
Consultant physician Dr. Chamal Sanjeewa has publicly raised concerns about procurement practices involving cancer treatment equipment.
He has previously called for independent investigations into alleged conflicts of interest and questioned whether proposed equipment purchases adequately meet modern clinical requirements.
His concerns include the possibility that administrative decisions and procurement disputes could delay the introduction of essential cancer treatment technology.
In relation to the five CT simulators, the supplied account attributes to him criticism of the Ministry’s handling of the procurement process and a call for urgent action.
He maintains that delays in obtaining necessary equipment could adversely affect cancer patients who depend on public hospitals.
Allegations of improper influence, undisclosed commissions or manipulation of tender procedures must, however, be supported by evidence before they can be treated as established findings.
No such misconduct has been independently established in the material reviewed for this article.
Nevertheless, the concerns justify transparent examination of the procurement process.
An independent review could assess whether appropriate procedures were followed, whether any avoidable delays occurred and whether corrective action is necessary.
Health Ministry Must Clarify Procurement Status
The responsibility for providing effective public healthcare extends beyond purchasing expensive medical equipment.
Authorities must also ensure that machines are delivered, installed, commissioned, maintained and supported by the facilities and personnel needed for clinical use.
Where projects receive international development financing, transparency is particularly important.
The Ministry of Health should disclose the current position of the five CT simulator procurement, the reasons for any delays and the steps being taken to complete the project.
It should also clarify the operational status of the associated radiotherapy equipment at each hospital.
If administrative or technical obstacles have delayed the procurement, those difficulties should be identified and addressed without unnecessary delay.
Any evidence of procurement misconduct should be investigated through the appropriate legal and administrative procedures.
For patients awaiting cancer treatment, the priority is straightforward: access to safe, timely and effective medical care.
The value of public investment in cancer treatment cannot be measured solely by the number or cost of machines purchased.
It must ultimately be measured by whether those machines are functioning properly and helping patients receive the care they need.
