The need for an Institute of Hospital Management.

The monitoring mechanism of activities of the government preventive health sector is better than that of the curative sector, although much more money is spent on the latter. Recent initiatives for monitoring the curative sector should be strengthened by establishment of an institute of hospital management. The need for such an institute has been recognised for about 15 years. This need has been further emphasised by recent studies and discussions.

The health services of Sri Lanka present and future.

1) Sri Lanka has achieved a high human development status; 2) The health sector, and particularly the government health sector, has played an important role in this achievement. 3) The health transition is going to increase the burden of disease and the demand for health services; 4) The government health services have been underfunded and the provincial health services have been more underfunded; 5) The most cost efficient health services, anywhere in the world, are government funded; 6) Therefore, it is our duty to lobby government to increase government funding for health services; 7) The preventive health service should continue to be funded fully by government. Prevention of non-communicable diseases should come within this orbit. Staff in preventive health services should be better remunerated; 8) The essential clinical package in the periphery must be improved to reduce by-passing and underutilization; 9) Management of tertiary health care facilities have to be strengthened. They should be given responsibility and autonomy; 10) A powerful unit should be established in the Ministry to study and implement cost recovery and cost containment in tertiary care institutions; 11) Senior doctors should take an active part in the management of the tertiary care institutions to make them more efficient. 12) Private hospitals should be supervised by the Ministry in order to ensure quality of care and to contain national health care costs:

The General Hospital Colombo Rehabilitation Project.

The General Hospital Colombo (GHC) Rehabilitation Project was to be implemented in 6 phases in about 25 years. The proposed funding was a grant of 100% from Finland for technical assistance and training, and 85% for investments. The development objective was to reinforce the status of the hospital as the apex of the medical care system. In Phase I (1985-1990) an 8 storeyed accident and orthopaedic services building with modern facilities has been commissioned. A water tower and a 'septic' operating theatre have been built. Infection control and maintenance organizations have been started. Phase I cost Rs.960 million. In the Bridging Phase, the existing six storeyed building is being renovated. Phase II has been drastically curtailed. It will concentrate on infrastructure development such as water supply, kitchen, stores and transport, and the construction of four new medical wards. The project will end in 1993.