Private Hospital Health Care Delivery in Sri Lanka: Some Issues on Equity, Fairness, and Regulation

Research team

by G. D. Dayaratne
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Published Year

June 2013


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The issues pertaining to the private health sector has not been addressed through task force reports or the Health Master Plan 2006. As a result, the government has been burdened with the delivery of public health care services, while the private sector growth has been not been planned or promoted as part of an overall healthcare system.

The size of Sri Lanka’s health care sector is reasonably large enough, however, distribution is lopsided – with the bulk of services (both public and private) skewed towards the Western Province, and main urban centres. This is further compounded by the fact that the government has provided land at concessionary rates to set up private hospitals, predominantly in urban areas.

The private sector has taken advantage of this and clearly identified the health needs of the new (and growing) middle class, associated with their rising quality of life. In order to meet demand, the private sector has embarked on the introduction of the latest bio-medical technologies at a high cost, alongside newly built hospital infrastructure characterized by utmost cleanliness, and adequate parking facilities.

Consequently this has led to an increase in the Out-of-Pocket (OOP) expenditure on healthcare on a household level. Less than 1 per cent OOP is covered by private insurance, which places an overwhelming financial burden on a majority of households. These expenses are not confined to medicines, but also include consultation fees, hospital charges, laboratory and investigation fees, and therapeutic charges, etc.

However, the ground reality is that the progressive private healthcare services are not exclusively utilized by the upper middle class who have the financial means to afford it. Poorer households are also forced to seek treatment at these facilities as a last resort, on account of the stagnant and overwhelmed public health care sector.