By Prof. Tissa Vitharana
Minister of Science and Technology
In the course of one's lifetime among the many people that one meets and interacts with their ideas remain fresh and alive in one's memory. Professor Senaka Bibile is one such person.
He was a charming and extremely interesting and intelligent person in whose company it was a pleasure to be. He had many interests and he was knowledgeable about most of them.
I had first heard about him when as a student at Trinity College, Kandy. He repaid the entirety of his scholarship that enabled him to graduate as a doctor from the University of Colombo with a first class and several distinctions. In this way the money could be used for another needy student. Instead of opting for a glamorous clinical specialty he chose pharmacology. As a teacher he made the subject interesting and meaningful and instilled a sense of scientific responsibility for the treatment of the patient. His attitude to us students was that of a friend and we felt free to discuss any matter with him. He participated in the life of the student community and was especially interested in sports like cricket and in music, but above all else he was intensely interested in the problems of society, being a socialist.
As a pharmacologist, Professor Senaka Bibile excelled both as a teacher and a researcher. His research findings were important and presented at the Sri Lanka Association for the Advancement of Science and published in scientific journals here and abroad.
But his main contributions as a pharmacologist were influenced by his political views. He conducted Marxist study classes at his house in Castle Street and I and several fellow students went on bicycles there once a week. He made the subject interesting and we had many discussions, sometimes heated but never acrimonious, which helped us to think like socialists. Inspired by him I formed the Socialist Society in the Faculty of Medicine, which was considered to be almost an act of fancy at the time when Sir Nicholas Attygalle dominated University life and our future depended on success at many interviews.
He was a member of the Lanka Samasamaja Party and besides being Treasurer of its Youth Movement actively participated in public politics. For instance at the height of the language issue when the LSSP, which stood for both Sinhala and Tamil being state languages, incurred the wrath of a majority of Sinhalese people. Senaka agreed to contest a by-election seat in the Colombo Municipality as the LSSP candidate, to fight for that principle, risking his life in the process and facing certain defeat.
With this outlook it is not surprising that he played the leading role in developing a rational pharmaceutical policy which ensured that the poor people would get good quality drugs at the lowest possible price to the country and that doctors would prescribe the minimum required drugs to treat the patient's illness. By setting up the State Pharmaceutical Corporation and calling for worldwide bulk tenders he successfully broke the stranglehold of the Multinationals on the drug trade and made them compete with each other and with generic drug producers enabling poor countries to obtain drugs much cheaper. This policy was supported by WHO and other UN agencies with enormous benefit to Third World countries. it is possible that the threat he posed to the powerful Multinationals may have had some bearing on his premature death while on a UN assignment in British Guiana to introduce these policies there.
Poor medical treatment kills thousands
Requiring doctors and hospitals to report publicly on their performance and tying their pay to the results would dramatically reduce avoidable deaths and costs attributable to poor medical care, says a new report from an organization that works to improve health care quality.
Wild variations in medical care led to 79,000 avoidable deaths and $1.8 billion in additional medical costs last year, the private National Committee for Quality Assurance said in its annual report released Wednesday.
The report described a substantial gap in quality between the best providers and the national average for treating a range of common conditions that would not be tolerated in almost any other sector of the U.S. economy. For example, failure to control high blood pressure resulted in up to 26,000 deaths last year that could have been avoided with competent medical care, the report said.
The differences in health care quality persist even as health insurance premiums have risen by more than 10 percent annually for the past four years. "This report underscores that all too often we are not getting good value for that money," said Peter V. Lee, president and chief executive of the Pacific Business Group on Health, a coalition of businesses that provide health insurance to 3 million people.
On the other hand, the report found that health insurance plans that publicly report their performance showed marked improvement in most areas, including cholesterol management, diabetes care, breast cancer screening and flu shots for adults.
Better control of blood pressure will lead to 2,500 fewer fatal heart attacks in 2004, the report said. Health plans also did a better job of reducing cholesterol levels among patients with diabetes, it said.
But those plans cover only about a quarter of the U.S. population, about 69 million people.
"The data we have tell a great story, health care quality is improving consistently and dramatically," said Margaret E. O'Kane, NCQA's president. "Why don't we have performance data for the other 75 percent of the U.S. health care system?"
Last year's Medicare prescription drug law took a step in this direction by linking a small portion of Medicare payments to hospitals' willingness to submit quality data and conducting trial runs that tie pay to performance for some health care providers.
One notable exception to the upward trend in quality was treatment of mental illness, which showed no improvement over 2002.
"Patients get the correct care only about 50 percent of the time," the report said.
Harvard Pilgrim Health Care of Massachusetts was the top-rated health plan for both clinical care and member satisfaction, the report said.
Source: People's Movement for the Rights of Patients (PMRP)