Why Sri Lankan Doctors Are Urging Changes to the 2026 Budge

Why Sri Lankan Doctors Are Urging Changes to the 2026 Budget

"A doctor’s honest message to protect our health system-and those who keep it alive"

I don’t usually write long articles, not since my school days. But today I feel that I must. This is not politics. This is the reality that doctors in Sri Lanka live through every single day.

I write as someone who has worked in busy city hospitals, rural outposts, and even abroad. Now, back in Sri Lanka, I write for all doctors-interns, medical officers, specialists, and medical students who are hoping to become future healers of our nation.

Why Write Now?

Because we are losing our doctors at an alarming pace.

Specialists, medical officers, interns, and even final-year undergraduates are preparing to migrate. Some have already left. Many are quietly making arrangements to go. I personally know several specialists currently waiting for their overseas paperwork to finish.

If this continues, our health system will collapse-not because of lack of buildings or new equipment, but because there will be no people left to run them.

It is not only doctors who are leaving. Nurses, laboratory technicians, and other healthcare workers are following the same path. They are welcomed overseas because their training and skills are strong, and they are paid well for the responsibility they carry.

Why Sri Lankan Doctors Are Valued Worldwide?

Our training is one of the strongest in the world. It produces disciplined, hardworking professionals who carry the weight of human lives every day. Abroad, they are recruited quickly and offered good salaries-because a doctor’s mistake can cost a life.

Like a pilot who carries hundreds of passengers, a doctor carries every patient’s hope of survival. This is not a job you “just do”. It is a responsibility you live with, day and night.

What the 2026 Budget Overlooked?

Yes, the government has proposals to invest in hospital infrastructure, new technology and development. Those improvements are appreciated.

But there is nothing in the budget to support the wellbeing and retention of medical professionals.

Nothing to stop the fast-growing migration.

Nothing to stabilise the staffing crisis.

Nothing to make a young doctor think, “Yes, I can stay in Sri Lanka and build my future.”

A modern hospital without staff is only a building. It cannot save a life.

The Daily Reality of a Sri Lankan Doctor?

People see the stethoscope. They don’t see the struggle.

• Doctors are posted anywhere in the country based on merit—not choice.

• Many are sent to faraway rural areas for years at a time.

• There is no protocol to value personal wellbeing of doctors, a couple with both doctors are not given any priority when allocating stations.

• Some families live apart because of their job. Children grow up without their parents at home.

Few examples:

A specialist couple returned from overseas training. The wife was posted to Mannar, the husband to Trincomalee. Their young children lived in the south with grandparents. They endured this silently. But today, many in the same situation would simply migrate.

Another example:

A medical officer I know travels nearly two and a half hours a day by bus just to reach hospital, because she cannot afford a vehicle. ( Otherwise she could reach the hospital within one hour by private transport) She came to work sweating and breathless, even before beginning her duties. Is this fair for someone expected to treat patients with full concentration?

This is the sad truth of many young doctors I meet day-to-day.

And my own experience:

During my internship in a paediatric professorial unit, I was on call every second or third night. Many nights we stayed awake monitoring dengue patients, worried that a child might collapse at any moment. There were dozens of admissions throughout the night on casualty nights. Then, without any rest, we worked the entire next day and the cycle goes on. This continued for months.

These are not isolated stories. This is the life of most Sri Lankan doctors.

Why Doctors Abroad Are Less Burned Out

In developed countries?

• Night-duty doctors get official rest days

• Leave is organised and respected

• Study days are provided

• Workload is shared among adequate staff

• Systems support them

They are well paid for their hard earned job and daily responsibility. Moreover, in some countries, there is a tax exemption to buy vehicles and other benefits.

In Sri Lanka:

• No rest after night duty

• Leave becomes a negotiation

• Units are understaffed

• No study days

• Family life is difficult

Currently, there is no system to assure doctor's wellbeing.

Yet, Sri Lankan doctors still give their best every day.

If This Migration Continues, What Will Happen?

This is not a prediction. It has already started.

• Wards will close due to lack of staff

• Operating theatres will reduce services

• ICUs will have fewer beds

• Waiting times will rise sharply

• New medical students will have fewer trainers and less exposure

• Private hospitals will also struggle because most private specialists come from the government sector

A health system does not collapse overnight.

It collapses slowly-then all at once.

Why Some Doctors Still Stay in Sri Lanka

Not because they lack opportunities.

Not because they cannot migrate.

They stay because:

• They love their country

• They feel responsible for their patients

• They want Sri Lanka to recover

• They hope for change

But even this dedicated group is losing hope now.

There may be a minority who are not leaving the country because of personal reasons. However, they are not without the capacity to leave the country at anytime.

Where Leadership Went Wrong?

To be fair, the government has taken positive steps-reducing corruption, digitalising systems, planning long-term investments.

But the repeated negative remarks about doctors-suggesting they want status or luxury- are demoralising. In taking a stance against one union, Mr President and the government overlook the issues they are voicing on behalf of all doctors and specialists.

Doctors are not asking for special treatment. They are asking for a fair salary that reflects their responsibility and helps them stay in Sri Lanka instead of leaving.

Removing the vehicle permit was another blow.

The President had promised before the election that these permits would not be removed, yet now he says he is dismantling a “permit culture.”

However, this is not a culture but rather a modest form of appreciation for executive-level employees in recognition of their responsibilities.

Simply, a businessperson can deduct travel expenses before taxes.

A doctor cannot.

A significant proportion of our salary goes to taxes, and what remains must cover transport (long distance travel to work, even frequent travel to work), fuel, housing, and family needs.

Not having a personal vehicle leads to a considerable amount of time to travel, and this becomes an added burden-especially for those who are already managing demanding schedules, long shifts, and heavy responsibilities. The extra hours spent on the road reduce rest time, increase fatigue, and place even more strain on individuals who are already stretched thin. Sadly, this is the truth about many young doctors who are living a daily struggle.

Is this fair for someone who works day and night to save lives?

What the Government Should Focus on First?

Before expanding infrastructure or initiating new services, the urgent priorities should be:

1. Fixing the shortages that affect patient care:

• Basic medicines

• Cancer drugs

• Emergency medicines

• Medical supplies

• Lab facilities

• Equipment maintenance and Quality assurance

• Transport services

2. Fixing the human resource crisis:

• Migration of doctors

• Understaffed hospitals

• Limited cadre positions

• Addressing the wellbeing of health staff

Without people, there is no health system.

A Final Message From My Heart

You may wonder how I found the time to write this. The truth is that after countless sleepless nights and endless duties, writing during a short quiet moment feels almost normal.

I wrote this because I love my country.

Because I care about my colleagues.

And because I fear what will happen if we remain silent.

Other sectors-education, engineering, banking, law-are also losing their best talent. This is not only a health crisis; it is a national crisis.

If nothing changes, the damage will be permanent.

Patients will suffer.

Families will suffer.

The entire country will suffer.

Doctors want to stay.

Doctors want to serve.

But doctors also need a reason to remain here.

If we want to save the Sri Lankan Health System, we must first protect the people who keep it alive.