29/06/2026
Healthcare Workload in Sri Lanka Compared with the United Kingdom: Are Sri Lankan Doctors Underpaid for the Work They Do?
Sri Lanka is widely recognized for achieving excellent health outcomes despite spending far less on healthcare than many developed nations. Universal free healthcare, high literacy rates, and a strong public health system have enabled the country to maintain impressive maternal and infant mortality rates and life expectancy. However, one of the greatest strengths of the Sri Lankan healthcare system—its workforce—is also one of its greatest vulnerabilities.
Patient Workload
A typical government doctor in Sri Lanka often sees between 60 and 150 patients during a routine outpatient clinic, depending on the hospital and specialty. In busy tertiary care hospitals, it is not uncommon for physicians to review over 200 patients in a single clinic session. Emergency departments and medical wards are similarly overcrowded, with doctors managing large numbers of admissions while also covering night duties lasting 24 hours or longer.
In contrast, doctors in the United Kingdom generally have substantially lower patient volumes. An NHS general practitioner (GP) typically consults 20–35 patients per day, with each consultation lasting around 10–15 minutes. Hospital physicians usually manage fewer patients per shift and work within teams that include physician associates, advanced nurse practitioners, pharmacists, and other allied health professionals, reducing the burden on individual doctors. The UK’s working hours are also regulated under the Working Time Regulations, limiting the average work week to 48 hours. 
Working Hours
Sri Lankan government doctors frequently work:
• Regular daytime duties.
• Overnight on-call shifts lasting 24 hours or more.
• Weekend and public holiday duties.
• Additional private practice after government work to supplement income.
Continuous 24-hour shifts remain common in many hospitals, particularly during staff shortages and disease outbreaks. Fatigue, burnout, and work-related stress have become increasingly recognized concerns.
In the UK, although NHS staff also experience pressure, resident doctors usually work within regulated rotas, mandatory rest periods, and strict limits on average weekly hours. 
Salary Comparison
The difference in remuneration is striking.
A Sri Lankan government medical officer typically earns approximately LKR 250,000–350,000 per month, depending on seniority, allowances, and on-call payments. While this income may appear reasonable locally, it has declined substantially in real value due to inflation and currency depreciation. Many doctors therefore rely on additional private practice to maintain their standard of living. 
In comparison, an NHS resident doctor in the UK earns approximately £40,000–£70,000 annually, while consultants typically earn over £100,000 per year, excluding additional payments for extra duties or private practice. These salaries are accompanied by pension benefits, paid study leave, structured career progression, and regulated working conditions. 
Productivity per Doctor
If productivity is measured by the number of patients reviewed per day, Sri Lankan doctors are among the busiest in the world. Many clinicians examine three to five times as many patients as their counterparts in developed healthcare systems.
This remarkable productivity allows Sri Lanka to provide universal healthcare at relatively low national expenditure. However, such efficiency comes at a cost:
• Reduced consultation time per patient.
• Increased risk of burnout.
• Higher likelihood of medical errors due to fatigue.
• Limited opportunities for teaching, research, and continuing professional development.
Why This Matters
The discussion should not simply focus on increasing doctors’ salaries. Rather, it should recognize the relationship between workload, responsibility, productivity, and fair compensation.
A healthcare system depends on retaining experienced professionals. When doctors work significantly longer hours, manage substantially larger patient loads, and receive comparatively lower remuneration, migration becomes increasingly attractive. Sri Lanka has already experienced a significant loss of medical professionals to countries such as the UK, Australia, and New Zealand, where working conditions and career opportunities are more favourable. 
Conclusion
Sri Lankan doctors continue to provide high-quality care under exceptionally demanding circumstances. Their ability to manage overwhelming patient numbers with limited resources has been central to the country’s healthcare success.
However, sustaining this model requires investment in the workforce. Reducing excessive workloads, increasing staffing levels, improving working conditions, and ensuring fair remuneration are essential—not only for the wellbeing of doctors, but also for maintaining the quality and sustainability of Sri Lanka’s healthcare system.
A strong healthcare system is built not only on infrastructure and medicines but also on a workforce that is adequately supported, valued, and retained.
