President Anura Kumara Dissanayake has outlined plans for a primary-care-based referral system intended to change how patients access hospitals and specialist services in Sri Lanka.
Under the model described by the President, patients would first consult a primary-care doctor, who would assess their condition and refer them to a hospital or specialist service when higher-level care is necessary.
The objective is to provide treatment at the appropriate level of the health system while reducing avoidable use of major hospitals for conditions that can be managed through primary care.
The proposal is linked to the Government's Arogya Health and Wellness Centre programme.
The Cabinet had previously approved the phased establishment of 1,000 Arogya Health and Wellness Centres during 2026-2028.
According to the Cabinet decision, the programme is intended to increase the total number of primary-care institutions, including existing divisional hospitals and primary medical care units, to 2,000.
The Government also plans to provide the human and physical resources required for the new centres.
The President said the proposed approach would provide families with a primary point of contact for healthcare and allow referral to higher levels of care where necessary.
What has been approved and what remains planned
The 1,000-centre programme has Cabinet approval for phased implementation during 2026-2028.
However, the broader referral arrangement described by the President should still be reported as a planned health-system reform, not as a fully implemented nationwide referral requirement.
Patients should therefore not be told that they are currently prohibited nationwide from directly attending a major Government hospital unless such an operational rule is formally introduced.
Likewise, the 1,000 Arogya centres should not be described as already operational.
Further details will be needed on implementation, patient registration, referral pathways, staffing and how emergency and other direct-access services will operate.