The original article can be found in: Trinidad Guardian By KALIFA CLYNE
The many problems in the health sector are inherently human resource issues, says Health Minister Fuad Khan. He said they are too numerous to list fully. Khan inherited a problematic healthcare system from his former colleague Therese Baptiste-Cornelis after a Cabinet reshuffle in June 2011.
Even before Baptiste-Cornelis held the post, complaints about the state of the health sector were numerous. In 2007, after receiving the report of a Commission of Enquiry into the Operation and Delivery of Public Healthcare Services in Trinidad and Tobago, then Prime Minister Patrick Manning proposed to send a copy to the Director of Public Prosecutions (DPP).
The commission said it had found evidence of corruption or other malfeasance in the public health system. Khan outlined measures intended to improve delivery of services in the health sector, listing speciality services, lab services and the number of beds to accommodate patients as the main issue he has had to treat with as minister.
There have been intermittent complaints over the years that patients at several hospitals, mostly the San Fernando General Hospital, had to sleep in corridors and on floors because no beds were available. Since then, Khan said, the outpatient clinic of the San Fernando General Hospital has been moved to the Chancery Lane Medical Complex and progress had been made in terms of availability of beds.
“So far we have been able to have a quicker movement of patient discharge where unless there is a very high number of admissions the bed problem seems to have abated.” Beds are not the only problem in public healthcare. Khan said development of speciality programmes such as cardiology, neurosurgery, reading of X-ray reports and the need for rapid movement in the reading of radiology investigations were additional problematic areas in the delivery of healthcare.“It is mostly human resource issues. “We are in the process of putting a system in place so that people would be able to get cardiac services such as angiograms from public healthcare institutions,” he said. Khan said cardiology services have always been lacking in the public health sector but the ministry is working on programmes to deal with that issue.
The minister admitted that T&T has long-term problems with staffing public medical institutions. “The remuneration packages given to doctors and specialised nurses does not augur well for them to enter into the public service.” He said this was the reason he felt regional health authorities should determine the salaries of their staff rather than relying on the Chief Personnel Officer (CPO).
“The RHA acts allows the authority to do negotiations with their staff except for salaries and allowances in excess of $150,000 per year which must be approved by the minister.” Khan said because salaries are not competitive it is difficult to get nurses and doctors to stay in the public sector.
“Right now we have space in the ICU and no nurses. I need to pay them more because the CPO did not give them what they asked for, although they gave the Tobago people more, and I find that strange.” The minister hopes that if doctors and nurses are given better renumeration, “renumeration that is in line with private hospitals,” they would be able to retain them in the public sector.
That alone won’t fill all the vacant positions in the sector though. The ministry is working with the Ministry of Tertiary Education to develop a programme to train more nurses. “I have sent a note to Cabinet to start back training nurses at different levels,” said Khan.
The need for nurses will become even more apparent once the children’s hospital to be built in Couva is completed and when refurbishment of several institutes, including the Sangre Grande Hospital, the Arima Hospital and the Women’s Hospital at the Eric Williams’ Medical Sciences Complex (EWMSC) are complete.Khan said these are all works in progress. He said the University of the West Indies (UWI) asked for more places to train clinical doctors. At present doctors are trained at UWI, St Augustine; the San Fernando General Hospital and the EWMSC. He said he is working with the regional health authorities so that every hospital could become a teaching hospital.
“I am also hoping to get health centres to open 24 hours in order to better serve the public and focus on customer service at every hospital.” Khan said one of his bigger failures was dealing with the dental programmes in the country. There is no dental department at the Port-of-Spain General Hospital.
The EWMSC has a backlog for dental surgery and dental services at most health centres are not properly available. “We are trying to produce a programme to increase dental care in the country but it doesn’t seem to be working,” Khan said. “It is something I will have to look at again.”
