Text from Health Minister
This week I got a text from Health Minister Dr Fuad Khan, who said he felt misrepresented in last week’s column regarding the lack of palliative-care drugs available to patients who are terminally ill.
He also believed I had misinterpreted the reason for his displeasure at not being present at the opening of the Caura Palliative Care Unit run by the North Central Regional Health Authority.
Coincidentally, this week, I also met with several doctors working in public health care, who outlined many cracks in the system.
I interviewed the minister in an effort to get to the truth of the exact state of public health care.
I suspect that we will need many such interviews across the board to understand why a system on which some $15 billion has been spent in recent times operates in this unsatisfactory fashion.
This is how our telephone conversation went.
IM: Why were you quoted as calling the opening of the Caura Palliative Care Unit in your absence “disrespectful”?
FK: The Palliative Care Unit was the brainchild of Sati Seemungal, as a tribute to his daughter, who died of cancer, not the chair of the NCRHA. Sati Seemungal approached me with the idea of a palliative care ward. Since we don’t deal with the terminally ill properly in this country, I worked with Sati and the RHAs to make this happen.
The name of his daughter should have been on the plaque. Or it should have been simply called the Palliative Care Ward. I was abroad when it was opened. I didn’t know there was going to be a plaque, and I certainly don’t care to have my name on it. What I object to is not being kept in the loop by the board of the NCRHA.
What exactly is your contention with the current board?
I am going to Cabinet to change that NCRHA board. The members of that board know exactly why. They are at loggerheads with one other and the management. The CEO is not in sync with the board. The chief of staff, consultants all have problems with the board. A lot of things are not being done as they should be at the RHA. If people are spending more time fighting and less doing their jobs, I have to make changes. I have to run the health sector for the benefit of the public.
Two years ago, I interviewed you following an appeal by Dr Jacqueline P Sabga to address the shortage of palliative drugs in the Vitas House Hospice in particular.
Last week, Dr Sabga said no progress had been made. You object?
I refute Dr Sabga’s claim that I am not doing anything to bring in palliative drugs. These are narcotics, not regular drugs. Regarding end-of-life pain palliative drugs, the reason we don’t have them is because we are short of suppliers. Nipdec brings in pharmaceuticals.
I have told Dr Sabga that if Vitas House Hospice or any supplier brings them in, I will expedite the process. I care deeply for cancer patients.
I pushed for the oncology centre and a radiotherapy and cancer centre in St James. I am pushing for a health card for patients to get ready access to drugs.
This week, several doctors gave me the inside story of the horrendous state of public health care. In summary, they said:
The San Fernando Teaching Hospital is a white elephant, largely empty, with a good view, and an entire floor devoted to the PM and VIPs.
It’s inconvenient to doctors and patients—a 20-minute walk from the lab, operating theatres.
Millions spent there should have been spent on equipment and supplies necessary for doctors to treat patients.
These include bone-cutters, nibblers (often diabetics in whom gangrene has set in get sicker and more septic waiting for availability), trolleys, needles, catheters, blood-collection tubes, basic and prescription drugs.
There are limited beds in San Fernando and one emergency theatre for all departments.
Outpatient time for CT and MRI scans ranges from six months to a year.
There has been no wage increase for public doctors, while foreign doctors such as the Cubans are being hired.
These doctors are reportedly a hindrance due to the language barrier and do not pull their weight.
PoS hospital is cockroach-riddled and badly equipped. At one point the CT scanner was down for nine months.
Your response?
That is nonsense. These issues are decades old. I can’t fix everything in three years. We have never had a master plan. I am working non-stop with the IDB for a 60-year master plan for PoS, San Fernando and Mt Hope.
Four and five RHAs are a waste of time. We need just two and one in Tobago, and a single board of directors.
There are issues, but we are making inroads. We have spent some $15 billion on health care. When I walked through the SF hospital people mobbed me, thanking me. Regarding the shortage, the pharmacy is regularly stocked. I have had reports that health workers are pilfering equipment and using it in private practice. We are addressing the equipment issues. There is pest control in all the hospitals, and we are purchasing equipment where required. The Cubans and Chinese may be threatening to local doctors. I acknowledge how hard our doctors work. I am a phone call away for anyone with questions or problems.