withstanding the low expectations and cynicism with which the population
regards politicians (with ample cause) I must congratulate you on your
firm handling thus far of the current industrial action taken by public
people of this country have watched with dismay, the casualties of this
action by the Medical Practitioners Association (MPATT): Dead infants
being carted off to mortuaries, pregnant mothers living with dead fetuses
inside them, waiting rooms overflowing with people ailing from renal
failure to high blood pressure and everything in between being forced to
turn home hours later, untreated, having to resort to borrowing or begging
to save their lives in private medical institutions for extortionate fees.
represented by MPATT are refusing to sign contracts until you renegotiate
with them, heads of medical departments are resigning, and hospitals are
eerily empty, devoid of care.
want you to renegotiate for higher salaries, better conditions before they
start doing their rounds of the wards again. They are taking out full page
advertisements simply begging you to talk to them.
action of members of MPATT, a yet unrecognized medical arm of the Public
Services Association (PSA) representing doctors, has been denounced as
“illegal” by the PSA’s President Jennifer Baptiste Primus who
nevertheless hasn’t let you off the hook claiming that your health
ministry must accept responsibility for creating “chaos” by sending
out letters advising doctors to go on leave after their contracts had
MPATTs defense Dr Phillip Ayoung-Chee, a urological surgeon, pointed out
in a Guardian column last Thursday that doctors in the public service are
underpaid, which is why we fail to attract foreign doctors or even locals
studying or working abroad.
have remained resolute in what amounts to a calamitous crisis in health
care, refusing to negotiate with this yet unrecognized body, correct in
your position that negotiations will contravene the Industrial Relations
the impasse must end. No doubt you have plan B in operation because
although you are correct not to be held hostage by MPATT on behalf of this
nation, as Health Minister you cannot allow more people to die of neglect
in our hospitals.
the time this is published the impasse may have been resolved but the
underlying rot in the practice of medicine in this country will continue
unabated as it has for decades.
is some poetic justice in your refusal to meet with MPATT since the
medical fraternity represented by the Medical Board and the Medical
Association of Trinidad and Tobago has also remained unanswerable to the
public for decades. I have personal experience of this. For some three
years now I have publicly presented to them case upon case recounted to me
by distraught relatives of a teenager, a cancer patient, a baby, an
elderly woman (the stories never stop) who died of negligence and
misdiagnosis. Each time the medical fraternity has been accountable. Curt
one-line replies have been issued from the Medical Board and Medical
Association promising a comprehensive response. Three years have passed
and the deafening silence grows louder. No investigations have been made.
Minister if you are firm in your resolve that the nation should not be
held hostage by doctors I suggest that you consider the following
proposals which I have put together with the help of several medical
doctors who are interested in creating systems that will enforce high
standards and accountability, yield better informed patients, and protect
both patients and doctors.
The Medical Association of T&T needs to revise its 30-year-old Code of
Ethics and Bill of Patients’ Rights. Both documents must be displayed
prominently in all public and private institutions.
The Medical Board currently has no power to investigate malpractice
complaints. The proposed Medical Board Act dealing with patients’ rights
issues has been tossed between the Board and the Ministry of Health for
the past six years. The previous Health Minister said he had been waiting
for a response from the Board for three years and under the circumstances
the Medical Board is not answerable to him or anyone else. I hope you are
not that patient.
Two years ago the Ministry of Health was drafting a Health Services Act
that would give the Health Minister the power to license all health
institutions, impose standards, create a disciplinary body, educate the
patient population, and hold all health professionals accountable. What
happened to that?
Private and public care should not co-exist since it encourages a system
that exploits patients, so that a patient who might die waiting for an
operation from a particular doctor in a public medical institution might
live if he pays the same doctor a hefty fee in his private practice across
the road. Then there’s that question of all that access to drugs. If the
system has to co-exist it needs to be monitored closely.
Although some of our doctors rank among the best in the world, many GPs
are sub-standard because there is no system of continuing compulsory
medical education for them. They are not kept up to date with the latest
drugs and medical information. In the US the doctors have 50 hours of
continuing medical education every year, and have to be board certified
every seven years or else they can’t get their license renewed. It’s
vital you institute that sir.
the following systems:
independent Medical Malpractice Board to examine complaints over medical
treatment. This Board should put forward decisions that can allow legal
action to take place in a reasonable time.
published National Data bank which would list doctors, their area of
expertise, including ongoing training, a record of complaints of both
breaches of codes of conduct, and record of malpractice complaints.
neither your Ministry not the Medical Board has the power to successfully
investigate charges of malpractice, enforce standards, or continuing
education. Our citizens have for decades been held hostage by the medical
fraternity since doctors rarely testify against one another in this closed
Health Minister, if you are serious about ending this hostage situation
use the resolve you have impressively demonstrated to cut through
ridiculous red tape, pay doctors what they deserve but also create systems
that ensure accountability, transparency and recourse to patients. If you
succeed it will be the noblest achievement of your lifetime and your