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
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
This is how our telephone conversation
IM: Why were you quoted as calling
the opening of the Caura Palliative Care Unit in your absence
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
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:
a) 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.
b) Millions spent there should have
been spent on equipment and supplies necessary for doctors to treat
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.
c) There are limited beds in San
Fernando and one emergency theatre for all departments.
d) Outpatient time for CT and MRI
scans ranges from six months to a year.
e) There has been no wage increase
for public doctors, while foreign doctors such as the Cubans are being
These doctors are reportedly a
hindrance due to the language barrier and do not pull their weight.
f) PoS hospital is cockroach-riddled
and badly equipped. At one point the CT scanner was down for nine
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.
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