Wednesday, January 17, 2018

Prescription for plenty

One doctor said last week it was “the formal handing over of the public health care system to a small group of private investors”. Another described it as “an abdication and abandonment” of T&T’s public health care system.

A third likened the Health Minister’s recent announcement of the new External Patients Programme (EPP) to the Life Sport Programme in which the Ministry of Sport allegedly handed over millions to unnamed special interests.

Late last month Minister Dr Fuad Khan announced that Cabinet had approved a $10 million initiative with private medical institutions, which would bring benefits to some 6,000 citizens who have been awaiting medical attention over prolonged periods.

Khan said the first phase of the programme would provide “quality and timely health care” to persons waiting up to three months for cataract, knee and hip replacement surgery, MRI and CT scans.

“After waiting three months (in the public hospital system), patients can enter private hospitals,” Khan said, where they would be afforded full-package pre- and post-surgery treatment.

In the past, the ministry paid specifically for surgery but under this initiative a full bill will be paid because patients will receive “all relevant health care treatment”, programme coordinator Beesham Seeteram assured at the EPP launch.

The minister, however, made no reference to his complaint on December 19, 2012 that the public health system had outsourced over $400 million in patient care services to 153 of these private medical institutions.

“This money should be used to upgrade the public health care system, develop procedures in-house; the money should be spent on much more comprehensive services such as increasing the amount of equipment in the system,” the Minister said.

In the Senate, he identified Caribbean Heart Care (Medcorp Ltd), Medical Associates, West Shore Private Hospital, Advanced Cardiovascular and the John Hayes Memorial Kidney Foundation as being among the institutions which benefitted from million-dollar, outsourced arrangements.

In 2009-2010, the total bill was $164 million; in 2010-2011 it rose to $179 million, and after the Senate sitting they told the Express that private medical institutions had received an estimated $400 million for outsourced services.

“Look at the kind of figures we are looking at…at the end of the day, if this continues, we will be spending money like crazy,” Khan said. He announced that public hospitals would stop outsourcing services to private institutions, except on his authority or that of the chief medical officer.

But one should recall that this was the minister whom this newspaper reported was “moonlighting” i.e. pursuing his practice at a private hospital. After the report, the Prime Minister suggested politely that Dr Khan was aware that he had a choice to make.

There are also some noteworthy statements from the minister, such as his proposal to sell the St Ann’s Hospital, so that the funds could be used to refurbish the health care system, and that T&T could be a destination for medical tourism.

So when the minister met, two days later, with the Private Hospitals Association, a complete turnaround was not unexpected. According to Dr Rupert Indar of the Association, the minister was made aware of the backlog in patient care, and the Association promised to submit proposals for the standardisation of hospital fees.

The then president of the Medical Practitioners Association, Dr Phillip Ayoung-Chee reacted prophetically, warning that the public health care system was heading for collapse.

Last week, another practitioner sounded another warning: “We are being conned; EPP is one of the biggest scandals. Our public medical system is now in the hands of private interests.

“Tell me which of my colleagues will work in any hospital, when they could be paid more than their month’s salary for one surgery in a private hospital? That is what EPP is all about.”

Well, let’s give Dr Khan his three months.

Keith Subero, a former Express news editor, has since followed a career in communication and management