Problems with Dr Khan's diagnosis
Health Minister Fuad Khan has offered a new take on the old story of inefficiency in the health care system. "Sabotage," Dr Khan claimed in response to queries about the lack of a drill to perform brain surgery on patients at the Port of Spain General Hospital. And what is the ostensible reason for this alleged sabotage? "I think people are resisting change," he said. "People live in a comfort zone and when you want to raise the bar and create a better system, people don't like it."
This, then, is the Health Minister's view of reality. He is the white-coated hero of progress, while arrayed against him are conservatives with an apparently homicidal bent. And so set against change are these hordes of unidentified persons that they are endangering patients' lives by sabotaging vital equipment.
It is a measure of how politics creates paranoia that Dr Khan so strongly believes this scenario that he is willing to make such serious allegations with no proof beyond malfunctioning machines. Perhaps he should pay attention to the dictum that one should never attribute to malice that which can be explained by incompetence.
More importantly, Minister Khan's conspiracy theories distract from the core issue of solving these problems. Sourcing equipment, keeping it repaired, and replacing it in timely fashion is not an issue peculiar to the health sector. But, whereas malfunctioning buses or copy machines merely result in delay, malfunctioning or missing medical machines result in death — as happened with 55-year-old Rahil Hosein, who died last Saturday because he could not get a brain operation due to the lack of a drill.
Dr Khan claimed that he had put in an order for a replacement drill some time ago, and had stopped the outsourcing of operations because of the cost. But that doesn't explain why Mr Hosein's surgery, and other operations, could not have been done while the PoS hospital was awaiting delivery.
None of the challenges the Health Minister faces is new. In other countries, audits of standard procedures and algorithmic approaches to diagnosis have improved patient care and reduced mortality rates. Is this what Dr Khan is trying to do, or is he simply adopting an authoritarian approach that is getting people's backs up?
The fact is, if the new strategies Dr Khan is trying to introduce are meeting resistance, then something is clearly wrong with his approach. It is hard to believe that nurses and doctors and other health personnel, if given proper explanations, would so stoutly resist trying something new — especially since they are ones who complain most about the deficient system they have to work in.
Perhaps Dr Khan skipped the first and most crucial part of introducing innovation — building trust.