Healthcare’s pulse

The gains made at the Eric Williams Medical Sciences Complex (EWMSC) in Mt Hope are an encouraging sign of an improved pulse in the healthcare system. However, the overall prognosis will remain dim unless the State is able to unravel the complications of the dual private/regional health authority structure as well as address large operating costs and looming vacancies nationwide.

That the State has managed to reduce congestion and waiting times at the EWMSC – a facility that received over 100,000 patients in one year – by more than a half is an achievement worthy of acknowledgement.

According to North Central Regional Heath Authority chief executive officer Davlin Thomas, the hospital also reduced emergency room visits in relation to the critical stages of certain non-communicable diseases such as diabetes, hypertension and cardiac disease. Thomas attributed this to successful community outreach. He said the EWMSC has recorded several successes in addressing critical illnesses including 360 open heart surgeries with a mortality rate of 1.5 per cent – exceeding international standards.

The NCRHA has also undertaken systematic changes to improve the delivery of health services to patients which included infrastructural upgrades at the Mount Hope Women’s Hospital, the opening of the Women’s Colposcopy Centre and Outpatient Clinics and the establishment of an NCRHA Incident Response Team.

But whatever gains have been made risk being negated by long-neglected problems.

With tighter purse-strings, there is considerable pressure on doctors at both State-run and private facilities to make do with less. The new tax on private hospitals announced in the budget on Monday is likely to be passed on to ill persons who turn to private hospitals because they are fearful of ill-treatment at public facilities. In turn, demand on public facilities may increase.

It is heartening, however, that Finance Minister Colm Imbert has assured that construction of several new hospitals will remain ongoing. These include the 150-bed Arima Hospital which commenced in 2015 and is 35 per cent complete. Unlike most public construction projects, the cost associated with this project has been revised downwards under the present administration, from $1.85 billion to $1.6 billion. The construction of the new Point Fortin Hospital is also ongoing.

Continuing construction has a dual advantage. In addition to generating much-needed infrastructure, it can generate employment and boost the construction industry in the short-run, killing two birds with one stone.

However, after the buildings are completed, the State will have to invest considerably. According to Imbert, the operational costs of the new hospitals are expected to run into, “several hundred million dollars,” with a projection of $430 million for the new Couva Hospital alone. It is not likely that the new taxes as well as penalty increases for offences under medical laws will be able to fund these costs.

While there is merit in a development programme, it must not be forgotten that the healthcare system is not just about new buildings. It is also about maintaining – and in some cases revitalising – existing facilities. The Port of Spain General Hospital has long grown ill-suited for many of its functions, with long waiting times for clinics and pharmacies, cramped conditions and visible signs of wear and tear in some areas. What use is the much-trumped patient’s charter of rights introduced under the previous administration in such facilities? Bring on the plans for renovation.

Miraculously, many hard-working doctors and nurses manage to provide a high level of service to members of the public notwithstanding limits to resources. But the intersections between the State and private hospital facilities have seriously undermined confidence. Measures such as a proposed cancer registry – which would help co-ordinate treatment – remain non-existent.

Progress has been made but more medicine needs to be administered.