TRHA $44M in deficit five months into 2018

The Tobago Regional Health Authority (TRHA) is currently operating with a deficit of $44 million, five months into the year, after having received an allocation of $230 million up to April.

The TRHA is hoping to make some money and end the year in the black by using its cafeteria at the Scarborough General Hospital as a profit centre, commercialising its laundry services and move to charge a fee for non-national clients to access services outside of emergency care at the hospital.

Angell Second-Ali, TRHA’s General Manager, Corporate Services, in presenting the financial report of the TRHA/THA for the period 2016-2018 at the Public Accountability consultation at the Calder Hall community centre last Tuesday, said the Authority was expected to remain in a deficit position at the end of September but expected to ease financial constraints and prevent a deficit at the end of the year with its planned income earning activities.

In 2016, the TRHA received an allocation of $499 million and in 2017, $435 million.

Second-Ali said 70 percent of the funds went to employees’ cost - $386 million - while 23 percent covered administrative and operating expenses - $25 million and $88 million respectively – altogether amounting to $499 million.

“Our total cash expenditure to date is $224 million, We are currently showing a deficit position of $44 million.

“We are predicting a deficit position by the end of September 2018. This would have been broken down to our recurrent advances which comes through the THA, where we would have received in 2017, $399 million with an additional $70 million for the payment of arrears to staff.

“We also received advances of $22 million from NIPDEC (The National Insurance Property Development Company Limited) for pharmaceuticals and $2.9 million in other income. Our balance sheet for total assets stood at $167 million, total liabilities $143 million and equity $24 million.”

The TRHA oversees the Scarborough General Hospital has 17 departments; 19 Primary Care Facilities throughout the island, and employs 1,532 persons with 50 percent of staff working in medical departments with 75 percent of its funds being spent on salaries there.

Second-Ali said the TRHA’s Financial Committee has focused on four major objectives to improve the Authority’s financial position over the last two years which included a review of banking services with three commercial banks invited to make presentations on how their services could present available services and the benefits available to assist the help the TRHA in its future financial planning.

She said this exercise saw the TRHA changing its bankers and developing new policies to govern electronic funds transfers.

Second-Ali said a major challenge faced by the TRHA Board was meeting statutory deadlines for annual financial statements. She noted that 2011 and 2012 audits were done and submitted to the Auditor General but that financial statements have been submitted only up to 2016.

“To address this deficiency, the committee reviewed the Finance Department’s internal system and structure and we also examine options for archive and management of records, as this was a weakness...

“The committee also started projects for reporting by output budgeting where we began the full automation of inventory management and commencing the implementation of a budget management and reporting system,” she said, adding that these systems were expected to be in place by early 2019.

Ingrid Melville, TRHA’s Deputy Chairman, in presenting the Chairman’s Report at the consultation, said financial constraints have been a major challenge and has resulted in major equipment failure at the Scarborough General Hospital because of lack of maintenance.

“We have been impacted by core preventive maintenance resulting in the failure of major equipment. This resulted in high cost to return various pieces of equipment, including air condition units and the fire water pump at the hospital, to name a few, to functionality,” Melville said.

She said the TRHA did refurbish the the Accident and Emergency waiting area, installed a new water dialysis unit at the Scarborough Health Centre and bought 50 new hospital beds.

“…the impact of the financial situation of the health services (run) by the TRHA cannot be underestimated. We have a new hospital facility and it can be perceived that capital cost in secondary care would be reduced but medical equipment has a lifespan to be considered,” she said.

Melville said the TRHA has implemented steps to reduce costs generated by organisational deficiencies and to enhance service delivery while embarking on an aggressive strategy to promote financial stability.

She said this includes using the cafeteria to establish a profit centre, commercialising laundry services and implementing a fee for non-national clients to pay for services outside of emergency care. Melville also spoke about promoting health tourism - to transform the tourism sector in Tobago from a holiday destination to a must-have state of the art health care experience.