HEALTH MINISTER Terrence Deyalsingh’s ultimatum to doctors to serve in the public sector or else repay their student funding suggests this is a problem which needs to be properly addressed. We call upon the Government to reveal how serious the problem is. Certainly, the fact that a minister is mentioning it raises the possibility that recalcitrance could be a rampant thing in the public health sector.
But it is not only doctors who get training under a scholarship regime. And it has long been standard in scholarship contracts for beneficiaries to be required to give back to their country in some form.
However, while some degree of leeway may be tolerable in other fields, in a situation where our health sector is in dire need of more resources and labour, it cannot be tolerable that people are effectively using the State to bolster their CVs then retreating into private practice.
There are many hard-working doctors in the public sector who do yeoman service, making the best of a system that is starved for resources. It is often a thankless job. Doctors are expected to get results and the slightest variable can turn situations into a nightmare for patients. Especially so for those who have little choice but to rely on the State-funded system.
At the same time, the dual system that sees medical professionals moonlight in private practice when they are not tending to their public sector job has long raised troubling conflicts. Coupled with the overly convoluted regional health authority system — which has long been subject to calls for review — the situation has become one fraught with administrative and ethical peril in which the only person who loses is the patient.
None of this is to suggest doctors should be pressured into repaying loans in situations where there is no suitable vacancy available to them. Rather, what has to happen is a better rationalisation of the way in which State sponsorship is allocated.
This is a complex issue given the length of time it takes for a doctor to obtain training, as well as the various factors that determine when an individual elects a specialty.
Still, it is only natural, and the minister is entirely right, to expect the State to enforce legal obligations created by sponsorship contracts. Indeed, many would have expected such enforcement to be taking place all along.
Meanwhile, the Government must have a holistic approach. About $6 billion was allocated in 2018 for health. What was the outcome of the public expenditure review as it relates to this? Drawing on Cuban doctors has clearly not solved the sector’s problems.
Asking our nationals to play their part is, therefore, not unreasonable.