Public healthcare on blast

If the members of the Joint Select Committee for Social Services and Public Administration hoped to get an idea of the problems facing the public health sector by hearing from the public, they got an earful on Wednesday afternoon.

The meeting, chaired by Independent Senator Paul Richards at the Cabildo Building in Port of Spain, offered a view of customer service in the sector that veered from the modern to the medieval.

Both patients and nursing staff offered a view of the regional health authorities (RHAs) that suggests remedial work needs to go further than tending to the aging bricks and mortar of the buildings.

Someone seeking care shouldn’t have to be at the Port of Spain General Hospital at 4.45am to be able to leave with necessary medication at 3.30pm.

Patient files are lost with frightening frequency. One patient was only able to keep her case on track because she took photos of the contents of her file.

These stories of staggering administrative inefficiencies and outright failures of procedure don’t inspire confidence in state authorities charged with the preservation and care of human life.

Idi Stuart, head of the TT Registered Nurses Association, said the smaller RHAs are working “reasonably well,” while larger ones struggle to deliver quality care.

Why? Is there more entrenched institutional inflexibility in larger RHAs?

If the government is seeking to improve public health care at the same rate in all RHAs, why are these efforts working in some and not others?

So many questions arose from this meeting.

Is there a system for keeping track of the wait times for critical medical procedures such as echocardiograms, and the relationship between extended wait times for testing and the state of delicate equipment?

If there are manpower limitations on digitalising critical documents to ensure they are available to medical staff, should RHAs partner with document-scanning institutions, or simply allow patients to copy their medical paperwork, using the same principle of shared workload that many public-facing government agencies rely on to offload generating and copying documents to customers desperate for more efficient service?

It isn’t sensible to pretend that systems are working when they obviously are not.

In an era of digital transformation, RHAs, which offer an important and free service, should triage their operations and concentrate on their core mission, delivering effective medical care, dispensing timely treatment while exploring ways to partner with their customers to simplify administrative chores that are clearly getting bungled.

This illuminating effort at public outreach by the JSC is a welcome addition to the normal sessions with stakeholders and should be emulated, where it makes sense, by other JSCs to give voice to a greater range of citizen concerns about governance.