Nurses not satisfied after meeting with Health Ministry

TRINIDAD and Tobago Registered Nurses Association (TTRNA) president Idi Stuart said he is not satisfied with the results of a meeting between the union and representatives of the regional health authorities on September 3.

He is calling on government to bring several pieces of legislation to Parliament and address outstanding benefits.

Speaking to Newsday via phone on September 4, Stuart said the association had written to the ministry twice requesting a meeting, but received no response until it wrote directly to the Prime Minister.

“Firstly, we wanted the minister to make a commitment to lay the National Health Services Accreditation Authority Bill in Parliament. We also wanted the minister to implement nurse retention strategies because as fast as we train them, we leave.

“We had written to the minister on May 16 and July 2 and received no response. In August, we wrote to the Prime Minister about the issues, indicating that we had not received a response from the Health Minister and that the Opposition had indicated it would support the bill in Parliament. Within 72 hours, we received communication from the Health Ministry citing the letter we wrote to the Prime Minister and indicating they were ready to meet with us.”

Stuart said the meeting was attended by Health Minister Terrence Deyalsingh, the Health Ministry’s permanent secretary, technocrats, regional health authority representatives, and union representatives.

He said the issues raised included nurse-retention strategies; permanent employment in the Northwest Regional Health Authority (NWRHA); scholarships and grants for postgraduate programmes; stipends for University of the Southern Caribbean and UWI nursing students; health-sector accreditation; delayed increment and pension payments; motor vehicle tax exemption for travelling officers; amending the Nursing Personnel Act; improving the compensation levels of nursing and midwifery personnel; creating new nursing levels according to the TTRNA draft collective agreement to allow greater opportunities for promotion; and filling existing vacancies in nursing management.

Stuart said Deyalsingh said he was willing to look at the issues raised, but many of them would need legislative changes and new legislation.

“Minister Deyalsingh said the government has already set their legislative agenda for the rest of their term, so he cannot assure us National Health Services Accreditation Authority Bill and the Nursing Personnel Act will be placed on the legislative agenda.

“We are not satisfied with this, as we have been lobbying for this for a while. The Nursing Personnel Act would have to be amended. Deyalsingh said the accreditation bill was in its infancy but it had been laid in Parliament in 2013 by Dr Fuad Khan, so the groundwork has been done.

“The minister said the ministry was in the process of hiring a director of quality who will be tasked with reviewing the bills, reviewing the structures that need to accompany the bills and making recommendations to the Health Minister. That is the only thing he agreed to. We would still like him to ensure these bills come to Parliament."

Stuart said many of the issues raised, particularly relating to benefits, were not new to the ministry or the RHAs.

“These are benefits we already had, but they were somehow stopped between the last tenure of the UNC and this current tenure of the PNM, and now we are lobbying to get them back. The bulk of the meeting was us lobbying to give us back what we had already negotiated for and used to get, like permanent employment, pension payments, increments owed, motor vehicle tax exemption for travelling officers, all of these benefits we used to enjoy.

“What we were really angered by was the notion we should be patient and understanding that the country was going through a financial crunch and we should not be asking for more. We had to remind the officials we are asking for what was originally ours.”

Stuart said the ministry said it could not afford to make contract nurses – who were working without a pension and a gratuity – permanent at the NWRHA because it would cost $26 million. He said he asked if the government knew the country was in a crunch when they built the Pt Fortin, Arima, and the Sangre Grande hospitals, as well as when the UNC began building the Couva Hospital during its term.

“All these facilities are under-utilised because they don’t have the staff to operate all of them. We are in a strange position in TT. The government is saying we don’t have money to pay existing benefits, to pay to make people permanent, but they have $4 billion to build four hospitals in TT. So they are creating the credit crunch and then asking the poor man to be patient and don’t ask for what we already agreed to.”

He said the motor vehicle tax exemption which all traveling officers used to receive had been removed in 2015. He said it was given back to doctors, but not nurses.

“The district health visitors, the district nurses, mental health officers are all required to have a vehicle to carry out their duties but they are not given a tax exemption, unlike the ministers. They are saying it is mandatory for you to have a vehicle but we will not compensate you by at least taking the tax off it.”

Stuart said while it was not brought up in the meeting, the union was aware that it took nursing personnel three years or more to receive their pension payments after retirement.

Stuart said the ministry also stated the Chief Personnel Officer would have to approve the benefits, which he rejected.

“The whole purpose of creating the RHAs was to get away from the public service, so the RHAs could operate more efficiently. In the RHA Act, it speaks to the CEO and management of the RHA replacing the CPO.

"Yet they are telling us that despite having hired a whole board of directors and executive management, bloated the administration of the RHAs, from having a Minister of Health and a permanent secretary, now you still have the permanent secretary, Minister of Health, principal medical officers and the whole executive level, plus now you have five boards, five executive managements, five RHAs. So we have top-heavy management and we are not benefitting on the ground.

“We are saying if the government cannot find $26 million to pay to ensure nursing personnel become permanently employed, then it is time to fire the CEOs of those boards of those RHAs and let us return to where it is only the Health Ministry operating these facilities, because obviously we are too top-heavy.”