Health sector gets $8.214m budget allocation

This year’s budget has seen the largest amount allocated to the health sector in recent history to the tune of $8.214 billion.

Health was second to education and training, which received $8.766 billion.

In the 2023/2024 budget, health received $7.409 billion, compared to $6.892 billion the year before.

Breaking down the allocation in his budget presentation on October 13, Finance Minister Davendranath Tancoo said the health sector will receive $35 million for refurbishment, $45 million in facility upgrades, $60 million to procure critical equipment, including CT scanners, X-ray units and surgical towers, $20 million for cardiac care, $100 million for dialysis and $10 million for orthopaedic and eye surgery.

He said Couva Medical and Multi-Training Facility will be refocused on children’s health and reverted to the Couva Children’s Hospital, which will be rehabilitated through an MoU with the United Arab Emirates and opened.

A new catheterisation lab will be added to the San Fernando Hospital, the Port of Spain central block will be operationalised by March 2026, Sangre Grande Hospital will be commissioned this year and 37 clinics will receive new equipment for dental services.

"Mr Speaker, we will cut, we will cut wait times for life-saving procedures, because faster care saves lives," he exclaimed.

Tancoo added that digitisation of the National Health Management Information System was advancing with a secure Health ID and the government intended to legislate a Medical Malpractice Court, No Fault Compensation Fund and a revised Patients’ Charter.

He also reminded the public that India donated 20 haemodialysis units and two sea ambulances, amendments were made to the Children’s Life Fund Act to cover life-limiting conditions such as sickle-cell disease and rare cancers, the CDAP Programme was modernised with new medication for hypertension, mental health and autism, and health centres in 12 communities were now operating with extended hours.

Head of Health Services Unit at UWI and former president of the Medical Board Dr Neil Singh said this was a generic, "window dressing" budget – one that was for show to use health care as a political pawn.

He said most of the health initiatives were geared towards tertiary health care when the average person needed primary and secondary health care.

"Primary healthcare brings no visible benefits in the short term because it’s more preventative, like screening and risk assessment. Whereas building hospitals and opening intensive cares and putting more beds is what will bring votes. They think it’s an attractive approach to show they are doing something for healthcare, but they are not studying what it happening in the system.

"It doesn’t impress the person who goes to CDAP when most of the CDAP medicines are outdated and not proven to improve longevity and quality of life as current medications do."

Singh said none of the measures presented in the budget would improve the quality of care of patients when there was a lack of facilities for angiograms, cardiac categorisation, investigation, human resources to manage the workload and more, all of which leave patients waiting for a year or more for surgeries.

He pointed out there were many unemployed doctors, while poor people had to take loans or otherwise find money to do operations privately.

He also complained the government was putting more money into dialysis when better primary health care could have prevented people needing it in the first place.

He said, similar to cardiac centres, the government would continue to out source dialysis to their partners and friends who had dialysis centres, instead of building a national hospital for dialysis. He added that about 70 per cent of dialysis patients died after five years so it was a waste of money unless the patient was getting a kidney transplant.

"They should have been taking about improving the renal transplant unit and getting more donors and doctors on board instead of promoting a service that is just buying time for people to die."

He also lamented nothing was said about mental health, although the country was short of mental health initiatives to address such a serious problem in the country, even among youths.

TT National Nursing Association president Idi Stuart lamented there was not much healthcare reform in the budget, saying what was mentioned had been spoken about before.

He said the expansion of and increased funding for the CDAP programme was a testament to the failing health care system, and expressed caution about the extended opening hours of health centres saying nurses had negative experiences with it in the past.

"What is innovative, if there's anything innovative particularly in the area of healthcare reform under the budget, would be the areas of Medical Malpractice Court and the No Fault Compensation Fund.

"Firstly, with the medical malpractice court. If it comes to fruition, it definitely would be a turning point in treating with medical complaints, medical issues that our patients have been suffering over the years. The association envisions it would increase cost to the state and the individual practitioner who has the responsibility for delivering this particular care. So we await to see how this fleshes out and how this would be integrated into the national landscape."

He said the association welcomed those initiatives but noticed there were no timelines attached to them, and hoped they would come on stream as quickly as possible. He expected the Health Minister Dr Lackram Bodoe to give further details and new information in his contribution to the Budget Debate.

Stuart also hoped the government would focus on having a mandatory patient-to-nurse ratio, and starting the National Health Accreditation Standard as well as the National Health Insurance System as they were promises made by the UNC in the manifesto and would take time to come on stream.