Where we stand‎ > ‎News & Comment‎ > ‎


posted 10 Nov 2015, 20:36 by Gerry Kangalee
So yet another committee has been appointed to review the health system. There have been committees, commissions, investigations, parliamentary examinations over the years and the health care system has only gotten worse and worse.

There was the Julien Commission of 1957, the National Advisory Council interim Report of 1978, the Toby Commission Report of 1982, the Gafoor Commission of 2006. There may have been more, but I’m too lazy to track them down.

Some of these committees recommended the decentralisation of the public health system. This became a reality during the 1990’s when T&T fell into the grip of the International financial Institutions. As a condition of the health sector loan (US $192 million) the government accessed from the Inter American Development Bank (IDB), the Regional Health Authorities Act was passed in 1994 (amended in 2000).

Eight IDB missions were dispatched to examine the feasibility of health sector reform as a lead- up to the disbursement of the loan. So it is fair to say that the health sector has been probed, analysed and studied to death, literally...for the sector is more comatose now than ever before.

So, we are going to be inundated with information that we have had before and we are going to hear recommendations which we have heard before. Maybe, the Welch Committee should just cut and paste previous reports and save the citizens much-needed public funds.

Any way let’s go through the motions! What is the remit of the Welch committee? According to the ubiquitous Minister of Information it will review the levels of health care delivered by the regional health authorities and rationalise the system of public sector doctors in private practice.

The problem in T&T is not lack of data about the workings of the health system. It is a question of implementing the measures we know are needed if the systems under review are to fulfil their mandate. But this is precisely where the problem lies. To do the right thing by those who fund and access the public health system is to interfere with the interests of those who profit and live like parasites off the system as is and who are powerful enough to block all attempts to reform it.

The question of health sector reform, therefore, is a question of class struggle and those in a position to implement that reform are not interested in doing so, since it would hamper the class interests of those who call the tune.

The National Health Workers Union has called for certain short to medium term measures to relieve the pressure on health workers which is a prerequisite for relieving the pressure on those who access the public health system. There can be no delivery of proper health care, if those who are mandated to so deliver are themselves under pressure and are suffering stress and burn out. (If I cannot take care of myself how can I be expected to take care of others?)

To transform the health care system into one that serves the needs of the public and not that of an elite medical mafia, party hacks, suppliers of medical equipment and pharmaceuticals, owners of security firm and well-connected contractors, the social arrangements must be transformed.

We live in a society where human needs are not prioritised; where contact and nepotism are the order of the day; where fairness, social justice and equity are trampled upon in the mad scramble to maximise profit and accumulate capital by any means necessary.

As workers and as members of the public whose funds which finance the public health system are often siphoned off into the pockets of medical capitalists, we have a duty to agitate and fight for a safe and affordable health system which entails an exploitation-free workplace, where workers rights have to be taken into consideration.

While the struggle for a long term solution to the woes of the health system must go on, in the short term health workers must demand:

an end to the dual track system where an elite group of doctors reap the benefits of operating in the public health system while operating private practises;

a massive programme of training, so that the appalling shortages plaguing the RHAs can be ameliorated;

an end to the super-exploitation of workers through the short term contract system;

an end to nepotism in hiring and promotion practises;

security that prioritises people over property.

The health system does not need yet another committee to go over the same ground and recommend the same things that have been recommended for years. What is needed is that the workers in the health system must organise themselves to put as much pressure as they can on their immediate bosses and on their ultimate bosses – the government – to ensure a safe and affordable health care system.

To achieve this, workers must unite and engage in collective activity so that they cannot be ignored and/or divided. The best way to unite and to engage in collective action is to seek majority union status through the National Health Workers Union and to secure workers rights and entitlements through substituting the master and servant relationship with a collective agreement. It is high time the health workers draw a line in the sand!