A cancer of inaction

It would be unfair to point an accusing finger at Minister of Health Dr Fuad Khan on his recent announcements about the National Oncology Centre. The Government’s plan to move the proposed cancer treatment centre from Mt Hope, where it remains a dream shrouded in wild grass, is no more confusing than the pappyshow that’s been played with public money on this project for the last five years.

In March 2007, the sitting Minister of Health, John Rahael, promised the people of Trinidad and Tobago that within 40 months, they would be enjoying a quantum leap in cancer treatment. A loan in the sum of $150 million was raised from the Inter-American Development Bank and a handsome artist’s rendering of the finished building, a striking modernist structure, was unveiled.

Fifteen months and $100 million later, the structure was a foundation with piles of material around it at Mt Hope, the first stage of the complete collapse of the project. That first effort collapsed after a conflict arose with the Canadian contract management firm EllisDon Consulting, which argued that the real cost of the project was $240 million.

The radiotherapists trained and recruited for the project were snapped up by private-enterprise cancer treatment centres. Over time, some remedial work has been done on the four oncology centres in Trinidad and Tobago, at the Port-of-Spain and San Fernando General Hospital, the Eric Williams Medical Sciences Complex, and, most thoroughly and successfully, at the current flagship of treatment, the National Radiotherapy Centre at the St James Medical Complex.

These improvements, as welcome as they were to citizens seeking treatment, fall short of the need for services. A dedicated national oncology centre remains a project that should be foremost on the agenda of the Health Minister. In more recent announcements, the minister has modified his original statement to encompass the construction of the Mt Hope centre as well as the new project at Penal, said to be driven by conversations that the Prime Minister has had with Canadian PM Stephen Harper.

As a medical professional, it must gall Dr Khan that the current plan would move the establishment of a robust oncology centre from the original promised date of 2010 to 2015. The Health Minister would be well aware that roughly 1,500 people die from cancer each year in this country and that the number of patients coming for treatment increases by 2,500 with each passing year.

The cost of radiotherapy for a cancer patient can be more than $100,000, and many of these patients simply cannot afford the cost of private care. Dr Khan must commit to changing the odds for the least financially capable among us as they struggle to manage their cancer care.

There is a desperate need to upgrade the quality of the equipment in use at all four public-sector treatment centres. Managing chronic understaffing at these centres and providing refresher training for existing staff would help as well. Better patient management and the development of a transportation network capable of moving seriously ill patients comfortably to the closest centre to them might provide a real salve to the situation as it stands.

Dr Khan should seek to ensure that his legacy is not just a functioning, game-changing National Oncology Centre, but an improved regime of treatment within the existing medical resources that bridges the gap between where we hope to be in oncology in 2015 and the grim challenges that gravely ill patients face today.