The chronic shortage of doctors and nurses was brought to the fore during yesterday's Joint Select Committee meeting held in Parliament, where it was recommended that foreign doctors be allowed to fill the gaps in the private health sector. Officials from the Health Ministry who appeared before the committee were made to account for issues which included:
• Annual services agreement
• Dental care
• Human resource issues
• Procurement
• Radiology
• Training
• Patient care
In raising the subject, Opposition senator Faris Al-Rawi asked officials to identify where was the backlog at the public institutions and what was the cost associated with it. "We have been bringing in doctors and nurses, we have them in the public healthcare system, we have had some of them here for many years. But for some strange reason, they cannot be certified by our medical board to work in private practice...so they good enough to work in the public sector, we won't give them certification to work in the private sector, but we're losing is the incentivisation to keep them there in the first place," Al-Rawi said.
He added that it was "notorious" that wages in the public sector were less than in the private sector. "If we had a mix in the contract which said you doctors who have come to assist us in the public sector have a mandate to work in the public service, and these are your minimum requirements, but we would also give you certification beyond three years to work in private practice, then we could better incentivise them to keep them here to fill up more holes in the system," Al-Rawi said.
Dr Rohit Doon, adviser of health promotion, communication and public health of the Health Ministry, said there was "great difficulty" with the Medical Board of T&T. In putting the issue into context, Doon said foreign doctors coming into this country began with UN volunteers and then the extension was made to Cuban doctors. "We recognised that we need to register and certify these physicians to practise medicine," he said.
"We had great difficulty with the Medical Board of Trinidad and Tobago, who felt we may be exposing the population with doctors who are really not up to specs. "Therefore we had to exercise a certain degree of scrutiny and stringency in the whole process and limit the scope and extent of the operations of these physicians, given the current climate in which they would have to operate, because to do private practice you would still have to go back to the Medical Board of Trinidad and Tobago, and they were not willing to do that even to start," Doon explained.
He said a parallel medical board was created which constrained the physicians to working in the public sector. The ministry's permanent secretary Antonia Popplewell, who used the example of Cuban doctors working in T&T, said they were contracted for a specific period, which was also an arrangement made with the Cuban government. "We cannot keep them longer than that," she said.
"They have to return so it is not the issue of them being here and not being registered. "The UN volunteer system was for a period of time and that came to an end."