I was in the US recently and stopped at a pharmacy to buy a tube of toothpaste. When I paid at the till, my US$4 purchase resulted in a 15-inch receipt.
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‘Abuse of taxpayers’ $$ at ERHA
Beleaguered CEO of the Eastern Regional Health Authority (ERHA) Ameena Ali is reporting as it is. Speaking of some of the ills at the ERHA, Ali pointed to the missteps of certain officials at the authority. Ali, speaking of improvements at the Sangre Grande District Hospital since she took over the ERHA last November, blames, to a large extent, managers who were not pulling their weight. One of the sore points is an overtime bill of more than $200,000 a month, in three departments.
Ms Ali, although you appear to be a bit relaxed, I couldn’t help but overhearing you telling somebody on the telephone a short while ago (before the interview began) that you were “fed up.” What’s the problem?
(A pause, while sitting in the living room of her home in Santa Cruz, Wednesday afternoon) An issue came up today that you really feel no matter what you do, you’re hitting your head on a wall.
Was it job-related?
Job-related. But I don’t feel I should go into that…I wouldn’t go into details, but it involves the abuse by the authority of taxpayers’ money. And Mr Raphael, I have to tell you that I got permission from the chairman of the ERHA to give this interview, ok?
Right. Ms Ali, you have been in the news recently and not all of it was positive. Is it reasonable to assume it is because you are a no-nonsense boss?
I would imagine that is the reason for zero-tolerance level for abuses of all kinds, particularly when we’re in healthcare, because our primary focus should be the patient, or client-oriented. So whenever we abuse anything—be it funds or otherwise—it ultimately affects our delivery of health care. You have been a public servant for 30 years before you took up this appointment November last. Are you of the view that the level of employee performance at the ERHA is not what it is supposed to be?
I wouldn’t say so. What I would say is, generally, it is a management issue. Because you get the same employees every day…(it) is how you manage your employees. If some workers feel they are getting more or better privileges than other employees, you would have no balance, you must get problems there. Some would do their jobs all-how—bypassing rules—and do not have that interest in what they are paid to do.
Is that prevalent at the ERHA?
What steps did you, or are you taking, to reverse that situation?
Well, that is what put me in trouble in the first place, right? (A quick stroking of her chest with one finger). When I got there, one of the big issues was staff-related, particularly doctors; and you cannot have healthcare without doctors. A senior doctor had grave problems in requesting (staff) through the HR department; he was getting nowhere, no staff, no doctors…he himself had to recruit.
The answer given to me was: “People do not want to come to Grande to work.” So one of the first instructions I gave was: “Let us re-advertise and let the applicants come to my office...what is taboo about coming to Grande?”
Well, after that, the department sent all applicants for jobs here to the CEO’s office, but I only wanted to see the doctors who were applying. I was getting conflicting figures from the department and the doctor, so I asked for an audit to ascertain how many doctors we were supposed to recruit. But for various reasons, recruitment of doctors would always be an ongoing issue, but because of that problem of HR not recruiting, I came upon something called service contracts.
Certain doctors are being paid $20,000 a month to work one day a week...eight hours a day!
Is this exclusive to the ERHA or does it apply to all the RHAs?
I cannot talk for the other authorities, but I almost feel certain...probably not, but I could tell you at Eastern I found that so obscene. I stopped it and I called the minister of health, who was very furious: he could not believe one doctor was being paid $5,000 a day. You pay a little more and you would get a full-time doctor.
What did you do to resolve this issue satisfactorily?
What I am trying to do to stop it is to recruit doctors; but remember, I do not recruit. I have to depend on HR and therein lies the issue. Because somebody goes to the chairman complaining that I am interfering with their work…right? So I have to step back and allow HR to do what they are doing. Then, to my amazement, HR doesn’t know anything, or gets involved in these so-called service contracts.
I cannot understand this sort of situation existing in any company, public or the private sector. How come you as CEO do not have the final say in what HR does or does not do?
Well, as you see—and what you know was the result of that in December—I was fired.
And Dr Khan ordered that you be reinstated?
Dr Khan did not order…he invoked the relevant section of the act and he has the final say in the employment of the CEO. I was doing something either fundamentally good or fundamentally bad.
Which one do you believe?
(Momentarily staring at Raphael) I know I get results, so I believe it was fundamentally good. Another thing, Clevon, I found is that as a non-executive board, it cannot deal with the operational aspect of the authority, and what was happening, apparently, because I am still not certain because of the limited letters I received way down in March, making reference to the chairman...
The chairman getting involved with general managers is one of those peculiar things; because the line of accounting is the board to the CEO, the CEO to the board, and the general managers to the CEO. So for the chairman to go to a board without the CEO…
Is it true then to say that when you were fired one month after joining the authority, you knew nothing about this going on?
Yes. I was busy. I did not know…When I was fired, I recall I was working at the Sangre Grande hospital on a Saturday, when an anonymous caller told me about a meeting concerning firing me was taking place with the board of directors and general managers, you know? I went to the meeting, but of course I had to leave (laughs) because I was not invited. So while I was busy working, you have a board engaging management to dismiss the CEO.
To dismiss the CEO in your absence?
Precisely. Another occasion, I was in Toco—which meant I had left home at 5 am—when the board secretariat called to tell me the chairman called an emergency meeting for 2 pm that day. I said I was in Toco, and I asked what the agenda was, and she said the chairman told her not to tell me, but it was some kind of letter to discuss. A lot of strange things take place with that board.
Ms Ali, what sort of relationship do you enjoy with your employees...do you think that they like you?
Mr Raphael (clutching her neck with her right hand), I never really sit to question who likes me, you know, but I would say, by and large, I have a good relationship, because I could not have done the things that we accomplished if I did not have the support of the staff.
Briefly, some of your major accomplishments?
Long-needed upgrading of the Sangre Grande hospital; sprucing up the hospital’s mortuary to give mourners a sense of dignity in their time of grief; extending the accident and emergency department; improving the dialysis unit; and so on.
Ms Ali, a birdie whispered to me that there is an exorbitant amount of overtime work here?
Well, that is a very sore point; overtime in the lab, the pharmacy and radiology...is over $200,000 a month. A hospital operates 24/7 and if you have shift workers, overtime would be at a minimum…it is human resources and management.
Ms Ali, is it fair to say there is no love lost between you and the chairman?
(Gesticulating with left hand in the air) Oh no. I love my chairman. We have the most beautiful relationship; we fight and we make up, and I will continue to say he probably means well, but he is being misled.
What is this about some ten managers leaving under your watch?
First of all, no ten managers left: two are under the ministry of health, so the ministry will shift them to any areas they are needed; so that is a blatant lie. One is permanent in OSH; others are contract workers and some of them were called for other jobs.
Finally, this talk we’re hearing that you got the CEO position at the behest of Minister Khan?
Well, if Dr Khan could have given me a job, that would be very good; and the fact is, I am getting too little pay. I was interviewed for the job. The board approved my appointment and it took into consideration that I did not have a masters graduate degree in health. But the fact is I am an attorney, I worked in the organisation for 30 years, I am results-oriented and I was the operating manager at the NWRHA. Can you, Mr Raphael, put in a word for me so I can receive a little more donzai? (laughs)