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Deyalsingh cracks down on ‘orthopaedic mafia’

Thursday, June 21, 2018

An orthopaedic “mafia” in the health sector.

This was United National Congress MP Ganga Singh’s description after Health Minister Terrence Deyalsingh yesterday slammed conflict of interest by surgeons who own orthopaedic implant companies and advise authorities which company to buy from.

“... And when you don’t buy from them, they’ll refuse to operate. It has to stop!” Deyalsingh added in Parliament yesterday.

Deyalsingh spoke about the situation while replying to Opposition questions on the recent issue of mismatched components for hip surgery at Port-of-Spain General Hospital.

Deyalsingh said the North West Regional Health Authority did an audit on the issue for the period January 2017 to April 2018 and a preliminary internal report stipulated comprehensive review and update of procurement processes for implants. He said staff was sensitised to the issue, notices were posted and service coordinators in the operating theatre were now monitoring component use. The NWRHA had also issued public expressions of interest for orthopaedic implants and consumables, he said.

“And all interested parties are expected to provide a listing of the names of directors of their company and to disclose any conflict of interest,” Deyalsingh added.

“I already have in my possession listings of directors of all companies and the names will scare you ...”

Interested parties also have to list surgical items provided, their place of manufacture and documents that they are internationally certified and of clinical quality standards. Prior to surgical procedures, the implants must be checked by the consultant surgeon, who should not have an interest in the company supplying the components, he added.

“That’s going to be strictly enforced: no consultant surgeon who has an interest in an orthopaedic supply company will be allowed to do this—none.”

He said the nurse theatre manager and supplier representative will ensure compliance with specifications in the purchase order. The NWRHA has also reviewed records to see all suppliers meet required international/clinical standards and only those who do will be used.

Deyalsingh said there’s been no patient complaint, but they strengthening the system.

“Conflict of interest—the genesis of the problem—is going to stop ... where you have an orthopaedic surgeon telling you, you will not use ‘X’ unless it’s bought from ‘X’ company and when you check the company, you’re seeing who owns the company - those days are going to be over!”

Of the list of names that would “scare” the public, Deyalsingh added, “There are names of directors on these companies who are the same surgeons who are operating on patients and they own the companies and they will tell you which company to buy from and if you don’t buy from them, they refuse to operate...the problem has nothing to do with wrong components, it has to do with conflict of interest.”

Deyalsingh claimed former health minister Fuad Khan knew of the problem but did nothing. When Khan asked if the situation began in 2007, Deyalsingh admitted it began “decades ago”.

On the recent behaviour of a medical intern, Deyalsingh said there are health and RHS Employee Assistance programmes for employees to have issues assessed. He said department consultants are also responsible for interns’ daily management to track their behavioural changes, in work performance, late arrivals or other signs of stress. While mechanisms are adequate, the issue was whether the consultants and staff heads are assessing interns as they should, he said

Deyalsingh said he suggested to the Medical Association, Medical Council and UWI that T&T should admit people to the Medical Sciences Faculty based on all-round qualifications, not academics alone.

“In T&T we give too much rating on pure academics—but everybody has four As,” he said.


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