Last week I spent a day at a Lon­don hos­pi­tal. I couldn’t help com­par­ing the care there with the care here. Com­par­isons be­tween hos­pi­tals are dif­fi­cult. There are many fac­tors in­volved, cul­ture and mon­ey be­ing the two most promi­nent, but cer­tain­ly we are sup­posed to be a car­ing peo­ple and we have spent much mon­ey on health­care over the last 25 years, enough to war­rant some form of de­cent pub­lic health­care but the ques­tion is do we re­ceive ad­e­quate health­care in our pub­lic hos­pi­tals?

I think not.

First, the build­ings. The Lon­don hos­pi­tal was not the most mod­ern but it is clean and re­fresh­ing with high ceil­ings, large win­dows that let in light, a well-lit enor­mous cen­tral atri­um, pas­tel-coloured walls, colour­ful plas­tic floor tiles that are easy to clean and easy ac­cess to the re­cep­tion­ist’s area and doc­tor’s of­fices. There’s lots of peo­ple move­ment but lit­tle crowd­ing. Staff is ef­fi­cient but friend­ly. We got in­to an el­e­va­tor and the young nurse al­ready there asked us for our floor and pressed the but­ton with a smile. That has nev­er hap­pened to me in any Trinidad hos­pi­tal.

Sec­ond, or­gan­i­sa­tion. Every­one seemed to be work­ing qui­et­ly and ef­fi­cient­ly. The ap­point­ment sys­tem worked. There was al­most no wait­ing. I saw some­one who had four dif­fer­ent ap­point­ments that morn­ing. Bloods at 8.30. Done. Con­sul­tant at 9.45. Done with lab re­sults avail­able. In­jec­tions at 10.45. Done. Tablets from the phar­ma­cy at noon. All done sim­ply and with­out fuss.

Third, at­ti­tude. I nev­er saw any staff on their phone. No one stood around chat­ting about the lat­est bac­cha­nal and get­ting in the way of pa­tient flow, yet, they are friend­lier than our peo­ple, who are sup­posed to be among the friend­liest in the world. Not any­more. Clean­ing of the floor was done be­fore pa­tients ar­rived and cer­tain­ly not in the midst of pa­tients ar­riv­ing and try­ing to get to the re­cep­tion­ist’s desk. Peo­ple were quick­ly ac­knowl­edged at re­cep­tion. Doc­tors came out of their of­fices to call pa­tients, on many oc­ca­sions in­tro­duc­ing them­selves by their first name. At times, it was dif­fi­cult to tell the dif­fer­ence be­tween doc­tors and pa­tients. Dur­ing the sev­er­al hours I spent ob­serv­ing in the re­cep­tion area, peo­ple were of­fered free drinks, tea of course, and bis­cuits.

There was more warmth in this Eng­lish hos­pi­tal than in ours. And far more ef­fi­cien­cy. On sev­er­al oc­ca­sions, I saw ad­min­is­tra­tors walk­ing through clin­ics.

Fourth, ad­min­is­tra­tion. Com­pare the above with the ab­sence of ad­min­is­tra­tors in our di­lap­i­dat­ed wait­ing ar­eas that haven’t changed since colo­nial times, where the an­tique bench­es haven’t been changed, the walls paint­ed, the floors cleaned, the dust in the cor­ners re­moved, for years. Where one has to strug­gle to get to re­cep­tion be­cause all of the pa­tients are giv­en ap­point­ments for the same time.

Fifth, ju­nior doc­tors who walk around re­fus­ing eye con­tact, heads in the air, cloaked in false pride, not ac­knowl­edg­ing or in­ter­act­ing with their pa­tients.

Pride is not that you are a doc­tor. Pride is in your sense of du­ty to your pa­tient. Pride is in the sense of joy that you are tak­ing prop­er care of them. Re­spect is not earned be­cause you grad­u­at­ed from med­ical school. Re­spect is earned the hard way. Pa­tient by pa­tient. Mis­take by mis­take un­til at the end of the day you can look back and say with sat­is­fac­tion, I did my best.

Do we have good doc­tors? Of course, we do. I week­ly in­ter­act with some of the most se­nior doc­tors in T&T who work in the pub­lic sec­tor. They are friend­ly, com­pe­tent, hard-work­ing and as good as any­one, any­where.

The main prob­lem, how­ev­er, is ad­min­is­tra­tion who do not un­der­stand what mod­ern health­care is about. Who do not walk around clin­ics and see what the prob­lems are. Who do not know what it is to be sick and have to wait for six hours in de­press­ing sur­round­ings that haven’t up­grad­ed since 1962.

Lit­tle has changed in the ad­min­is­tra­tion of health since 1962. Change is im­por­tant. It opens the mind to some­thing dif­fer­ent, of­ten bet­ter. No change sti­fles the mind and sur­round­ings.

When ad­min­is­tra­tors and politi­cians say peo­ple will not change, for ex­am­ple, in the ap­point­ment sys­tem, that is in­sult­ing. If prop­er­ly and re­spect­ful­ly done, they will.

That’s the colo­nial men­tal­i­ty that led doc­tors to say in 1980 that our moth­ers would not want to spend time with their chil­dren to oral­ly re­hy­drate them. They did. It’s what led to our po­lit­i­cal lead­ers re­fus­ing to trust peo­ple to do the cor­rect things dur­ing the COVID pan­dem­ic and re­sult­ed in the pro­longed lock­down of the coun­try with its at­ten­dant ills.

Trust peo­ple, work with them and we will have a pub­lic health sys­tem that we can be proud of. Just like the Eng­lish.