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Monday, July 14, 2025

Doctors’ lobby group: Medical Council must be transparent, accountable

by

Ryan Bachoo
386 days ago
20240623
Dr Rajiv Seereeram

Dr Rajiv Seereeram

Lead Ed­i­tor–News­gath­er­ing

ryan.ba­choo@cnc3.co.tt

On Tues­day, the Med­ical Board will con­vene a spe­cial gen­er­al meet­ing to dis­cuss pro­posed changes to the Med­ical Board Act. In re­cent weeks, doc­tors, led by Dr Ra­jiv Seereer­am, formed a lob­by group called Doc­tors Ethics and Au­ton­o­my Lob­by (DEAL). They have been ad­vo­cat­ing for wider con­sul­ta­tion on the pro­posed amend­ments to the act while cau­tion­ing against some of the changes. Ahead of the spe­cial gen­er­al meet­ing, the Sun­day Guardian sat down with Dr Seereer­am to find out more about the group’s con­cerns with the pro­posed changes. The group is call­ing for trans­paren­cy and ac­count­abil­i­ty from the Med­ical Coun­cil.

Q: What is the mem­ber­ship num­ber for the Doc­tors Ethics and Au­ton­o­my Lob­by (DEAL)?

A: It was formed by a quo­rum of physi­cians like my­self, Dr David Stri­siv­er, and Dr John­ny Siu Chong, and we have some oth­er core mem­bers. When we first start­ed to ad­dress the is­sue of the leg­isla­tive amend­ments, we got about ten doc­tors to come on and form the quo­rum. There­after, we set up our net­work, and peo­ple start­ed to join us and pay at­ten­tion. I think what you may find on the is­sue of the leg­isla­tive amend­ment, par­tic­u­lar­ly in re­gards to claus­es 12A and 12B, which is a new amend­ment that is pro­posed, you would find that the ma­jor­i­ty of physi­cians are ac­tu­al­ly aligned with our po­si­tion on the is­sue. So, be­cause we are an­oth­er group, a new group that is new­ly es­tab­lished, the reg­is­tra­tion is now com­ing in, but ba­si­cal­ly, we have re­ceived over­whelm­ing sup­port from the med­ical fra­ter­ni­ty.

What are the pro­posed amend­ments to the Med­ical Board Act that the lob­by group is op­pos­ing?

I think the pub­lic is prob­a­bly fa­mil­iar with an ar­ti­cle that came out in Feb­ru­ary high­light­ing some ques­tions about fi­nan­cial im­pro­pri­ety with­in the board. There was a meet­ing in March, and in that meet­ing, we were pre­sent­ed with three pieces of leg­is­la­tion, or, I should be more ac­cu­rate, and then two reg­u­la­tions, and then the changes to the act. The board has not asked for in­put on changes to the act. How­ev­er, we were asked to com­ment on reg­u­la­tions that were re­lat­ed to CME (Con­tin­u­ing Med­ical Ed­u­ca­tion) and un­re­lat­ed to spe­cial­ists.

What we re­alised is that the changes that were in the act were quite sig­nif­i­cant. For ex­am­ple, if harken­ing back to the orig­i­nal pa­per, there was an ar­ti­cle in the press that raised ques­tions about fi­nan­cial in­de­pen­dence with­in the board. We re­alised that there was a new quote, a new clause, and a new sec­tion with­in the act en­ti­tled ‘Ex­emp­tion from Li­a­bil­i­ty’, and this spoke about pro­tec­tions or in­dem­ni­ty specif­i­cal­ly for the coun­cil. We thought this was some­what an­ti­thet­i­cal to what we ex­pect­ed in the amend­ment. I think the board was look­ing for­ward to more trans­paren­cy in the deal­ings of the coun­cil.

While we un­der­stood from the coun­cil that they gave a ra­tio­nale for amend­ments to these new ex­emp­tions from li­a­bil­i­ty, we had an is­sue with that.

What we did is we looked at it and said, okay, lis­ten, in fact, what we need is fidu­cia­ry trans­paren­cy. We need to be able to de­fine the fidu­cia­ry du­ties of the coun­cil. We sat to­geth­er, and we de­cid­ed we need­ed claus­es with­in the act for an an­nu­al au­dit, which has not been done for sev­er­al years. When you don’t have a prop­er fi­nan­cial au­dit for sev­er­al years, we need to make sure that we have a bud­get.

Your group con­tends that some changes threat­en the in­tegri­ty and in­de­pen­dence of the med­ical pro­fes­sion and un­der­mine pa­tient rights and pub­lic health. Please elab­o­rate on this.

If you look at what hap­pened dur­ing COVID, you will see that there was a dif­fer­ent type of gov­er­nance set­ting dur­ing the pan­dem­ic—it was top-down gov­er­nance. It was, I would say, a bit au­to­crat­ic. So, we have a lot of bu­reau­crats in­ter­na­tion­al­ly gov­ern­ing or mak­ing de­ci­sions, pub­lic health de­ci­sions, and dic­tates that are ap­plied across the globe. Of course, we’re in a pan­dem­ic sit­u­a­tion. But what hap­pens is that there’s a coun­ter­bal­ance to that and the ex­pe­ri­ences, the train­ing, and the prac­ti­cal and em­pir­i­cal in­for­ma­tion and em­pir­i­cal ex­pe­ri­ence that are em­a­nat­ing from the prac­ti­tion­ers on the ground. So, the prac­ti­tion­ers on the ground who are in­ter­act­ing with pa­tients, who are us­ing the tech­nolo­gies and the drugs, have to be able to meet with each oth­er. They have to have a fo­rum in which they can de­bate, they can dis­cuss pol­i­cy where it says clin­i­cal pol­i­cy, pub­lic health pol­i­cy, and then once we meet, as we are do­ing right now, we have trig­gered a de­mo­c­ra­t­ic ... we have trig­gered a ref­er­en­dum.

DEAL has ex­pressed con­cern that these amend­ments were sanc­tioned by the Med­ical Coun­cil with­out ad­e­quate con­sul­ta­tion or ap­proval from the gen­er­al mem­ber­ship of the Med­ical Board. What time frame did the con­sul­ta­tion take place, and why the gen­er­al mem­ber­ship of the board hasn’t raised con­cerns about their in­abil­i­ty to pro­vide suf­fi­cient in­put?

The vast ma­jor­i­ty of the board mem­bers were to­tal­ly un­aware of changes in the leg­is­la­tion. In fact, if you speak to most mem­bers, the vast, vast ma­jor­i­ty, the first time they would have ever heard about this is on March 6, when it was an­nounced that the changes to the amend­ments to the act by the board had al­ready been sent to Par­lia­ment or were be­ing sent on their way to Par­lia­ment. And I raised that ques­tion in the board meet­ing at that time, and I said, hold on, are you say­ing that these amend­ments, you are ask­ing us to vote on oth­er reg­u­la­tions and so on, but the amend­ments to the act, which in­clude amend­ments to change our mem­ber­ship sta­tus, the reg­is­trant, it in­cludes the in­clu­sion of oth­er caus­es, for ex­am­ple, the in­dem­ni­ty clause, you telling me that we, our in­put is not sought on these amend­ments? It’s not need­ed, and it’s al­ready be­ing sent to Par­lia­ment. So, I ob­ject­ed at that time. And that is, when we de­cid­ed, when we start­ed to look at the col­umn, how can we ap­prove this? The board has not got­ten a chance to look at these amend­ments, and we want to bring them back here be­fore us. We want to de­mo­c­ra­t­i­cal­ly have a ref­er­en­dum on them, and we would like to re­solve and have some in­put in the change of our law.

You raised the is­sue of trans­paren­cy and ac­count­abil­i­ty. DEAL claims the pro­posed amend­ments fail to ad­dress trans­paren­cy in com­mit­tee ap­point­ments and re­port­ing and in­tro­duce an in­dem­ni­ty clause for the coun­cil, which DEAL ar­gues un­der­mines fi­nan­cial ac­count­abil­i­ty. Please elab­o­rate.

We are ask­ing for an au­di­tor now. We want to make sure we have peo­ple on the coun­cil who are reg­is­tered with their statu­to­ry bod­ies and un­der their reg­u­la­tors to en­sure that we have con­fi­dence in their pro­fes­sion­al in­tegri­ty and the qual­i­ty of their pro­fes­sion­al ser­vices, and one of those peo­ple is an au­di­tor. We would like to make sure that go­ing for­ward, as the board sets out, hope­ful­ly, this has to do with a bud­get. I think that it’s pret­ty sur­pris­ing that, so many times, there’s no bud­get be­ing pro­vid­ed. We want to make sure that there’s some­one on the coun­cil who we can de­pend on and who has their own qual­i­fi­ca­tions and rep­u­ta­tion. I’d say, of course, that they will be look­ing at all of the process­es, whether it is what­ev­er ex­pen­di­tures come, if there’s any hir­ing, if there’s any, for ex­am­ple, ten­der­ing, they have to be any ten­der­ing if the board is go­ing to em­bark on, or per­haps con­struc­tion of our new build­ing.

We’re hear­ing talk about set­ting up new sys­tems, on­line sys­tems, and so on. We want to make sure that those process­es are com­plete­ly trans­par­ent. And I think that, in keep­ing with good cor­po­rate gov­er­nance, it’s on­ly fair that we have an au­di­tor on board. In ad­di­tion to that, we have just put very ex­plic­it claus­es with­in the fidu­cia­ry du­ty sec­tion, which we have fleshed out with­in the app. And you can see one of the goals: for ex­am­ple, we need to have an an­nu­al au­dit. Maybe some­body can chal­lenge us and say, ‘Well, how is it pos­si­ble that you need to put this in­to law?’ Un­for­tu­nate­ly, it would ap­pear that we need some­thing like this to make sure that our board op­er­ates trans­par­ent­ly.

Do you an­tic­i­pate a well-at­tend­ed ses­sion for the spe­cial gen­er­al meet­ing that’s hap­pen­ing on Tues­day?

Once all no­tice gets out prop­er­ly. This has been one of the is­sues be­cause we be­lieve that the board has a role in fa­cil­i­tat­ing pro­fes­sion­al com­mu­ni­ca­tions among its mem­ber­ship, mean­ing that the sec­re­tary has a new board. And the coun­cil has a role in re­lay­ing com­mu­ni­ca­tions be­tween the board mem­bers. We have great ea­ger­ness for a ref­er­en­dum, or, what I’m say­ing, we must get our no­tice. We had a pref­ace to the nurs­es ex­plain­ing the pur­pose of the meet­ing, that the mem­bers of the board need to un­der­stand what the pur­pose of the meet­ing is, and that right now we are re­liant on the coun­cil to cir­cu­late that no­tice, re­ly­ing on the con­cept of cir­cu­lat­ed no­tice, and to en­sure that the ra­tio­nale be­hind the meet­ing is very clear­ly pre­sent­ed, in­clud­ing the ref­er­en­dum, so that all of the fra­ter­ni­ty un­der­stands the grav­i­ty of the mat­ter that is be­ing added as be­fore­hand and is be­ing put to vote on at the end.

Now, what is the feed­back so far? Well, we have over­whelm­ing sup­port among the net­works that we have tapped in­to, and that in­cludes sev­er­al hun­dred doc­tors, right? 


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