With heart dis­ease one of the lead­ing caus­es of death in T&T comes a rev­e­la­tion that the Scar­bor­ough Gen­er­al Hos­pi­tal has a mul­ti-mil­lion dol­lar Car­diac Catheter­i­sa­tion Lab­o­ra­to­ry which has not been used for years and in­stead pa­tients are be­ing trans­ferred from To­ba­go to the Er­ic Williams Med­ical Com­plex (EWM­SC) putting ad­di­tion­al pres­sure on the sys­tem and poor­er out­comes for To­bag­o­ni­ans who get heart at­tacks or have heart prob­lems.

In ad­di­tion, ac­cord­ing to the Pub­lic Sec­tor In­vest­ment Pro­gramme, $70 mil­lion was spent on the fa­cil­i­ty which has be­come a prover­bial white ele­phant.

The PSIP 2015 showed that $50 mil­lion was “utilised for the sup­ply and in­stal­la­tion of a Mod­u­lar Car­diac Catheter­i­sa­tion Lab­o­ra­to­ry and Mag­net­ic Res­o­nance Imag­ing Unit for the new Scar­bor­ough Hos­pi­tal in To­ba­go.”

The doc­u­ment not­ed that dur­ing the pe­ri­od un­der re­view (2014) “the or­der was placed for the equip­ment and ex­ca­va­tion works and foun­da­tion works com­menced.” The PSIP 2015 added that the project was sched­uled for com­ple­tion in Feb­ru­ary 2015.

Sub­se­quent­ly, the PSIP 2016, which would have been pre­sent­ed in Oc­to­ber 2015, said: “The Cath Lab at the Scar­bor­ough Gen­er­al Hos­pi­tal in To­ba­go utilised the sum of $20 mil­lion and is due to be opened in 2015.” It con­tin­ued to note that the Cath Lab will aid med­ical pro­fes­sion­als to ef­fi­cient­ly di­ag­nose dis­eases of the heart, valves and coro­nary ar­ter­ies.“

This means that $70 mil­lion would have been spent on the es­tab­lish­ment on the Cath Lab in To­ba­go.

Iron­i­cal­ly it was al­so dis­closed in 2016, that the Mag­net­ic Res­o­nance Imag­ing (MRI) Unit al­so pur­chased the wrong sized MRI ma­chine at the cost of $34 mil­lion. An­oth­er waste of tax­pay­ers mon­ey.

The non-func­tion­ing of the state lab was re­vealed to the Busi­ness Guardian by the med­ical chief of staff, of the hos­pi­tal, Dr Vic­tor Wheel­er. When asked about the util­i­sa­tion rate of the Cath Lab at Scar­bor­ough, Dr Wheel­er said:“It’s not func­tion­al at the mo­ment.”

When pressed as to the rea­son why the Cath Lab was not func­tion­al, Dr Wheel­er not­ed that it has not been func­tion­al for ap­prox­i­mate­ly five years. Ac­cord­ing to the med­ical chief of staff the lab is not op­er­a­tional be­cause “there’s no staff that we can have to use it.”

Con­sid­er that there is no Cath Lab at the Port-of-Spain Gen­er­al Hos­pi­tal, none at San Fer­nan­do Gen­er­al Hos­pi­tal nor at the San­gre Grande Re­gion­al Hos­pi­tal and the one in To­ba­go is sim­ply not be­ing used due to a lack of staff.

Dr Wheel­er added that be­fore he as­sumed of­fice the Scar­bor­ough hos­pi­tal had a con­tract with a ‘Trinida­di­an ser­vice provider’ to op­er­ate the lab­o­ra­to­ry. Al­though Wheel­er not­ed that this con­tract was not re­newed, he did not have the in­for­ma­tion con­cern­ing the com­pa­ny nor the terms of the con­tract un­der which it was hired.

In a re­cent in­ter­view, In­ter­ven­tion­al Car­di­ol­o­gist, Dr Ronald Hen­ry said the Cath Lab in To­ba­go was not utilised be­cause the hu­man re­source ca­pac­i­ty was not de­vel­oped in tan­dem with the in­fra­struc­ture.

Dr Hen­ry said: “If the hu­man re­source isn’t de­vel­oped in par­al­lel, then you would end up ex­pen­sive white ele­phants be­ing built. This is the chal­lenge for de­vel­op­ing the way for­ward.”

Re­spond­ing to sub­se­quent ques­tions, Dr Hen­ry ar­gued that this hu­man re­source com­po­nent has to do with the avail­abil­i­ty of med­ical pro­fes­sion­als and fa­cil­i­ties that would cater to the “pro­vi­sion of emer­gency an­gio­plas­ty to per­sons suf­fer­ing with Acute My­ocar­dial In­farc­tion.”

He not­ed a pro­ce­dure is prop­er­ly called Pri­ma­ry PCI (Per­cu­ta­neous Coro­nary In­ter­ven­tion) re­ferred to as PP­CI.

Dr Hen­ry ar­gued that the ev­i­dence sup­port­ing his con­tention is found­ed up­on his ex­pe­ri­ences when he start­ed the coun­try’s first Cath lab at EWM­SC around 1990, with a team that he had trained in-house.

He dis­closed that four years lat­er, on Feb­ru­ary 22, 1994, the same team per­formed the coun­try’s first coro­nary an­gio­plas­ty. He not­ed that a quar­ter cen­tu­ry lat­er, EWM­SC still does not of­fer the coun­try a PP­CI ser­vice, de­spite hav­ing state of the art Cath labs.

Hen­ry con­tend­ed: “The les­son here is painful­ly ob­vi­ous: The pro­vi­sion of in­creas­ing in­fra­struc­ture, as im­por­tant as it is, does not nat­u­ral­ly evolve in­to the long an­tic­i­pat­ed and over­due PP­CI ser­vice.”

The prop­er im­ple­men­ta­tion of a Na­tion­al PP­CI Pro­gram, ac­cord­ing to Hen­ry, would “de­crease the du­ra­tion of time spent in hos­pi­tal, hence sav­ing dol­lars, in­crease the sur­vivor­ship and al­so in­crease the re­turn of the pro­duc­tive mem­bers of so­ci­ety back to work, which has huge eco­nom­ic ben­e­fits.”

He said that the old way of do­ing things, where med­i­cine is giv­en to pa­tients with heart at­tacks and the out­come is await­ed, con­tributes to the loss of lives and ul­ti­mate­ly the loss of pro­duc­tive mem­bers of the labour force.

As a re­sult of this type of treat­ment, peo­ple not on­ly stay away from work longer, but many of them nev­er re­turn to work, be­cause even if they sur­vive they have parts that are weak­ened per­ma­nent­ly. A prop­er­ly man­aged and PP­CI pro­gram would as­sist in avoid­ing these cir­cum­stances, ac­cord­ing to Hen­ry.

Hen­ry al­so em­pha­sised that if T&T were to in­sti­tute a Na­tion­al PP­CI Pro­gram, “this would al­so cre­ate the op­por­tu­ni­ty to ne­go­ti­ate Gov­ern­ment to Gov­ern­ment arrange­ments so that Cari­com states with less re­sources could tap in­to our Na­tion­al grid us­ing a Hub-and-Spoke mod­el. This would mean in­flows of much need­ed for­eign ex­change for T&T.”

The Busi­ness Guardian reached out the Min­istry of Health to ob­tain com­ments from the Min­is­ter of Health but was re-di­rect­ed to the To­ba­go House of As­sem­bly’s Di­vi­sion of Health Well­ness and Fam­i­ly De­vel­op­ment.

The Di­vi­sion of Health Well­ness and Fam­i­ly De­vel­op­ment (DHWFD) con­firmed that the Cath Lab is not cur­rent­ly in op­er­a­tion.

Tra­cy David­son-Ce­les­tine, Sec­re­tary of the DHWFD point­ed out that the Cath Lab “has oc­cu­pied our at­ten­tion and sev­er­al op­tions are be­ing ex­plored for it op­er­a­tions.”

She added: “We are com­mit­ted, the Di­vi­sion and TRHA, to make this hap­pen in the quick­est time pos­si­ble. But this is not an easy or cheap task.”

The sec­re­tary al­so said: “It will be pre­ma­ture to dis­cuss the de­tails as much work has yet to be done and re­sources con­sid­ered.”

She ad­mit­ted that the Cath lab has “been on the back burn­er” for a long time and in­di­cat­ed that of­fi­cials are work­ing to­wards a so­lu­tion.

Ac­cord­ing to David­son-Ce­les­tine the DHWFD is work­ing at a steady pace to bring all hos­pi­tal ser­vices to the lev­els “to meet the needs of the pub­lic and in­ter­na­tion­al stan­dards.” She as­sert­ed that they are work­ing on a range of ser­vice im­prove­ments and projects along­side the TRHA.

David­son-Ce­les­tine con­tend­ed that “To­ba­go con­tin­ues to be one of the lead­ing lo­ca­tions the re­gion in num­ber of health care fa­cil­i­ties per capi­ta and that’s be­cause at DHWFD we put peo­ple first.”

She con­tin­ued: “While we are not per­fect and en­counter chal­lenges every day, in­clud­ing COVID 19, we are work­ing non- stop to con­tin­ue to pro­vide health care ser­vices.”

Cur­rent­ly, the Scar­bor­ough Gen­er­al Hos­pi­tal em­ploys one in­ter­ven­tion­al car­di­ol­o­gist, Dr Clif­ford Thomas, who vis­its To­ba­go twice per month. Ac­cord­ing to the Med­ical Chief of Staff the Scar­bor­ough Gen­er­al Hos­pi­tal has full time ra­di­ol­o­gists but not in­ter­ven­tion­al ra­di­ol­o­gists.

How­ev­er, Dr Wheel­er al­so dis­closed that pa­tients that must un­der­go car­diac pro­ce­dures are trans­ferred to Trinidad.