12 Mar 2008

Crisis and contrasts

Reports are that the health sector in T&T reached reached 'critical proportions a long time ago.' Nothing surprising there; I worked in the health sector for a few years and since 1990 I met the same situation time and time again. Imagine that even back then we did not have paper to write reports. We used the clear backs of old computerised paysheets that were deemed 'no longer needed'.

Reports that this situation extends even further back is not that surprising either. One wonders how the hell Pa-trick, Tattoo, Bank Thief, and others can fully justify buying a jet at this time when people don't even have a bed to lie in at the hospitals, or drugs to help them.

Then again, maybe I can't understand since I do not have the PNM mentality.

One difference that is glaring between Trinidad & Tobago and the UK:

Primary care here is excellent compared to that of T&T. On the occasions I had to go to the doctor, I called and booked an appointment, usually same day. Calling at 8:00 AM can get me an appointment at lunchtime or evening, or I can walk in and wait to see the duty doctor (who is rotated daily).

When the 'surgery' opens at 8:00 AM, doctors are already there, and having 8 or so doctors there is a big help. I add here that my 'surgery' is smaller than the Oxford Street Health Centre, more like the rural ones at Penal, La Romaine or Pleasantville.

But the doctors are pleasant, and efficient. Patients can go for one or most two complaints at any one time; no more. Scheduled 15 minutes apart, the patients are rapidly dealt with and sent on their way. (I know doctors in Trinidad spend less time per patient). Many of the doctors at my 'surgery' are specialists holding several degrees at post graduate level.

Contrast that with Trinidad. Doctors (MBBS physicians) at health centres have private practices which they attend to at 8:00 AM. Then they leave their office to go to the health centres at about 10:00 AM. Once there, they see about 80 patients (if so many remains after getting fed up waiting, since they have to go from 6:00 AM to get a number) in less than half hour. Most of these will be referred back to the doctors' private practice where they will pay for treatment.

Also, the doctors charge for filling in forms (insurance, sick leave etc) which are meant to be done for free.

Long before 11:00 AM the doctor is back in his private office waiting on the health centre patients to turn up. Oh, and he does this one day per week.

He may also double as the DMO (District Medical Officer) and in event of murders etc he has to see the body and pronounce death before it can be moved. Usually it takes 4 to 8 hours for him to turn up at the scene.

It is not only a lack of resources that defeat good health care in Trinidad. It is the mentality of the professional who use the poor people; from Pa-trick et al, to the doctors and care workers. Screw them well.