The Ministry of Health’s multi-million dollar External Patient Programme (EPP), in which patients at public hospitals are transferred to private medical facilities at the expense of taxpayers, is “scandalously corrupt” and must be abolished. So far, $60 million has been spent on the programme which started in July 2014. This figure represents the amount spent between 2014 and 2015. The 2015 to 2016 figures are still outstanding.
Sunday Guardian obtained the information which was submitted by the National Workers Union (NWU) to the Dr Winston Welch-chaired committee which was established by Cabinet last November to “review the levels of healthcare delivery by the regional health authorities, and to rationalise the system of public sector doctors in private practice.”
The NWU, which made its submission to the committee on February 16, has also questioned the criteria used by the Health Ministry in the selection of the private medical facilities used in the EPP.
According to the NWU, “public health institutions are now holding bays and clearing houses for the routing of patients into the private health system and the State pays—another disgusting incident of the looting of public funds by politically connected persons.”
The EPP was launched in May 2014 by the Kamla Persad-Bissessar-led People’s Partnership administration.
On May 29, 2014, the Cabinet approved $10 million for Phase One of the EPP.
Phase One of the EPP began on June 2, 2014, and included cataract surgeries, knee and hip replacement surgeries, computerised tomography (CT) scans and Magnetic Resonance Imaging (MRI) scans.
“All citizens of Trinidad and Tobago are eligible to apply. Applicants must be registered patients of a public health facility for a minimum of three months awaiting the service applied for,” the EPP states.
The NWU said this criterion accounts for “99 per cent” of the external patients at the nation’s public hospitals.
In December 2014, then health minister Dr Fuad Khan announced that the EPP would be expanded in 2015 at a cost of $50 million.
Khan said over the first six months of the EPP, 94 angiograms, 14 cataract removal surgeries, 748 CT scans, 543 MRI scans, three dental procedures and 200 knee and hip replacements had been done at private medical centres.
On May 5, 2015, the National Health Workers Union (NHWU), an affiliate of the NWU, wrote Persad-Bissessar on the issue stating that Khan was “most interested in promoting” the EPP “which has been described as benefiting a clique of medical doctors masquerading as public officers in the public health system while actually operating a private hospital sector funded by the State.”
The NHWU said the EPP was promoting a “medical mafia.”
No action was taken following that letter to Persad-Bissessar, the NHWU stated.
As a result of this inaction a letter was written to Health Minister Terrence Deyalsingh when the People’s National Movement administration was voted into office.
That letter was dated September 17 last year.
The NHWU told Deyalsingh that they wrote Persad-Bissessar “informing her about the horrendous situation existing within the public health system and recommending mechanisms which may be applied to begin to ameliorate the situation in the short term”.
“Needless to say there was no consequent action on our letter,” the NHWU stated.
The NWU and the NHWU most recently took their complaints about the EPP to the Welch-chaired committee.
“In the estimation of the NHWU the dual-track system of senior medical personnel operating in both the public and private heath care systems must be abolished. The External Patient Programme (EPP) benefits a clique of medical doctors in the public health system that actually operates a private hospital sector funded by the State,” the NWU wrote.
“This situation has become so scandalously corrupt that medical capitalists have transformed public health institutions into gathering stations for those in need of medical procedures...” the letter stated.
The NWU urged the Welch-chaired committee “to walk very softly” and to take “an all-sided examination of the EPP’s “merits before pronouncing upon it.”
“Other corrupt practices are associated with the External Patient Programme. Several private dialysis centres are being supplied with patients and being paid for by the State (At this time there are requests for proposals for the provision of dialysis services being advertised in the media),” the NWU wrote.
“It would be interesting to uncover what are the criteria used in selecting these centres and how much it actually costs the citizens of our country,” NWU stated.
Deyalsingh: I’ll check the claims tomorrow
The Sunday Guardian contacted Deyalsingh about the claims made by the NWU in its presentation to the Welch-chaired commission.
Deyalsingh said he would check the claims made by the NWU tomorrow.