The TRHA says it needs an additional 623 staff to bring the organisation to the full complement of 1625 employees needed to effectively run health care in Tobago.
This information was revealed when the Board of Directors of the TRHA and Senior Hospital Managers appeared before the Joint Select Committee of Parliament on Wednesday. However, Chairman of the TRHA, George Bell indicated that part of this figure represents additional staff needed for the new Scarborough Hospital.
Dr. Tim Goopeesingh questioned the level of staffing at the Authority. He asked if the TRHA is not overstaffed taking into consideration the TRHA serves approximately 60,000 people in comparison to Trinidad where RHAs serve approximately 300,000. In response, Bell noted that there are 84 Health Centres in Trinidad, compared with the 21 in Tobago. The hospital, he added, must operate 24 hours and the Health Centres have to be appropriately staffed. He noted that much of it has to do with geography. Bell indicated that the ratio of Health Centre to patient in Tobago is 1:2700.
With regard to vacancies, Bell explained that there are 44 vacancies for Medical Practitioners and 200 vacancies for nurses.
Dr. Goopeesingh also raised concerns over the mortality rate at the Scarborough Hospital. Pointing to the fact that 21 out of every 1000 people admitted to the Scarborough Hospital die, the Medical Doctor noted that this figure is astronomically high. "You all have to hold yourself responsible for it," Goopeesingh stressed.
He told the Board that he is fearful of falling ill in Tobago. "I am afraid as a national of Trinidad and Tobago, of getting a heart attack in Tobago. You cannot encourage tourism in Tobago, if you cannot have a proper health care system in Tobago," Goopeesingh stated.
Meanwhile, Senior State Counsel, Alvin Pascal argued that The Tobago Regional Health Authority is subject to the Tobago House of Assembly. Pascal was responding to a question posed by Committee Chairman, Dr. James Armstrong regarding the relationship between the TRHA and the Ministry of Health.
Pascal maintained that the statute which created the TRHA determines the regulatory framework under which the RHAs and the THA acts. "The TRHA is an entity which is governed by a Board of Directors and if you look into the TRHA Act, you would see that the management of the Regional Health is the function of a Board," Pascal stated. He maintained the shareholder of the RHA in Tobago is the Tobago House of Assembly.
The State Counsel went on to deal with some of the shortcomings of the Act, including the fact that there was no mention of penal sanctions for any RHA which refuses to follow the guideline of the Minister of Health.
Dr. Tim Goopeesingh further pressed the Board about the relationship between the Division of Health, the TRHA and the Ministry of Health, making reference to the good working relationship that exists between his Ministry and the Division of Education in Tobago. Pascal explained that the Minister of Health may give general advice to the Division and the Division is likely to address those concerns.
Chairman of the TRHA, Keith Charles explained that the Minister of Health meets monthly with all Chairmen of the RHAs. He believes there is a good working relationship with the Ministry. CEO, George Bell also sought to reiterate the point that there is good collaboration with the Ministry. He cited the management of the recent H1N1 virus as an example of the collaboration.