THE board of the North Central Regional Health Authority (NCRHA) met in emergency session on the “insistence” of the Health Minister on Monday afternoon and ordered an immediate audit of all outpatient clinic appointments.
The action comes on the heels of a Sunday Express expose which revealed a barrage of patient complaints over long delays for appointments and treatments and serious shortcomings in the primary health care system.
Responding to an urgent question from United National Congress Senator David Nakhid in the Senate yesterday, Health Minister Terrence Deyalsingh said the entire board met with the executive management, from the CEO down, and ordered an immediate audit of all outpatient clinic appointments- both medicine and surgical- to determine the magnitude of the problem and the number of patients affected.
“We are strengthening our tele-medicine initiative to access and triage patients, determined their need and urgency for care. We have instituted already a pharmacy pick-up collection service to be established for stable patients requiring refilling of prescriptions. We are reviewing the appointment system and we have done an operations review of the clinic management process with a view of improving efficiency and patient comfort, and this is a very fine balancing act, while maintaining all Covid protocols, guidelines and public health measures to ensure safety and to mitigate risk to both patients and staff,” Deyalsingh said.
T&T leading the way
Asked by UNC Senator Anil Roberts why the meeting took place only yesterday when there appeared to be a deficit in the delivery of medical services for some months now, Deyalsingh said: “One must realise without making excuses that we are in the middle of a global pandemic and that health systems around the world have crashed. In California right now you cannot get an ICU bed....you have to wait for a patient to die to get access to the equipment used for that patient.
These are not normal times. But that is no excuse but our parallel healthcare system both arms have been working fantastically. So this review has been going on for a while but the recent urgency prompted me to get the board involved and hold the executive management of the RHA to account.”
Deyalsingh added that the Best Western hotel in London, England, was taking in Covid patients because hospitals had run out of beds. “We are in the middle of a global pandemic and little Trinidad and Tobago is leading the way. Things are not ideal, we admit, but we are in the middle of a global pandemic and balancing protocols to prevent infections and patient care,” he said.
Minister: No shortage of MS drugs
Meanwhile the minister denied a report that there was a shortage of drugs in the public health care system to treat multiple sclerosis (MS).
Dr Daphne Phillips, president of the Multiple Sclerosis Support Foundation (MSSF) of Trinidad and Tobago, had told the Express on Monday that MS patients were experiencing great difficulty in sourcing medication to treat their ailment.
Responding to an urgent question from Senator Wade Mark, Deyalsingh said he was glad for the opportunity to “correct the public record”.
He said 600 syringes of the drug Beta Interferon were received in December and more were expected in January.
However, Deyalsingh said this particular drug has a 30 per cent efficacy rate and was no longer recognised as effective treatment for multiple sclerosis. “We are now looking at new drugs given orally with better compliance and a 50 per cent efficacy rate in 2019.
You must question the advocacy which ignores the medical status of the drug versus the commercial interests of manufacturers. Read between the lines, we have a better newer drug given orally versus an older drug given by injection which has a lower efficacy rate and is no longer recognised as effective treatment for multiple sclerosis. I urge all who are advocating for better in the future to be careful because the doctors are absolutely appalled by the story. They are appalled and saddened at how far the commercial interest advocacy has not reached in this country,” Deyalsingh stated.
Asked by Roberts why if the drug was so old and ineffective why were stocks ordered in December, Deyalsingh said one could not transition patients from one drug to another “at the drop of a hat...You have to manage the progression of the disease and watch the response to the newer and better drug and then you transition them. So your question shows an acute lack of knowledge as to how drugs work and the clinical protocols to determine how a doctor uses a drug.”