Home' Trinidad and Tobago Guardian : September 8th 2013 Contents A6
Sunday Guardian www.guardian.co.tt September 8, 2013
RHONDA KRYSTAL RAMBALLY
The health sector continues
to be plagued with a plethora
of problems. Like crime, gov-
ernment after government has
been grappling with a system
that is in dire need of resusci-
tation. Last year, health received
the third-largest allocation in
the national budget.
A total of $5,1108.7 million was
allocated to health, while edu-
cation and training received the
largest chunk---$9,149.1 million.
But several delays have caused
close to $400 million of last
year s allocation to go back to
the Consolidated Fund (CF),
since the construction of several
hospitals had not started in the
fiscal year in which the money
But funds simply cannot be
moved over to cover other areas
deemed critical. In fact, it is nor-
mal for funds to return to the
CF if they have not been spent
for the purposes intended.
Tomorrow, Finance Minister
Larry Howai will deliver the
fourth budget under the People s
Partnership Government. It will
be his second budget presenta-
Health Minister Dr Fuad Khan
is the second person to be
appointed the portfolio since the
PP assumed office in May 2010.
His predecessor Therese Bap-
tiste-Cornelis was fired in the
first Cabinet reshuffle in June
In his presentation last year,
Howai said, "We are addressing
the well-being of the citizens
of this country through the
expansion in healthcare delivery,
as well as improving healthy
lifestyles among our citizens."
Among some of the projects
he listed were new hospitals in
Point Fortin, Arima, Sangre
Grande and Chaguanas, Nation-
al Public Health Laboratory,
Caribbean Public Health Agency
at Caura and the upgrade of the
San Fernando General Hospital.
Howai then said the Ministry
of Health would fund these proj-
ects through public-private
partnerships and joint ventures.
He said the ministry was also
at an advanced stage of pursuing
such arrangements for oncology,
cardiac surgery and organ trans-
"Moreover, negotiations are
at an advanced stage for estab-
lishing financing agreements for
a hospital in Couva which will
cater for children and adults and
which would have a burns unit,
a teaching hospital at Chancery
Lane San Fernando and a
National Centre for Non-Com-
municable Disease in Penal."
But despite all the plans and
initiatives, many citizens con-
tinue to complain about the
delivery of services.
Delays in project kicking off...
so $$ goes back
On Friday, Khan said under
recurrent expenditure, $95 mil-
lion was going back to the CF
and $168 million from a budget
of $396 million from the Devel-
opment Programme was also
unspent. Additionally, close to
$150 million under the Infra-
structure Development Fund
(IDF) was also not spent.
Khan said this was because
of delays in projects kicking off.
However, he said most of them
were expected to be awarded
and construction will begin in
the upcoming fiscal year.
He said, "What tends to hap-
pen is that once Parliament dic-
tates this has to go a certain
direction, the only way you
could change that is you have
to go back to Parliament, that s
why we have the Supplementary
"We cannot use the money
for anything else."
He said the money was
specifically for construction of
certain hospitals such as the
Women s Out-patient Clinic,
San Fernando Enhanced Health
Centre, the Sangre Grande
Health Centre and several others.
Khan said the recurrent
expenditure was mainly for
He said money in the IDF
could not be touched once the
Parliament had made a decision
and the budget was passed.
"You cannot spin it around at
He said if the money was not
spent for what it was supposed
back to the fund.
Khan said detractors may want
to say he did not spend the
money but it would be illegal for
him to make a decision to use
"It is illegal and the Ministry
of Finance will never allow us
to move money like that," he
So what exactly was the bulk
of the money spent on?
Khan said the Chancery Lane
project which is set to be
opened by year-end, purchase
of equipment, refurbishment
of A&Es, health centres,
improvement of a mortuary,
Toco Health Centre, Mayaro
Hospital and a new Blood Bank
were some of the areas the
money was spent.
He said despite this, the com-
plaints will not cease.
A big chunk of money is also
spent on tertiary-level services.
He said the health centres and
health offices will be opened
later to take the load off the
However, several doctors and
nurses do not want to work late
because of the poor salaries
they are paid, Khan said.
Khan: Big deterrent
is proper salaries
Doctors and nurses are not
paid sufficiently, Khan said.
He said the MPATT was try-
ing to place a proposition to
the CPO to increase the salaries
of doctors and other person-
The basic salary of doctors
range from less than $20,000
to about $33,000 for consult-
ants. This is before tax.
Khan said this was low when
compared to the international
"This is low. I can t even get
a neurosurgeon to work because
a neurosurgeon will make in
one surgery three times that
Khan said getting more
equipment meant getting more
"You have to pay radiogra-
phers, you have to pay radiol-
ogists, you have to pay escorts.
"If they don t want to work
because they aren t paid properly
and you can t get that volume
of professionals to work, then
you re going to have a backlog."
He said human resource and
salaries were major setbacks.
He claimed the Regional
Health Authority Act had a prop-
er remuneration scheme but it
went "haywire" under another
adminstration and it was placed
in the hands of an inter-minis-
terial committee and the CPO.
He said the CPO keeps salaries
in structured ranges like in the
Public Service but it ought not
to be like that.
"It supposed to be on need
and shortages...supply and
$400m from Health
goes back to
Contacted yesterday, a former
health minister said, "If there is
money allocated and it is not spent
what you can do is apply to the Min-
istry of Finance and get the necessary
approvals and the Cabinet approval
and it can be re-allocated."
But it s not so simple.
The former minister said, "A good
minister in the mid-term review will
have a fair idea of where he is going."
The contact said, however, the $95
million that is recurrent expenditure
that is going back to the fund cannot
be used for goods and services.
"Ideally, money from the Infrastruc-
ture Development Fund (IDF) cannot
be used to purchase equipment or be
used in another area.
"You can t do that."
The former minister said most times,
money for a hospital will come from
the IDF and particularly in the first
"These things are done in years.
"So like if a hospital is costing $600
million, in the first year you will not
spend $600 million, so the first year
they may only allocate like $120 million.
"It is always over a period of time."
A minister has the option to decide
if he or she wants to apply for a re-
allocation of funding.
"I did that several times but it is
based on the minister s discretion.
"What you can do is go to the Min-
istry of Finance and tell them what
you want to do...that we re not going
to finish these projects and this is what
I am looking to do."
'Minister can apply for
reallocation of funding'
Liseli Daaga, one of the founders of the National Women's Action Committee
(NWAC) and wife of NJAC leader Makandaal Daaga, receives an award from
Melissa Dennis at NWAC's 31st annual Emancipation rally, held at the Port-
of-Spain City Hall auditorium yesterday. PHOTO: MARYANN E AUGUSTE
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