20150214, ministerial response - 13th report - jsc group 2 - commissioning … · 2015-06-22 ·...

Ministerial Response to the

Thirteenth Report of the Joint Select Committee of Parliament on Ministries, Statutory

Authorities and State Enterprises (Group 2) on the

Commissioning Process for the New Scarborough General Hospital


Authorities and State Enterprises (Group 2), on the Commissioning Process for the New

Scarborough General Hospital

RESPONSE TO THE RECOMMENDATIONS/COMMENTS OF THE 13 TH REPORT

OF THE JOINT SELECT COMMITTEE

In keeping with Sianding Orders 71B(13) and 79B(13) of the Senate and House of

Representatives respectively, the following is presented responding to the

recommendations/comments of the Joint Select Committee as contained in the Report:

Objective 1

Clarify the relationship between the Tobago Regional Health Authority (TRHA) and the

Ministry of Tobago Development, the Tobago House of Assembly (THA) and the Ministry

of Health.

RECOMMENDATION

We recommend that urgent consultations be held at the managerial level to assess the

accountability and reporting requirements of the TRHA to the THA, Ministry of Health

and the Ministry of Tobago Development with a view to resolving some of the existing

ambiguity regarding the multiple authorities which exercise oversight of the TRHA. In the

end, there must be clear and distinctive jurisdictional boundaries in respect of the three

bodies exercising oversight.

The TRHA notes the recommendation of the Committee.




Objective 2

Identify the changes made to the organisational structure from the year 2011

RECOMMENDATIONS

A. We recommend that a process be established to conduct periodic reviews of the

organizational framework against other applicable models to ensure that the

resources of the TRHA are organized in the most efficient manner so as to

effectively respond to the growing demands for health care services in the island of

Tobago.

B. In addition, steps should be taken to fill the position of Director of medicine on the

Board of the TRHA.

The TRHA acknowledges and notes that conducting periodic reviews is inherent in effective

management of any organization. The TRHA is in the process of establishing its five-year

Strategic Plan 2014-2018, to guide its delivery of quality health care in keeping with the growing

demands of the population as well as the dynamic needs of the health sector. This is to ensure a

healthy population in accordance with national policies determined for reduced occurrences of

communicable and chronic non-communicable diseases, and a population that is aware of its

responsibility in this regard.

The TRHA is aware that steps are being taken to ensure the composition of the Board of

Directors is in keeping with the RHA Act No. 5 of 1994, Second Schedule, Section 1, Sub-clause

(2) (a) (iii) that "at least one member of each Board shall: ... be a registered medical

practitioner."

TRHA Response to the 13th Report of the JSC on the Commissioning Process for New Scarborough General Hospital 2




Objective

Determine the status of recruitment and filling of managerial positions in the

organisational structure

RECOMMENDATIONS

A. We strongly recommend that the TRHA review its Human Resource Management

plans and ensure that comprehensive succession and human resource planning

strategies are included.

B. Also consideration should be given to a proper compensation/incentive

regime/scheme for the purpose of reducing skills flight or brain drain in the Tobago

Health Sector.

C. Clear time-frames should be set to fill vacant managerial positions.

The TRHA acknowledges and notes that a review of its current Human Resource Management

Plan is one aspect in the development of its comprehensive and progressive Strategic Plan, to

ensure that it not only attracts the right staff (in terms of fit and competence) but is also able to

retain such individuals long-term.

The TRHA will be presenting a proposal to the Tobago House of Assembly for the upgrade of

salaries for its executive, middle-management and technical staff

The TRHA's Human Resource Management Plan dictates the urgent filling of both managerial

and critical positions required for the effective delivery of quality health care services.





Objective 4

Identify the status of the commissioning of the new services to be offered at the hospital

Cardiology Services

RECOMMENDATIONS

A. We firmly recommend that additional efforts to recruit a Cardiologist include the

modification of the proposed compensation package for this position in order to

enhance the number and quality of prospective candidates.

B. We also recommend that the recruitment process for this position be advertised at a

regional or hemispheric level to increase the possible number of applicants.

C. We further recommend that the conditions of employment include a requirement

for the Cardiologist to assist with training junior doctors in this specialty and that

the necessary training be provided for local doctors in the area of Cardiology as a

means of ensuring that future demands for skills in this specialist area can be

satisfied locally.

The TRHA acknowledges the recommendation made to modify the compensation package for

this position and notes this has been seen as a requirement to attract prospective candidates,

including nationals practicing in this field abroad.

The TRHA will be advertising this position again which will include at the hemispheric level.

As part of its recruitment campaign use is presently made of the portal "Caribbean Jobs.com ".

The TRHA notes that it is already a requirement for such senior doctors to train junior doctors.

Similarly it is necessary for the TRHA with the support of the THA and Ministries of Health and

Public Administration to make available national scholarships for locals to be trained in this and

other specialized areas, i.e., Neurosurgery, in order to meet the demands for a comprehensive

secondary-care/tertiary level health delivery system.


Thirteenth Report of the Joint Select Committee of Parliament on Ministries, Statutory Authorities and State Enterprises (Group 2), on the Commissioning Process for the New


CT Scanning and Digital Radiology

RECOMMENDATION

We recommend that immediate action be taken to speedily rectify the issues with the

printer(s) in the imaging department. It is untenable that a new hospital was

commissioned and lacks a basic facility in its early stages of operation.

The TRHA is pleased to report that the connectivity issue with the printer was resolved in June

2013. Similarly, the TRHA in October 2013 commissioned a Picture Archiving Communications

System (PACS) which allows for remote communication of scans/images taken to doctors on/off

site. The TRHA's Information Communication & Technology (ICT) department is nearing the

completion of the installation of a Wide Area Network (WAN) which would allow for the

deployment of PACS to TRHA Health Centres.

Pathology including Histological Analysis and Microbiology

RECOMMENDATION

We recommend that given the general shortage of pathologists in Trinidad and Tobago (in

contrast to the increasing deman& for forensic autopsies and general pathology services)

that the Ministry of Health in collaboration with the University of the West Indies Faculty

of Medical Sciences develop an incentive regime in order to encourage aspiring doctors to

specialise in this area.

The TRHA acknowledges and agrees with the recommendation for collaboration. The TRHA

advises that it has contracted a sessional pathologist for the provision of autopsies and other

pathological services and that a House Officer is assigned to work in this department; a

commitment has also been given by the doctor for the arrangement to be converted to a full-time

one as soon as he becomes fully available. The TRHA is presently in discussion with the Faculty

of the University of the West Indies (UWI) with respect to the Scarborough General Hospital

being an approved training site for graduate medical education and training. These discussions

were very fruitful with all parties aiming for the first intake of students by February 2014.



Scarborough General Hospital Kitchen

RECOMMENDATIONS

A. We recommend that subsequent to the completion of the kitchen facility, that a

maintenance regime be established to ensure that fixtures and equipment in the

kitchen are checked and repaired on intervals rather than allowing the facilities to

deteriorate to the point of disrepair or total shut down.

B. Furthermore, we recommend that all Occupational Health and Safety standards be

clearly communicated and displayed in a prominent area for the guidance and

benefit of the works and users of the facilities.

The TRHA acknowledges and notes that a preventative maintenance plan is in place to ensure all

fixtures and equipment in the kitchen and throughout the hospital are checked routinely as

specified by the various manufacturers, with repairs undertaken as may be required.

The TRHA acknowledges and notes that its Occupational Safety and Health (OSH) Officers and

Quality Department are required to and have been consistently reviewing all areas of operation

and providing the necessary recommendations to management for improved on safety standards.

All measures have been taken to ensure safety standards are implemented in a timely manner;

including the display of safety reminders. Through the TRHA's Education Department routine

safety and health programmes are provided for staff depending on their areas of work.

Laundry

RECOMMENDATION

We recommend that the work required to complete the laundry be executed with alacrity

in order that the laundry be opened.

The TRHA acknowledges and notes that the necessary remedial works are scheduled to

begin on January 20 th and completed by January 29 th to allow for the re-testing and

certification of the compressed air and steam systems. The projected date for the next phase

of commissioning and training of staff is the week of February 2014 for eight days.




Incinerator

RECOMMENDATION

We strongly recommend that the TRHA conduct the necessary toxicity tests of the fumes

being emitted from the incinerator to determine whether a potential health hazard/risk

exists. In addition, subsequent tests should be conducted as a means of monitoring air

quality in the vicinity of the incinerator.

The TRHA acknowledges and notes that the incinerator at the Scarborough General Hospital has

been approved by the EMA and has a built-in water-scrubber to reduce emissions. The TRHA

will ensure that routine air quality tests are conducted periodically.

(

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20150214, ministerial response - 13th report - jsc group 2 - commissioning … · 2015-06-22 ·...

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