THE performance of the health sector remains a priority for Cabinet, according to Head of the Presidential Secretariat, Dr. Roger Luncheon, noting that Cabinet sub-committees monitor several sectors for the inter-current events affecting them.Dr. Luncheon explained however, that the monitoring of the health sector is directed at three areas, child mortality, maternal mortality and the licencing of facilities.
In 2014, a report by the Health Ministry, reviewed by the Cabinet monitoring group and discussed by Cabinet in January was completed in February of this year. It was pointed out that the sector had achieved its Millennium Development Goals (MDGs) with respect to maternal mortality, notwithstanding the fact that 18 deaths were recorded across the country, 10 of these at the Georgetown Public Hospital Corporation.
The non-compliance or indifference to reporting on maternal deaths, with specific regard to the timing of their reportage within recognised timelines, was among the issues expressed in the report. Dr Luncheon said the report highlighted this “minimal indifference and sometimes even worse, in so far as the reporting by these private institutions”.
Child mortality rates, in the report, focused on those under five years and neonatal, Dr Luncheon stated. “The issues that arose in the report were the comparison and using the MDGs of the reductions from figures of earlier years (1991/92) and what we intend to achieve in the signal year of 2015”. He added that the neonatal rates had more to do with the efforts of the Health Ministry to enhance efforts to allow for the salvage of what ordinarily might have been unsalvageable births”.
He further added that creation of intensive care neonatal units has in effect contributed to the “picture of neonatal deaths that Cabinet was so distressed about”.
Health Minister Dr. Bheri Ramsaran further explained to Cabinet that the aforementioned was a population that is of low birth weights, and short gestation periods, with inherently high mortality.
The challenge in adequate reporting was also brought to the fore by the report, said Dr. Luncheon.  “We have cultural norms against fundamental tools in the evaluation of infant deaths, like post mortems. The report commented on the considerable difficulties that exist in getting parents, perhaps institutions, and even conniving officials to enforce those requirements to have post-mortems done. In many places it just doesn’t happen”. The postmortem is a statutory part of the requirements, captured in the regulations to allow the proper delivery and maintenance of statistics. The export groups, convened by the ministry, Dr Luncheon stated, to address the issues of culpability, whom or under what circumstances these deaths occurred, would generally express their findings and make recommendations.
“Cabinet had to face those instances when either the autonomous Medical Council or lesser frequently the High Court, disposed of the recommendations of the expert group as they sought to have disciplinary measures against malpractising professionals, keeping in mind the Medical Act, applicable regulations in the face of what has been reported in 2014, to overcome these obstacles to indeed ensure maximal enforcement”.
With regard to complaints about the attitude of healthcare providers to patients, especially those at government funded institutions, Dr Luncheon reiterated that over the 2001 to 2006 period, an initiative to have “Service level agreements” was instituted. These agreements cover the waiting times for non-critical and critical care at public health facilities, for example. This initiative is undertaken with assistance from various non-governmental organisations, the Cabinet Secretary explained, and improvements have been seen from this intervention which has been sanctioned by the health minister.
In closing, Dr. Luncheon indicated that Cabinet is satisfied with the efforts being made and the measures being put in place by  the Health Ministry to address these issues. (GINA)