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 this year. It was pointed out that the sector had achieved its Millennium Development Goals (MDGs) with respect to maternal mortality, although 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 regards 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 5 years old and neonatal, Dr Luncheon stated. “The issues that arose in the report was 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 said that creation of intensive care neonatal units have 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 don’t happen.” The post-mortem is a statutory part of the requirements, captured in the regulations to allow the proper delivery and maintenance of statistics. The expert 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 mal-practicing 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 regards 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 Cabinet Secretary, Dr. Roger Luncheon indicated that Cabinet is satisfied with the efforts being made and the measures being put in place by the Health Ministry to address the aforementioned issues. (GINA)