Ideas for Health Sector Reform in Trinidad and Tobago

Health reform refers to the changes in health administration, health planning and, health research that places significant focus on local health challenges aimed at improving health administration, health planning and healthcare. They objawy depresji will combine to produce an efficient style of healthcare delivery capable of increasing patient physical, medical and psychological safety. Health reform should be driven by empirical data, best practice and evidence based practice. A variety of health statistics; such as mortality, manpower needs, technology functioning and patient satisfaction; should be analyzed and used in strengthening health systems.

In Trinidad and Tobago the current system of healthcare is highly centralized. The Ministry of Health maintains in business oversight of five regional health authorities. These are the North Western Regional, North Central Regional, Eastern Regional, South west Regional and Tobago Regional. South west, North Western and North Central are the largest regions; each catering for the healthcare needs greater than 3 hundred thousand people.

A significant reform should be the specialization of the Ministry of Health in fewer functions aimed to improve healthcare efficiency. For example, it can concentrate on data system and analysis. It must be staffed with expert health researchers tasked with analyzing changes in epidemiology, and trends in morbidity and mortality. Furthermore, the Ministry of Health should have the capability to instruct regional authorities to make systemic and resource changes based on the statistics collected and analyzed. Regional bodies should be mandated to provide health based statistics to the Ministry of Health quarterly. The Ministry of Health must maintain general oversight of regional authorities. It should produce annual reports based on self- monitoring and evaluation of the systems, activities and challenges in each region. Financial statements and audits should be submitted annually to the Ministry of Health and factors accounting for deviation should be justified. Recommendations should be designed for improvements and cases of white-collar crime prosecuted.

One major reform that is implemented is approving absolute autonomy to regional health authorities for the delivery of healthcare. They should be able to generate their own funds by charging fees for their services. This would eliminate reliance on the state or Ministry of Finance for funding. Each regional health authority should be able to invest in the currency markets or undertake other income generating measures it makes feasible. Its funds should be spent relative to the health needs of the population it serves. Regional authorities should lead to primary, 2nd and tertiary healthcare. In addition, they should be given oversight of nursing homes and health facilities in their geographic regions. Private facilities should be controlled by price controls to avoid exorbitant charges and may have to pay at least 10 percent of their annual profit to the regional authority.

In addition, regional authorities should have the capability to ensure that all health institutions and providers adhere to national accreditation standards. The Ministry of Health should be charged with responsibility for developing national accreditation standards in all elements of the operations of health institutions. These includes doctor’s offices or restaurants, pharmacies, private practice. Also conventional and alternative medicines should be controlled by accreditation standards. Everything and every health based institution should be controlled by accreditation standards comparable with those of more developed countries such as Europe and the united states.

It is palpable that the limits of each regional authority be redefined so that they are of almost equal population size. At this time South west Regional is accountable to slightly over one half million people. Therefore given its limited resources, it cannot be expected to perform with greatest efficiency. Given the fact that the better health facilities are situated in urban centers, this would be a challenge that must be overcome judiciously. To accommodate this reform, regional authorities should induce joint public and private partners in the provision of healthcare centers in countryside and other zones less accessible to major doctor’s offices or restaurants and health centers.

To make the health system efficient, a centralized electronic health record system should be developed and implemented. This would ensure that patients could access care in different region. Thus it would make it accessible health records from any healthcare facility owned and administered within any regional authority. It is expected that the Ministry of Health should take a leading role in this enterprise. Records of patients in nursing homes should be accessible to regional authorities simply because may be moved to a public hospital if the care they must be given cannot be attained there. Sometimes for financial reasons such as exorbitant cost, patients may be moved to a public hospital.

Employment policies should enable the free movement of skills and expertise across regions. Sometimes, highly specialized cosmetic surgeons and caregivers should be made available to patients in other regions on a needs basis. In other words, one region pays another for the services of its skilled human or physical resources demanded.

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