Brebnor says patients ‘don’t realise how good they have it’ in Tobago health system

KEVON FELMINE

Se­nior Re­porter

[email protected]

With some To­bag­on­ian pa­tients trans­ferred to Trinidad for spe­cial­ist care and fac­ing ex­tend­ed waits be­fore treat­ment, To­ba­go House of As­sem­bly (THA) Deputy Chief Sec­re­tary Dr Faith Breb­nor says many res­i­dents don’t re­alise how good they have it in To­ba­go’s health sys­tem.

Con­tribut­ing to the THA bud­get de­bate last week, Breb­nor, the Sec­re­tary of Health and Well­ness, said the ex­pe­ri­ence of off-is­land re­fer­rals is re­shap­ing pub­lic per­cep­tions of health­care de­liv­ery in To­ba­go.

She said while pa­tients are of­ten flown to Trinidad for ur­gent or spe­cial­ist treat­ment, in­clud­ing by he­li­copter in crit­i­cal cas­es, de­lays in ac­cess­ing care can be sig­nif­i­cant once they ar­rive in the pub­lic sys­tem in Trinidad.

“In many of those in­stances, the fam­i­lies then come back to say what we have in To­ba­go is re­al­ly good be­cause they did not re­alise how bad it was in the pub­lic health sys­tem in Trinidad in com­par­i­son,” Breb­nor said.

“Some­times we need a lit­tle bit of ex­pe­ri­ence to help us recog­nise how well we are do­ing.”

She said the com­par­i­son, while dif­fi­cult for fam­i­lies, has high­light­ed the need to strength­en To­ba­go’s own ca­pac­i­ty so few­er pa­tients have to be re­ferred off is­land in the first place.

Breb­nor said the To­ba­go Re­gion­al Health Au­thor­i­ty (TRHA) is be­ing de­vel­oped in­to a more “tan­gi­ble space” for de­liv­er­ing health­care, with on­go­ing ef­forts to ex­pand spe­cial­ist ser­vices and re­duce de­pen­dence on Trinidad.

She point­ed to a se­ries of planned in­fra­struc­ture de­vel­op­ments, in­clud­ing the es­tab­lish­ment of a To­ba­go On­col­o­gy Cen­tre, a Pub­lic Health Ob­ser­va­to­ry, the re­turn of a catheter­i­sa­tion lab­o­ra­to­ry and the ex­pan­sion of the Neona­tal In­ten­sive Care Unit.

She said the up­grades are in­tend­ed to keep more pa­tients on the is­land, par­tic­u­lar­ly vul­ner­a­ble groups such as pre­ma­ture ba­bies who are some­times trans­ferred to Trinidad for care.

“It breaks my heart when we have to send those pre­mies to Trinidad,” she said.

“We are go­ing to work on en­sur­ing we can keep at least some of them, de­pend­ing on their cat­e­go­ry, with To­ba­go.”

Breb­nor said the ex­pan­sion dri­ve is part of a broad­er strat­e­gy to im­prove ser­vice de­liv­ery while ac­knowl­edg­ing ex­ist­ing lim­i­ta­tions in spe­cial­ist ca­pac­i­ty.

She said the health sys­tem is al­so be­ing re­shaped around pre­ven­tion, with a stronger fo­cus on non-com­mu­ni­ca­ble dis­eases, well­ness and ear­ly in­ter­ven­tion rather than treat­ment alone.

Breb­nor said the bur­den of chron­ic ill­ness con­tin­ues to place both a clin­i­cal and eco­nom­ic strain on the health sys­tem, cit­ing com­pli­ca­tions such as am­pu­ta­tions linked to un­con­trolled di­a­betes and high blood sug­ar.

Along­side the pol­i­cy shift, she said the TRHA is ex­pand­ing ser­vices across mul­ti­ple ar­eas, in­clud­ing phar­ma­cy op­er­a­tions, week­end ser­vices at the Scar­bor­ough Gen­er­al Hos­pi­tal and strength­ened ser­vices at Rox­bor­ough. Pri­ma­ry care ser­vices are al­so be­ing widened, with plans to re­store ser­vices in Char­lot­teville.

On staffing, Breb­nor said 129 reg­is­tered nurs­es are be­ing tran­si­tioned from con­tract to per­ma­nent po­si­tions, while out­stand­ing gra­tu­ity pay­ments are be­ing ad­dressed with sup­port from a $20 mil­lion al­lo­ca­tion to the TRHA. She said about 800 health sec­tor work­ers have been re­cruit­ed, and To­ba­go con­tin­ues to main­tain a stan­dard nurse-to-pa­tient ra­tio.

Breb­nor al­so stressed the im­por­tance of sup­port­ing health­care work­ers, say­ing the sys­tem must be built around staff well-be­ing in or­der to func­tion ef­fec­tive­ly.

She said while progress is be­ing made, the health sys­tem re­mains a work in progress as To­ba­go con­tin­ues to ex­pand ser­vices and re­duce re­liance on off-is­land spe­cial­ist care.