Ministry of Health
Health Sector Reform Programme of Trinidad & Tobago
 Bringing Health care closer to you !

  

  

 

   

 

 

 

 

 

Reforming the Health Sector: Where are We

 

Presented by Valerie Alleyne-Rawlins, Manger, Quality Management, Ministry of Health

 

Developed countries such as:

  • The United Kingdom
  • France
  • Australia

And developing countries such as:

  • New Zealand
  • South Korea
  • Japan

Commenced reforms in the mid eighties

 

CARICOM countries took the decision to introduce reforms at a Montego Bay Summit in the mid-eighties.

 

The leading causes of mortality showed:

Heart disease                                     -24.6%

Cancer                                               -12.4%

Diabetes mellitus                                -12.1%

Cerebrovascular disease                      -11.4%

Injuries                                               -09.2%

 

The findings of the HSRP studies can be summarised under 4 key headings:

  • Administrative inefficiency
  • Allocative inefficiency
  • Operative inefficiency
  • Quality

 

A new Mission Statement was developed:

The Ministry of Health is in the business of promoting wellness and ensuring the availability of quality health care to the people of Trinidad and Tobago in an affordable, sustainable and equitable manner.

 

This marked the departure from the old to the new with the Ministry of Health retaining responsibility for:

  • Financing health services
  • Policy formulation
  • Regulation
  • Monitoring and evaluation
  • Discharging essential public health functions

 

1. Establishment of New Structures

Such as:

  • Implementation Steering Committee (ISC)
  • Project Executive Team
  • New Organisational Structure for Head Office
  • Project Administration Unit

 

2. Management Systems Development

  • Re-engineered integrated management operating systems to effect the steering role of the Ministry
  • A rolling five (5) year Business Plan to be reviewed and updated annually
  • A purchasing / contracting system for monitoring performance, setting new benchmarks and ensuring best value for money
  • An effective financial management system to ensure greater accountability and fiscal prudence

 

3. Strengthen Primary health care and health promotion

·         National Emergency Ambulance Service

·         National Service with linkages to other established systems such as Fire services, St. John’s Ambulance Brigade and Private Sector Agencies

 

5. Information System / Information Technology

A comprehensive information system to support organisational processes including health informatics, finance, HR, quality, medical records, patient management and inventory management systems

 

7. Health Sector Financing

  • Introduction of a National Health Insurance Scheme
  • Development of a Population Registration System

 

Present Status highlighting Milestones:

  • New organisational structure for the Ministry developed
  • Purchasing / contracting system – ASA initiated
  • Policy and procedure manuals for Finance and HR
  • Strategic Plan for Nursing developed
  • Family Medicine programme commenced
  • Training Programme for District Health Visitors increased
  • Health Centre based Wellness programmes established
  • Strategy for Health Promotion developed
  • Health Promotion Council established
  • Health Services Quality Act and RHA bylaws developed
  • Quality Improvement Units established at 3 RHAs
  • Patients’ Charter developed
  • Risk Management System designed
  • Quality Control Procedure Manual for Radiology finalised
  • Twelve Oncology Nurses trained
  • Training programmes for Registered Nurses accelerated and numbers increased
  • Twenty-two Health Centre built / upgraded and commissioned
  • Policy framework for Community Care developed
  • Sector Policy for management of Chronic Diseases developed
  • Three District Health facilities built – 2 commissioned

 

Challenges:

  • Inadequate institutional capacity for:
    • Strategic planning and analysis
    • Health systems management
    • Policy formulation
    • Maintaining sustainable processes in the absence of corresponding management structures at RHAs
  • Outdated framework and systems for inter, intra and external communication
  • Seeming reluctance to introduce new systems and business processes
  • Inconsistent levels o stakeholder support
  • Dual track employment – RHA vs MoH

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