NCRHA Letter of Concern 1

The board of the North Central Regional Health Authority (NCRHA) will meet today to discuss a call by 11 doctors for the reinstatement of and an apology to four senior doctors who were recently transferred from the Couva Hospital and Multi-Training Facility.

The board’s meeting this morning will examine a call made by the 11 senior medical practitioners, who’ve insisted the board immediately do a probe into why the four senior specialist doctors were removed from the Couva Hospital recently.

“We look forward to your urgent action and to any dialogue which may be desirable and hope we can look forward to the correction of what appears to be a very serious default,” the 11 practitioners stated in their letter to the board on Tuesday.

The signatures affixed were from:

Dr Fareed Ali (acting head of Cardiovascular Services),

Dr Nazim Boris Mohammed (acting Head of Medicine),

Dr Barbara Rampersad (Head, Pediatric Surgery/Neurosurgery),

Dr Marlon Seenath (Head, General Surgery),

Dr Rheana Sieunarine (Head, Anesthesia and Intensive Care),

Dr Robbie Rampersad (acting Head, Radiology),

Professor AVC Rao (Head Diagnostic Laboratory Services),

Dr Camille Greene (HOD Paediatric Medicine),

Dr Curtis Young (HOD, Speciality surgery),

Dr Sushil Devarashetty (Head, PICU),

Dr Parmanand Maharaj (Former head, Radiology/Consultant radiologist).

The 11 called out the board on the issue of former Couva Chief of Staff Dr Don Martin, who was among four senior specialists at that COVID crisis centre, who were transferred by the NCRHA last week. Shifted along with Martin were Drs K Kernahan, A Maccum and S Mohammed.

In a press release on the issue, NCRHA CEO Davlin Thomas had said it was a rotation on the doctors’ request after consultation with NCRHA Director of Health Dr Malachy Ojuro. However, Martin subsequently denied this was requested, stating it was critical the existing team remained in place.

The letter sent by the 11 practitioners to the NCRHA board stated that “significant and disconcerting discordance still persists between the two narratives.”

They said they reached out to the board since the matter was of singular importance, involving the most experienced physicians in T&T in the care of COVID-19 patients at a time when their services are most desperately needed. They noted the Health Ministry’s acknowledgement of the current worst COVID wave and that T&T’s under a State of Emergency.

“We find it concerning in the extreme the NCRHA has decided to remove these physicians at this time,” they stated.

“Why were these doctors removed? Were their preferences taken into consideration?

“The wider appearance, including the inconsistent and confusing explanations proffered by the Regions, suggest that these physicians were removed without clear justification, against their will and with no thoughts as to the adverse impact on the wider public. The NCRHA and Dr Martin’s points are clearly contradictory.”

They noted the removal attracted wide adverse public comment, including from a current Member of Parliament, the T&T Medical Association and T&T Registered Nurses Association.

Given the impact of the decision on the NCRHA and T&T, the doctors felt it would be reckless not to pursue an independent assessment of why and how the action was conducted.

“We owe it to the physicians, who are nothing short of national heroes and we owe it to every citizen,” they said.

They pointed out that destabilising the delivery of health care to COVID patients has the potential to affect all patients and was of direct relevance and extreme importance.

In view of the information available to the public, they said they were also concerned about the treatment of their colleagues, “… And the possibility of defining a new status quo: is this how we ourselves can expect to be treated by the Region in the future?”

In light of all of this, the 11, who Guardian Media was told are attached to the Eric Williams Medical Sciences Complex in Mt Hope, said they were insisting:

1. That the board take immediate action to conduct an independent and transparent inquiry into why the physicians were removed and why the action was conducted in such a curious and undesirable manner. If wrongdoing is identified, a clear accounting delivered to the individuals responsible.

2. An apology to the physicians who were removed and an offer for immediate reinstatement so as to reduce any adverse impact upon patient care.

3. Clear feedback from the Region as to how it intends to engage with medical staff moving forward with reassurance that this sort of episode will not be repeated.

Their letter added, “As medical professionals, we continue to act in what we consider the best interest of providing public health care at a fraught and difficult time in our nation.

“We write this letter to the members of the board in the belief that they, as fiduciaries of the Region, share these values and will be motivated to investigate what appears to be a serious breach of the Region’s responsibility to prioritise patient care and secure wider public interest.”

The NCRHA board members are Steve de Las, Elvin Edwards, Randolph Clouden, Yvonne Bullen-Smith, Marie Ayoung-Chee, Stewart Smith, Dr Maria Bartholomew, Dr Keith Clifford, Anita Sohan, Kimoy Thomas and Kadeen Graham.

Yesterday, NCRHA CEO Davlin Thomas said since the board had received the letter, it would engage them and it was inappropriate for him to comment.

Board member Edwards, meanwhile, indicated that the board meets today and the letter would be discussed. Health Minister Terrence Deyalsingh did not reply to calls or messages yesterday.

Gopeesingh: PM must intervene

Prime Minister Dr Keith Rowley must instruct Health Minister Terrence Deyalsingh to meet the NCRHA to discuss what’s taking place, United National Congress member Dr Tim Gopeesingh said yesterday, adding he had received a copy of the 11 doctors’ letter on the recent transfer of their colleagues.

Gopeesingh said when doctors were demotivated and had an unpleasant working environment, their ability to work is relatively diminished. He questioned the health management ability of NCRHA CEO Davlin Thomas, whom he said was NCC deputy chairman and was manager for PNM’s San Juan election campaign.

”He’s a non-plus for health. So when he makes these moves, with the work these frontline doctors do, he’s destabilising the system.”

Gopeesingh was concerned Deyalsingh had said hospitals’ management stopped at his door and Rowley also echoed that. Gopeesingh said the appointments for RHA boards were done by the Cabinet, which Rowley headed and to which Deyalsingh belongs.

“The Cabinet should bring to account the RHAs, especially NCRHA.”

He noted the transfer issue’s occurred when T&T reached a dark milestone of COVID-19 408 deaths, and 7,000 COVID-positive patients at home, endangering others.

“This transfer situation is an uncomfortable one. Patient management’s at risk. We call on the Prime Minister to instruct his Health Minister to meet the relevant RHAs to discuss what’s taking place and come to logical conclusion to go forwards.” (GAIL ALEXANDER)