Motions
FULL VIDEO
REQUEST FOR THE EXECUTIVE COUNCIL TO TAKE IMMEDIATE AND APPROPRIATE ACTIONS FOR THE URGENT APPOINTMENT OF A T.R.H.A BOARD OF DIRECTORS
As I wrap up and as I finish this debate, Madam Presiding Officer, I want to finish as I started, which is to caution my Colleagues - we are not a law unto ourselves. We all took an oath to uphold the Constitution and the law. We all took that oath and many of us took it on the Holy Bible. Therefore, it requires us to live up to that oath of office. It cannot be that we can just decide to do our own thing - treat matters as we would want it to happen. Yes, you might have your own way, but until the law changes, we have no choice but to follow the law. Until we as an Executive lobby and get the autonomy that we deserve, and we can come here and make our own laws, we have to follow the law. That is all I am asking. So, the process has started as far as I am aware.
I also want to clarify and clear up something because this matter has nothing to do with the hardworking public servants; the hardworking healthcare professionals. What it has, is an Executive Council who continues to show Tobagonians that they just do not respect the law and I am asking you as I wrap up, let us fix this - follow the law.I thank you. [Desk thumping]
Madam Presiding Officer, at the end of the day, I have
been elected by the people of Tobago to speak on their behalf, so, I would continue to raise the issues on behalf of the people of Tobago. When I come here, I do not come here with any malice towards anyone, I come here simply to treat with the business and I will dispel those functions to the best of my ability. I do not come here with any personal grudge. When I leave, I go home to a beautiful wife (I have no issue) and I hug up and I love her up.I do not have an issue with nobody here. So my business, is the people of Tobago.
Madam Presiding Officer, it is just to show the kind of level of disregard for process and law that is happening in this space that is unprecedented. I would give way because the person asked me to raise it, so I will give way for the Secretary, if he so chooses, Assistant Secretary...
[Interruption]
In fact, I may have to make a call now because the process is now with the Cabinet. I was trying to get her to clarify the date upon when the Executive Council submitted these recommendations to the Cabinet. That is instructive and that is important because my information is, that sometime around September or so, the approval was had at the Executive Council level. Then, the Secretary thought she could have just gone and appoint the Board. It is only when she recognized, no she does not have that authority, she was forced to have to go through the proper process. She has come here to the House, once again misleading the House, giving the impression that she would have gone through the process, done the right thing and now it is the Cabinet holding back the process. Well, she asked me to make a call, I came here prepared - so I made the call since Monday and up to Sunday, I was told that there is nothing in front of the Cabinet. I want to repeat, there is nothing with respect to the appointment of the TRHA Board, in front the Cabinet. And that is why I was simply asking her - she said she sent it.Tell us the date you got the acknowledgement that your communication was received... [Interruption] [Crosstalk] some of you Lord! I sigh because sometimes I wonder if it is kids we are treating with in here. We are dealing with serious business, the life of Tobagonians and some of you all are thinking it is a joke.
Look, I just got a message that the Unemployment Relief Programme(URP)- they have not been paid.
It seems as if this Executive Council, the people who govern the affairs of the island, have no regard for the law and have no regard for order. Do you see how they are behaving? If as the governing Body, you have such disregard and disrespect for the law, what do you leave for the ordinary man; the ordinary citizen? It therefore begs the question, if you are not abiding by the law with these matters that are currently in the public domain, it leaves us to wonder what else is happening in the dead of the night behind closed doors, that we may not be aware of.
I want to remind this Administration, that in matters such as those outlined above, it is not for the discretion of a Secretary to decide whether she feels like appointing a Board or she needs time to appoint a Board. The law is clear - it is in black and white.
Section 4 (1) of the Act plainly says that there must, there shall be a Board of the TRHA to manage its affairs. It does not even mention the Secretary. Who it speaks to, is a Minister, so I do not know why the Secretary believes that she has discretionary privilege in this matter, discretionary privilege to the point that she would give a commitment in May. She said in a couple weeks that this Board would be appointed, and now she is coming to tell us today, that she got some kind of epiphany and she needed five (5) more months. Five (5) more months to do what? I listened and she was not able to provide any justifiable cause, why she needed five (5) months. Even if you are looking for the best, you are telling me that in Tobago, little Tobago with only about sixty thousand (60,000) people, it is taking you eleven (11) months to find about seven (7) good people to be on a Board?
Madam Presiding Officer, I do not know if they do not understand the legal consequences of this. I remind you that when you are looking at use of seal and you need seal to certify different contracts and those kinds of things, the law is clear. It says here, “the Board remains in overall control of the affairs of the TRHA”. Our advice is confirmed by section 11of the RHA Act which provides that:-
“The seal of the Tobago Health Authority (shall) must only be used with the permission of the Board of the Tobago Regional Health Authority. Matters for example, which require the affixing of the seal to bind the TRHA, require the approval of the Board.”
In effect, Section 4 (2) of the RHA Act which says that the affairs of each Authority shall be managed by a Board. It is not displaced by any powers given under the THA Act. So, all the quarrel and all the thing about who have the power, it is clear here - in black and white. It is the Board that is empowered under the Act, to treat with the management of the TRHA, not the Secretary. It begs the question, who employed the CEO? With the checks I have made, I was told that there was no formal contractual arrangement made before the last Board demitted office. So, is it that the Secretary would have taken up responsibility upon herself? She made the point that for about three (3) years, if you add total sum of the PNM being in power, they would have had Board lapsed and they had many acting CEOs, but that was for this very specific reason, because the PNM understands the law. The law is clear, that once you do not have an effective Board, once you do not have an appointed Board, you just cannot take it upon yourself to appoint a CEO. So, what would you do? You would provide a short-term arrangement - you would have acting CEOs. But what we have here, is a Secretary who decided or believed that she had super powers and she has given to the CEO, an appointment that she does not have the power to so do. So, we have the TRHA operating illegally and perhaps, we now have a situation where even the CEO is appointed illegally. That is why the focus on this debate, is not so much that you are going to appoint the Board or the Board is in the process of being appointed, but is to highlight to Tobagonians, that what we have currently in front of us, is an illegal operation. The CEO is operating illegally. We have the Secretary operating unlawfully, because she has admitted that in the absence of a Board, she has her Administrator signing on behalf of the TRHA. I know my learned friend who was a former senior public servant, may have something to say on this. [Laughter]
Madam Presiding Officer, you may skin your teeth, but this is serious business; this is a serious, serious matter and I am disappointed at the Secretary who would have come here and trivialize it as, well, you know,this is something that we could just carry to the court and let the court decide. This is big. The Secretary - and I want to clear this up, because she made the point that they have already started the process.
Well, since the Minority Councillor was not given the time, I would read it for her, because I would ensure that we spend the time to do the people’s business. (They are not getting to run off here today).
As citizens, when we sit and observe what is happening and it suggests procedurally, the current Executive Council is either not mindful of the law and regulations of the land, or it seems as we are seeing here, that they just do not care. Look at all that is happening on the island in the recent past. There are several examples where this Administration is running afoul of the law - building a stage on the coastline with no proper regulation, no proper approval...
Madam Presiding Officer, I rise to conclude this debate. It is clear that on that side, they are more interested in feting, in liming and in breaking the law, than dealing with the people’s business. I feel it for some of the Members, because I know there are some who genuinely care about the people of Tobago. So, we are here - we come here once every month and you are telling me that we have only spent three hours in this House, and people are so busy to go down and fete down by ‘Burna Boy’, and fete in whatever all-inclusive and fete all over, that they cannot spend ten minutes extra time to allow the Minority Councillor to elucidate her points? We are talking about TRHA which is the health care service provider on the island, that is the difference between life and death, and this Administration does not see it important. They want to run off. We have only spent three hours in here. What did they think it was when they took up the opportunity to come and serve the people? What did they think it was? They thought it was gimmick or they thought it was child’s play?
Thank you, Madam Presiding Officer, thank you to Colleagues for extending the time.
Additionally, Madam Presiding Officer, who is currently reviewing and monitoring the allocation to ensure that it is being spent appropriately? This is one of the functions of the Finance Committee of the Board, and therefore, to ensure accountability and transparency of the financial resources of the Tobago Regional Health Authority, the Minority is making an urgent appeal for the Board to be appointed immediately.
Madam Presiding Officer, the final Committee that I want to look at,is the Human Resource or the HR Committee. This committee provides guidance on the human resources management and reviews, monitors, and makes recommendations to the Board of Directors on matters of human resource strategy and the policies. If we look at it from a disciplinary point of view, and we consider the conduct regulations of the Regional Health Authorities, the question now arises, how are we currently dealing with these matters? Again, Madam Presiding Officer, I go back to the Regulations; I go back to the Act. So, the Regional Health Authorities’ Conduct Regulations 2008, under Section 35 sets out the procedures for disciplinary action.
Section 21 states:
“Where an allegation of misconduct is made, the Chief Executive Officer shall:
DANIEL-BENOIT (Cont’d)
(a) In addition to making a report as required on Regulation 20 (1) inform the employee in writing of the allegation; and
(b) Forthwith refer the matter to a neutral employee to investigate the matter.
(2) It says the employee referred to in sub regulation 1 (b) shall be a senior employee against whom the allegation has been made; and
(b) employed with the same authority.
(3) It outlines who the investigating officer is
The Investigating Officer shall:
(a)give the employee written notice within three (3) days of his appointment, requiring him to give a written explanation concerning the allegation within seven (7) days from the date of the receipt of the notice;
(b) shall require those persons who have direct knowledge of the alleged misconduct to submit written statements to him within seven (7) days, shall submit to the Board all original statements, explanations, relevant documents and his report of the investigation within forty (40) days of the appointment; and
(d) may be granted an extension for a period of up to thirty (30) days by the CEO, to submit the report.
Section 22
(1) The Board shall decide whether to lay a charge against the employee with misconduct after considering the report of the investigating officer.
(2) Where the Board decides to lay a charge against the employee,the Board shall give him/her written notice of the charge together with the particulars of the allegation on which the charge is based within seven days.
23 (1) the Board may appoint a disciplinary tribunal to hear and determine any charge of misconduct made against an employee;
(2) says:
“The disciplinary tribunal shall consist of (a) one person, or (b) an uneven number of persons be no more than five, three of whom shall be employees of the Authority or members of the Board;”
and 24 (1)speaks to:
“An employee who is charged with misconduct, shall be requested to admit or deny the charge and give an explanation of factors in mitigation to the Disciplinary Tribunal or the Board within a specific period.”
24 (2) says:
“Where the employee makes an admission of guilt in his explanation
on the sub regulation 1, the Board may determine the penalty to be
imposed without further inquiry.”
Madam Presiding Officer, again and the conduct continues to deal with disciplinary action. Based on the Act, there is no mention of the role of the Secretary of Health in dealing with matters of discipline to staff.Madam Presiding Officer, it has come to the attention of the Minority,that staff is being hired and fired at the Tobago Regional Health Authority.Who is approving the engagement of these persons hired? Who is given the authority for persons to be dismissed?
The Minority is also advised that there are a number of senior managers, as well as doctors who were interviewed and yet to be engaged,obviously, because there is no Board in place to approve the appointment of these senior managers and doctors. The engagement of the appropriate personnel is very important to the provision of efficient and quality health care; because these are critical positions and they have not been filled, there are several complaints (I would have heard of some of them) by citizens and there are seemingly efficiencies in the system.
So earlier this week, Madam Presiding Officer, we heard that a family in the East, went to the Roxborough Hospital to deliver a baby, (the mother was in labour) only to be told that delivery cannot happen at that facility. This was compounded by the fact that there was no ambulance at the facility at the time. The father anxious and confused, now had to rush his wife to Signal Hill in the Scarborough Regional Hospital. The child was almost delivered on the way, Madam Presiding Officer.
This Administration, (I do not know what they are called) promised to fix it. They promised to fix health care on the island and this is definitely not fixing it. Waiting time in the Accident and Emergency Department in the hospital seem to have increased.
Another incident was reported where an elderly man, a senior citizen,was waiting in Accident and Emergency for two (2) days; it was reported Madam Presiding Officer. He was sitting on a chair. He could not be warded because there were no beds available. The report was that because the Department was short staffed also, he was waiting on a chair for two (2) days, Madam Presiding Officer.
Member, you have approximately eight (8) more minutes of speaking time. However, it is 4.30 p.m. and we are supposed to break at this time. So I am going to ask if anyone is going to extend, are we going to sit until we have concluded this afternoon’s proceeding or are we going to decide as a collective that we are going to break for refreshment and come back?
Who will therefore set the financial priorities of the TRHA? Madam Presiding Officer, when this Administration came into office, the Chief Secretary was on record saying that they will do a reallocation or reprioritization of the financial resources. In the case of the Tobago Regional Health Authority, who would have authorized and approved the reallocation then of the finances of the Tobago Regional Health Authority?
Additionally, Madam Presiding Officer... [Interruption].
Madam Presiding Officer, I want to now turn my attention to the work of the Tenders Committee of the Board. Under the Regional Health Authority’s contracting - and all these things that I am quoting, Madam Presiding Officer, is an Act of Parliament - they are the law. So the Regional Health Authority’s contracting for goods and services Regulations part 2, section 4, provides for the establishment of a Tenders Committee.
Section 4 states:
“A Board may establish a Tenders Committee for the purpose of inviting, considering, accepting or rejecting offers in excess of one hundred thousand dollars ($100,000.00) for the supply of goods or the undertaking of works or services necessary for carrying out the objectives of the Authority and for the disposal of surplus or unserviceable goods.”
Is the TRHA currently accepting or rejecting offers in excess of one hundred thousand dollars ($100,000.00), Madam Presiding Officer, for the supply of goods and services? And if yes, who is approving it, Madam Presiding Officer, and under what authority are they approving these expenditure in excess of one hundred thousand dollars ($100,000.00)?
We hear about the cataract clinic. The persons engaged to do the cataract surgeries, are they engaged for free? Who has authorized that expenditure, Madam Presiding Officer? If we consider section 6 of the Regional Health Authority contracting for goods and services regulation, it
states:
“A Board or a committee appointed under regulation 4 shall:-
(a) Determine whether an invitation to tender should be public or selective and in the case of selective tendering, determine which person or business entity should be invited to tender.
(b) Establish such evaluation committees as it considers necessary.
It says:
“The Board of a committee appointed under the regulation shall...
It goes on to 2:-
“A Board or a committee may by process of selective tendering, purchase goods worth or services for use by the Authority where: -
(a) There is a limitation of sources of supply of the goods or worth of services;
(b) The goods are spares or replacements and parts for other goods or form part of a system already in use by the authority;
(c) The goods, works or services are (and it has):-
(i) Propriety or speciality products;
(ii) Supply or dispose of on a repetitive basis; and
(d) Such goods form part of the Authority’s inventory of stock items, the replacement of which is repetitive and cost effectively negotiable at each point of replenishment.”
Madam Presiding Officer, section (3) (and I am quoting here from the
Regulations says:-
“Where the Committee appointed under Regulation 4(1) proposes to award a contract, the value of which is one million dollars ($lm) or more, the Committee shall seek the prior approval of the Board, but no committee shall, for the purpose of avoiding the stipulations of the sub-regulation, sub-divide the quantity of the goods to be supplied or
the works or services to be undertaken into two or more portions so that the value of the portions is less than the one million dollars
($lm);”
Finally, sub-section 4 says:-
“The Board with the approval of the Minster, may by Resolution, vary the limit of one million dollars ($lm) given in sub-regulation 3.”
Madam Presiding Officer, has the TRHA over the past eleven (11) months engaged in any award of contracts in excess of one million dollars ($lm) in the absence of the Board? Under what authority were those contracts awarded? Are the contracts or the service providers properly engaged, Madam Presiding Officer? There are more questions than answers.
Section 9 of this Regulation provides for emergency cases and it reads:
“In the case of an emergency, the Chairman or in his absence, his alternate Board member of the Tenders Committee, or in the absence of them both, the Chief Executive Officer shall be empowered without inviting tenders to authorize the award of contract for the supply of any goods or undertaking of any works or services necessary for the expeditious handling of such emergency, the total cost of which does not exceed three hundred thousand dollars ($3 00,000.00) and when any such action is taken, it must be reported to the Board or to the Committee at the next succeeding meeting.”
So, Madam Presiding Officer, the Regulation provides for emergencies, however it must be done within the ambits of the law and under the premise that a Board is in place. This is another example where the TRHA is operating outside of the law and therefore, has opened up itself to serious litigation.
Madam Presiding Officer, I want to move on. So now I turn to the Finance Committee of the Board, and the purpose of this committee is :-
“To assist the Board of Directors in fulfilling its oversight responsibilities with respect to the financial viability and the financial stewardship of the TRHA and related matters.”
There are a number of responsibilities of the Finance Committee, but I will just identify a few:
“To study and recommend to the Board for approval, a business plan and detailed budget for the capital and operating revenues and expenditure for the ensuing fiscal year;
To study the detailed financial statements on a timely basis and report thereon to the Board;
To advise the Board with regards to donations and endowments;
To review and provide advice on major transactions of corporate projects that are presented by management.”
Are there any projects that were presented that are currently being undertaken that has not been approved?
“Semi-annually, review and approve the travel and other expenses incurred personally by the CEO and the senior management …
(note, all expenses of the CEO must first be approved by the Chair or the Deputy Chair).
...prior to reimbursement being processed by the Finance Department of the TRHA.”
Madam Presiding Officer, we saw only maybe a month or so ago, where the CEO was on overseas travel. Who approved that, Madam Presiding Officer?
“Ensure procedures are established and maintained for the receipt, retention and treatment of complaints reviewed by the TRHA regarding accounting internally;
Inform the Board on financial matter.”
Madam Presiding Officer, there are a number of roles and responsibilities of the Finance Committee as I would have indicated. So, we understand and it is easy to understand why the work of the Finance Committee of the Board is so extensive, because if we consider the allocation of the TRHA, it is one of the largest line items on the Estimates, and for instance, in fiscal 2022/2023, it accounts for actually approximately seventy-five percent (75%) of the Division of Health’s allocation, and this is a recurrent allocation.
So, in fiscal 2022/2023, the recurrent allocation for the TRHA amounted to seventy-five percent (75%) of the Division of Health’s recurrent allocation. If we break it down into dollars and cents, the revised recurrent allocation for 2022, was six hundred and ninety-nine point five four six million dollars ($699.546m), with the allocation for the TRHA being five hundred and twenty-five point seven two eight million dollars ($525.728m). For fiscal 2023, which is the current fiscal that we are in, the Division’s recurrent allocation is seven hundred and thirty-nine point eight four three million dollars ($739.843m), while the allocation for the TRHA, is five hundred and fifty-six point eight million dollars ($556.8m). So, in the absence of the Board and the Finance Committee, who will approve, who has approved, who is approving the budget for the operating development and capital expenditure of the Authority?
On Thursday May 26th, 2022, at the Sixth Sitting, the following question was filed under my name to the Secretary of Health, Wellness and Social Protection. The question reads:
“As it relates to the Tobago Regional Health Authority, Section 4 (2) of the Regional Health Authority Act, provides that each Authority shall be managed by the Board of Directors.
Can the Secretary indicate the timeline for the appointment of the Tobago Regional Health Authority Board of Directors in keeping with the THA Act?”
And the response of the Secretary was:
“The new Tobago Regional Health Authority Board will be announced in a couple weeks.”
Madam Presiding Officer, the last time I checked, a couple was still two (2). We are now at the Tenth Sitting on October 27th, 2022, five (5) months later, and the Board of the Tobago Regional Health Authority (TRHA) has not been appointed. For eleven (11) months, Madam Presiding Officer, one month shy of a year, and the TRHA is still without a Board. Madam Presiding Officer, I find this very disturbing and disappointing, to say the least.
Under Section 4 (2) of the Regional Health Authorities Act No. 5 of 1994 amended by Act No. 8 of 2012. It states:
“Each Authority shall be managed by a Board of Directors.”
The operative word is ‘shall’.
Madam Presiding Officer, in her presentation, the Secretary would have indicated that Boards in the past would have made decisions that in her opinion, were not right decisions. But Madam Presiding Officer, that does not debar you from abiding by the law. It says it shall be managed by a Board, and ‘shall’ meaning mandatory; it is not subject to discretion.
The Act continues in Section 5(1) and it says:
“Subject to subsection 2, a Board shall exercise its powers and functions in accordance with such specific or general directions as may given to it by the Minister.”
We had a debate a while ago, whether if the THA Act is subject to the RHA Act. Yes, subsection 5 (2) recognizes the institution that is the Tobago House of Assembly, and as such there are provisions in the Act to address same. Therefore, Madam Presiding Officer, subsection 5 (2) states:
“In the exercise of its powers, the Board of the Tobago Regional Health Authority is subject to the provisions of the Tobago House of Assembly Act.”
Madam Presiding Officer, the question has to be asked, in the absence of the Board, who is overseeing the health care system and the delivery of health care services on the island? With no Board in place, Madam Presiding Officer, who has the legal authority to so do? It may appear that the TRHA may be operating illegally for the last eleven (11) months, since the last Board demitted office.
Madam Presiding Officer, Regional Health Authorities are creatures of the Health Sector Reform Programme, designed to strengthen the health sector’s policy making, planning, and management capacity, as well as separate the provision of services from the financing or the purchaser. In this instance, the Tobago Regional Health Authority is the service provider, while the Tobago House of Assembly or the (THA) is the purchaser. The Act therefore seeks to create RHAs as a semi-autonomous Body, or as it states in Section 4(1):
“A body corporate devolving service, delivery, and management to Regional Health Authorities to bring cost-effective solutions; establish new administrative unemployment structures that encourage accountability and increase autonomy, among other objectives.”
If this is what the Act seeks to do, how can these objectives be achieved in the absence of the Board? How can this be achieved, Madam Presiding Officer, when the Chief Executive Officer (CEO) is reporting to the Secretary of Health? When the Secretary is bogged down with the day to day operational matters of the TRHA, where is the time to provide policy direction, visioning and establishing the priorities for the health sector in Tobago? Who sets the standards, Madam Presiding Officer, and monitors the achievements of these standards when the CEO is reporting to the Secretary? It should be the Secretary who provides the policy direction and monitors the agreed upon standards. The Board manages the implementation of the policy through the CEO. The CEO operationalizes the strategy and is accountable to the Board, who in turn reports to the Secretary, providing a clear separation of roles and responsibilities. Madam Presiding Officer, if you consider the composition of the Board, it is set up in such a way to facilitate the efficient management of the RHA.
Schedule 2 which speaks to the constitution and procedure of the Boards of the Regional Health Authority, sets out how the Board should be appointed and who are to be selected members of the Tobago Regional Health Authority or Regional Health Authorities.
Further, Madam Presiding Officer, under the said Section 13 (1):
“The RHA Act empowers the Board to delegate to a committee, any of its powers and functions concerning the delivery of health care including staff related matters.”
As such, Madam Presiding Officer, the Tobago Regional Health Authority would have appointed a number of committees, be it planning, tenders, finance, quality, mental health and human resources. And Madam Presiding Officer, I want to consider a few of the committees (not all).
Firstly, I want us to look at the Audit Committee. The purpose of this committee is to assist the Board in fulfilling oversight responsibilities with respect to integrity of the Tobago Regional Health Authority’s (TRHA’s) internal procedures, financial statement reporting and on compliance with legal and regulatory requirements, as well as risk management, among other responsibilities given by the Board to the Audit Committee.
It must be noted, Madam Presiding Officer, that in this instance, the Internal Auditor has dual reporting responsibilities - so the Internal Auditor reports to the CEO on administrative matters, while at the same time reporting to the Audit Committee on oversight. This is done in such a way because the Internal Auditor is employed by the management yet reviews management’s conduct. Therefore, to maintain a level of independence, the dual reporting relationship is necessary. So as I indicated on matters of an administrative nature, the Internal Auditor reports to the CEO and for strategic direction, reinforcement and accountability, the Internal Auditor reports to the Audit Committee.
The Board of the TRHA approves the work programme of the Internal Audit Department;
The Audit Committee reviews the findings and the recommendations of each audit conducted and it reports to the Board;
The Audit Committee also reviews and monitors management’s responsiveness to the Internal Auditor’s findings and recommendations.
Madam Presiding Officer, what is currently happening with the work of the Internal Audit Department in the TRHA? Who is currently reviewing the internal audit reports? Who is reviewing and monitoring management’s responsiveness to the internal auditors’ findings and recommendations,Madam Presiding Officer? The fact that the Secretary indicated that there were seven (7) periods that there was no Board in place, and when they were on the Minority side they said nothing or did not bring a Motion of the sort, it means that there was a dereliction of duty on their part and they were not doing what they should have done. [Desk thumping]
Thank you, Madam Presiding Officer, for the opportunity to contribute in this debate, where the Minority seeks to have the Executive Council take immediate and appropriate actions towards the urgent appointment towards the Tobago Regional Health Authority Board.
Madam Presiding Officer, my contribution today will focus on the roles and responsibilities in the main of the committees of the Board and the importance of such committees in the oversight and management of the organization.
I am not on qualification, but I have a Master’s in Employment Law and one of the Employment Law, is that you learn to understand words, any kind of law; you have contracts, etcetera. What that simply means and I read it earlier -1 took some time off to explain it.
Under Section 25 of the Tobago House of Assembly Act, sub-section 3 speaks about how we are subjected to the THA. But my good friend as a teacher who always sleeps in class, continued to sleep while the class was taking place. Let me just emphasize for clarity again.
“Where a Statutory Authority or state enterprise provides services in Tobago, the RHA, ...
(I repeated it about four times, but they were sleeping. That is their practice. That is why they are no longer there - sleeping)
...that Authority or enterprise shall in exercise of its duties in relation to those services, act in accordance with the policies or programmes of the Assembly.”
At that time I chided the Assembly for not creating any policies or
programmes. Let me drop it like it is hot. [Crosstalk]
Point of clarification to the Member for Roxborough/Argyle - RHA Act, part 2, section 5, item 2:
“In the exercise of its powers and functions, the Board of the Tobago Regional Health Authority is subject to the provisions of the Tobago House of Assembly Act.”
So, I think you need to withdraw your statement, kind Sir.
I think that he has misguided and misled not only the House, but the people of Tobago and I think that reading, reading, reading is important here. It clearly stated... [Crosstalk]
Thank you, Madam Presiding Officer. I rise on Standing Order 44(b) to the Member for Roxborough/Argyle, to elucidate some matters raised by that Member during the course of his speech, where the Member was speaking - of course he spoke before, but I would like to bring some clarity. We are in the House and of course, this information goes on the Hansard. He spoke to the fact that the THA Act and the TRHA Act are on par. I wish to bring some clarity to that, Sir. [Crosstalk]
When I was on that side, I was living a lie, but on this
side, I bear true witness to the people of Tobago. Something is wrong with that side. I thank you, Madam Presiding Officer.
The motion today is a serious one. It is something that we should just vote on, and Minority Leader, thank you for the push. Not that they needed it, but at the end of the day, they also needed it, because there is no way that the public would have known what is going on with the Board, because they are operating in silence, as if it is a private organization; as if it is some kind of secret society that they are running. This is a democracy. [Crosstalk]Like you share the clothes with the Member across there - pure gangster; no wonder that I am on this side. But I must say that I miss my friends; I miss my brothers and my sisters who are on that side.
Thank you very much. I know the Minority Leader would extend my minutes if I so desire, because he understands when good talk is being made on the platform. It is amazing to understand we campaigned - my Colleagues, my brothers and sisters who are around me, on that side, this side, and wherever they are, because I recognize that the shepherd has not come today. He has left the sheep to wander in the wilderness. I recognize the shepherd is not here today. Madam Presiding Officer, we campaigned;we all campaigned and my good friend, Dr. Faith B.Yisrael,Member for Belle Garden/Delaford, knows fully well. We said that instead of flying people out, we are going to fly specialists in - it is cheaper. It is cheaper, so why aren’t the doctors and nurses who deal with trauma and those people who put people to sleep and all those blood transfusionists; all those technical names, why are those people not housed within the vicinity of the Roxborough hospital? Why are we not prepared for any foul play? That is the role of the Board. If we had a good Board, then they would have created policies and they would have directed the operation of that place, but what we have going on here, is someone who is not even a medical doctor - just has a love for medicine and doctor business, sitting on top there and making all these decisions for like eleven months now, and they are comfortable with that. I beg this House to understand that we are in a situation; we are in serious problems because what we campaigned on, we ought to be delivering.
They spoke about eye surgery in Roxborough. Imagine I am the Representative for the district and no one has written to me officially about eye surgery for Roxborough and to enquire if there are any members within my constituency who may require eye surgery. That is what is going on - a law unto themselves, who built themselves a tower without any windows; they have blocked it up shut and they are getting high on their own fumes.
You could imagine, Madam Presiding Officer, they have employed people in the Roxborough ‘hospital,’ and no one said to the Assemblyman, “Look, we have employment here, what about persons in your district, do they want jobs?” - not one word. The Board who is responsible for hiring people, would have assisted in that, but there is no Board and they are busy plugging all the holes themselves, because they want nobody to have control.
The THA is operating illegally. I want to put it in the Hansard, that the THA is operating illegally and you all have to stop it.
I stood on the side and I somehow like this side [Indicating] because this is a side of truth. See them across there, there is something about that side across there. When you go across there, it is lies and more lies and more lies, and lies with a smile. I am not saying that those across there are liars...
It is like a merry-go-round; it is like in Walt Disney - your head gets dizzy. People get sick just from travelling from Scarborough to Roxborough and Roxborough to Scarborough. Countrymen do not get sick, but town people do get sick - just going up like that; too much corners, and whereas we are supposed to be self-sufficient, we have a situation where we have to run to town or fly to town, because when you check out the cost of a helicopter ...
The Executive cannot hire him. The TRHA Act says how he should be hired, and he has to stick to that. Good point by the Minority Leader. He must take a little feather in his cap for that - he raised the point; he saw it. So many degrees on that side; more degrees than a thermometer and they could not see it, or maybe they saw it and are pretending to be blind.
I know that Brother Wasp would have seen that. He is a grounds man; he is a linesman. He knows when something is out of line; he knows when something is foul. He knows foul play. My Brother Wasp, he knows foul play. On that side they cannot laugh; they told them that they cannot laugh. On that side they say, “Hold one head”.
Reminds me of a story I watched one time. It was a painful story but a real story of an American preacher (very persuasive) who took a whole number of people and carried them to Guyana, to a place called Jonestown - built a beautiful place. When the time was going against him, he mixed cool aid with a dangerous substance, and he told them to drink it. Most of them drank it blindly, because they believed in him. I want to say to my Colleagues in this House, that no matter how pretty something looks, no matter who tells you to drink it, examine the contents. Self-preservation is the first thing.
I charge my Colleagues today, that the Board has to be in place now. Any act done by the purported CEO, is illegal. There is something called The doctrine of necessity’. We understand that. The place needs to run. That is why you have the old Board there. That is why you should have told the old Board, ‘Hold on, you cannot leave; you remain there; you cannot leave’.
Could you imagine us trying to have the THA without a Presiding Officer and saying that we must talk, even if she goes out, and the Deputy Presiding Officer is not there - let us talk because we are intelligent? Could you imagine that? It is illegal. You could imagine a CEO operating without a Board? Well I can tell you the result of that. When I wrote to him - no response. I wrote to him again - no response. I asked him about basic policies; I wrote to him again, and that time I brought it to the Executive Council’s attention that ‘aye’, I wrote this man trying to get information and got no response. Do you know what they said in a meeting? I tell you, I believe some of these people are in a place liken to Jonestown; a place where there is a religious leader leading them, giving them something beautiful in a bottle, telling them to drink it. Some of them are consuming it, killing themselves and the nation. They said to me, at the meeting, that I should write the Secretary. But where is the Board? If there is no Board, the only person who has any legality to be on the Board is the CEO, because the CEO is a defacto member of the Board. He cannot vote, but he can be there at any Board meeting; he can contribute. I do not know that a Secretary could be there. There is no Board. The closest thing to the Board,is the CEO managing himself, or the ‘purported CEO’. That is the kind of trouble we have.
Let me tell Tobago this. When we think about the composition of the Board, the Board’s composition is not up to the THA. It is defined again by the RHA Act. These things are legal. It says that you must have someone in there who represents the public interest, yes, and their welfare - basic people, a man on the street; a street man, representing them.
Then it says also, it must have:
A Registered Medical Practitioner;
A Registered Nurse;
A THA employee;
and you must have specialists in the areas of:
Finance;
Accounting;
Economics;
Business Management;
Personal Management;
IR which is industrial relations and law, or any other thing.
It is a well composed Board that will present the best feedback on any issue. I hope that whatever they present, reflects that. Trinidad and Tobago has forty-five (45) State Boards. We have the Tobago Regional Health Authority (TRHA) for which we are responsible, and that one that we have responsibility for, is left without a Board.
Studley Park is that State Board, right? That is a Board created by THA. It is a different kind of Board. That is a ply board. That is what you call the Studley Park Quarry. It is a ply Board. You see the TRHA? That is what you call ‘Green Heart Board.’ That is what we called a Board. It is a Board that ought to be dealt with and treated specially. To my friends on my side I would say, (I almost said the other side) but to my friends and my brothers and my sisters on that side, let me tell you how we are reeling from lack of the State Board.
Because there is no State Board, the dogma that says we have ahospital in Roxborough continues to run. We are having media presentations ever so often, etcetera, etcetera, etcetera. Yeah, Madam Presiding Officer, fooling the people of Tobago as if we are illiterate, when the Scarborough General Hospital is way superior than the Roxborough Hospital. The Scarborough Health Centre is superior to the Roxborough so-called hospital.Why? There are no specialists operating in the Roxborough so-called hospital. There is a retired gynecologist there; (he is a good man, but retired) who they brought back, yeah; that is the specialist. There is no anesthetists or whatever you want to call it; the man who puts people to sleep. There is no transfusionist; the man who takes the blood and put blood inside of you, in case you need blood. There is no specialist for mental health there. The specialist doctors are not there; just House Officers doing their day to day jobs.
They claim that they open from 7.00 a.m. to 7.00 p.m. Yesterday I spoke to a mother who was grieving. She said that her granddaughter was sick and she took her around 5.00 pm to Roxborough and they said that there was no doctor there - the doctor gone! Could you imagine that? Where is the doctors’ quarters in Roxborough? Roxborough is far from Scarborough.
Where is the doctors’ quarters that we are saying the doctor for this area resides here? Those are the responsibilities of the Board. The Board would have fixed those things. Where is the nurses’ quarters? I could show you. It is opposite what we call ‘courtyard.’ The galvanize sheets are flying off and cutting power lines ever so often; totally derelict building, and they refuse to fix that building up. It once was a home to nurses who worked overnight at the health centre, to keep Roxborough and that entire Eastern region well protected it. There is none now. That is the role of the RHA Board - to ensure that doctors are housed, nurses are housed and other specialist persons are housed, but there is none there.
We need an RHA Board to create a Dental Department. The Roxborough Health Center, has a dental department - no dental services taking place up there right now. A man cannot even take out a rotten tooth.Those are the kinds of problems.
Madam Presiding Officer, we are just under-staffed at Roxborough.They treat it as a glorified health centre; big, big building, but their operations are likened to that of a health centre. If there is a serious accident, those persons involved will have to be taken to Scarborough. You cannot sedate them; you cannot put them to sleep and operate on them right away. If they go to Scarborough,Scarborough itself is in a bad condition.
You might have to fly them out to Trinidad when thing gets serious. The journey from Roxborough to Scarborough is not an easy one. You have to fly pass, four (4) traffic lights and you have to turn seventy-three (73) corners. I checked them myself.
That Authority states that the Board shall employ the Chief Executive Officer - not the Secretary, not the Executive Council. It is illegal; that is illegal and some ten, call it eleven months, ‘witherhenof months after, she comes here strutting her stuff as if she has done what she can do. Not good enough! Where was the one hundred (100) day plan? Where was the emergency situation we entered here during a pandemic? We did not enter here on a nice ship, joyriding. This was a pandemic. People were dying; the morgues were piling up; people could not get the right kind of assistance; persons were dying under the tents. We were in a quandary; people were pulling out their hair. That was when we needed the Board, but that was when the Board was not yet and still we do not know when they submitted the request. It did not say; at least I did not hear.
Madam Presiding Officer, this is a House and ought to be the House that represents Tobagonians. I cringe; I shudder in my boots to sit here and listen to how we trivialise issues of health.
Let me tell you something. The RHA Act I remind you, is not beneath the THA Act. They are on par - both of them are statutory laws. One cannot conflict with the other because the laws of Trinidad and Tobago prevent that. The RHA Act deals with RHA specifically and it has to be adhered to. So, even in the RHA Act they make mention where they were pulling persons for the Board and they said one member must have local government experience, etcetera; they said except for the Tobago House of Assembly. This is because they understand it is different in the Tobago House of Assembly, but what they were trying to say, is that one of the members on the Board should have to have the experience of the governance bundle, where within finds itself. That is why these are called Regional Health Authorities - one down in the South, because the people there are a little different; one up North - the people there are a little bit different; one in the East and one in Central (they all appeal to a specific demography - that is the whole purpose of it) and one in Tobago. So let us get things straight. Let us understand that this is not a joke; this is not about whether they did this or they did that, or people are getting money or not - irrelevant!
My question today is, who will be held accountable? Not the Secretary - she cannot be held accountable by law, though she wants to be a boss. She is a boss maybe, for those who are spraying the roads for insects; those who are cutting the roads - for those persons, but she is not a boss for the RHA. The RHA is clear - the boss for the RHA, is the Minister of Health and this is why before they could even approve the Board, it must have the Minister of Health’s blessings and the Parliament’s blessings. But they must come through the Minister of Health, must. If he does not see it, it cannot go anywhere. Let us understand our role. That is what it means to live in a country where you are a ‘ward.’ I want you to understand that. Some of my Colleagues on the other side - God knows I love them, but at just different levels of the game - we are simply a ‘ward’. It means that there is nothing that we can do without Trinidad supervising or stamping it. So, you find health services under the THA - under section 23 (you will find health services). Look at Schedule 5, the 23 rd matter - health services - not the TRHA - health services - spray for rats; spray for mosquitoes; cut the bush - keep it low. Those kinds of things - health services.
What speaks to the RHA, is section 25 of the THA Act. And 25 sub section 3 states:
“Where a Statutory Authority (and I am going to skip some words) or
state enterprise provide services in Tobago as the RHA, that Authority or enterprise shall, in exercising its duties in relation to those services, act in accordance with the policies and programmes of the Assembly.”
(taking care of people, ensuring that that is provided for - whatever, whatever, whatever; it might be making babies, whatever, that in exercising its duties)
.. .in relation to those services, act in accordance...
(this is the important part; this is the part where the THA has a role; this is the part where the good Secretary and the Chief Secretary and my Colleagues - we all have a role)
.. .with the policies and programmes of the Assembly.”
Let me drop it like it is hot, because we have an Assembly that is playing who could take the best camera pic, while they are ignoring the necessary policies [Desk thumping] or programmes that are required to run the health system. That should have been a one hundred day activity.
Where are the policies? Now we are hearing about TRHA Governance Plan.
What are the policies?
Madam Presiding Officer, the role of the THA - because the problem we are having with the absence of the Board, is not that of the Secretary. I would not blame the Secretary even though she may be guilty; I will not blame the Secretary. I am blaming the Tobago House of Assembly for that.
All of us are guilty, including myself, all of us are guilty. You see the roles and responsibilities of the Assembly, under section 25 (1), says:
‘Without prejudice to section 75 (1) of the Constitution, the Assembly shall, in relation to Tobago, be responsible for the formulation and implementation of policy in respect to the matters set out in the Fifth Schedule.”
What are the policies? What are the policies that this new THA has made regarding health? What are the types of discussions we are having at Executive meetings? What are the types of discussions that we are having within the various Divisions? Are they lending themselves to the formulation of policies, or are we now trying to come up with some TRHA Governance Plan that is being reworked by the THA? You see, there cannot be any TRHA plan without a Board in place, because the Board has the wherewithal to treat with these issues, unless the THA is having some specialists do some consultation and provide some report, but even that the Board is the one which is responsible for the TRHA.
Let me give this example. When I once occupied the position of Deputy Chief Secretary and I was told that I have responsibility for monitoring the policy and evaluating it, (of all Divisions) I had cause to pay attention to what was going on in Health. Understanding that there were no Board there, Madam Presiding Officer, I decided to write the CEO, only asking him to present the obvious. I asked, what are your policies on sick leave; what are your policies on vacation leave; what are your polices for grievance handling, etcetera.
Madam Presiding Officer, in a different incarnation, I was the President of the Public Services Association and I know those policies, but I must divorce myself from what I know and pretend I don’t know and ask for those policies. To my surprise, the CEO did not respond, or the person who is acting as the CEO - the ‘purported CEO’ - let me call him that, because as far as I understand he is illegal. Who hired him?
Thank you, Madam Presiding Officer. I wish to thank all the speakers who would have gone before, the Minority Leader included and the Secretary of Health, Wellness and Social Protection, Member for Belle Garden/Glamorgan.
These are serious times in the island of Tobago; these are times when the populace is looking for more. We campaigned on giving the populace more. These are times when it is not good enough to have a near miss - we must always hit, ‘bull’s eye’.
I understand the efforts of the Secretary of Health who is the Member for Belle Garden/Goodwood, but I dare say those efforts are not good enough for me nor for the persons whom we all represent.
Any government or kwasi government, upon entering office, must deem a priority, the State Boards that need replacing or you leave the State Boards that are in place, in place, until you replace them.
It is a tragedy that we took office in December 2021 and we are now just a few weeks away from December 2022, and I am hearing the Secretary of Health, Member for Belle Garden/Glamorgan, stating over there, that ‘we have submitted the names’. That is unacceptable, totally unacceptable.
This is the reason why we craved for autonomy; this is the reason why we campaigned on autonomy, not to be sitting ducks on a pond waiting for someone in Trinidad to give us the okay. But again, like the Board of the Tobago Regional Health Authority, the idea of Tobago’s autonomy has taken a back seat.
We are in trouble, Madam Presiding Officer, we are in serious trouble.This is not partisan politics. We as a people in Tobago, are in trouble and we have to quit the game that says T won, you lose; I am on this side, you are on that side’. We have to always bear in mind that when we come here,we come here as one House. This is the Tobago House of Assembly. It is not PDP on that side and PNM on that side. Minority Council and the Executive Council together, and the Presiding Officer and all those other persons here, make up the House of Assembly. This important matter being brought to the Tobago House of Assembly should take on a little more significance from speakers. This is not about the THA forming a governance plan or some governance policy; this is not about training people in postnatal and health care doing well. This has to do with the legality of our health care services; whether or not the CEO has been properly appointed, and who appoints him? I know the THA Act says that the Tobago House of Assembly can employ persons on contract, but I dare to say to them, the THA Act cannot override the RHA Act. I repeat, the THA Act cannot override the RHA Act. They are two (2) separate Acts - one deals specifically with THA, yes, and the other deals with the RHA. It is illegal for anybody to employ the CEO without the Board. The RHA Act which is on par with the THA Act - those Acts are passed by Parliament - that means an Authority by statute; by law; not some flimsy, whimsy, wishy-washy Authority that somebody makes up and registers a company. This is legal...
Thank you, Madam Presiding Officer, and I do not think that I will need all of it.
I just wanted say, that yes, we have a situation where we came in with very demoralized health care workers and we have actually been working to bring them up to a place where they feel more comfortable to provide the quality service that I know, and we know they can actually provide.
I would want to round out, Madam Presiding Officer, with correcting something that is inaccurately circulating. I got a message about it (I think yesterday) and I just want to be on record saying that when the Minister of Health spoke in the budget presentation a couple weeks ago, spoke about (and I almost hate this term now) ex-gratia payments to health care workers -what was indicated in his presentation, was that these payments were going to be made for the RHAs in Trinidad. He spoke about them because they are under the Ministry, and he did not include the Tobago Regional Health Authority, for obvious reasons. The Minister is not directly responsible for the Tobago Regional Health Authority. What I want to state explicitly, is that those payments (when it is of course, approved and they send the money from Trinidad and all of that good stuff) will take place for all of the health care workers in Tobago - all. There is a rumour going around that only the doctors and nurses might get it. That is not true, because we recognize over the last couple years that those who you probably do not think about, were probably the most important. The sanitation workers were probably the most important people in the health care system at that time. So all of the workers will be getting it. This Executive Council is trying its best to govern Tobago and to do it in a way that makes sense and does not necessarily make enemies with the Cabinet, just because we are on different sides of the political fence.
So, when the Minister contacted me, even before anyone knew publicly about it, the Minister called me and said, “Faith, (he calls me ‘Sister Faith’) we are doing this; send me the number, send me the dollar figure for Tobago”, and that is what I did. I sent the full dollar figure. When I heard the uproar about them only speaking for four (4) RHAs, I then messaged him again, I said, “What is going on?” He said, “Sister Faith is what you told me, not the figure? That is the figure I put in it; it will just of course,come through the Ministry of Finance because that is where the money comes through to get to Tobago”. So, to all of the health care workers in Tobago, those of you who are part of the Tobago Regional Health Authority, and those who worked with the Office of the County Medical Officer of Health, all of you - that payment as promised by the Minister, should be coming to you as soon as they work out the process for that. [Desk thumping]
In the end, Madam Presiding Officer, I would ask those of us on this side to -1 mean, why are we here at this time?
“BE IT RESOLVED that this House agrees that the Executive Council should take immediate and appropriate actions towards the urgent appointment of a Tobago Regional Health Authority Board of Directors”.
This Executive Council has already done that, and it is now up to the colleagues in Trinidad to do their part, to bring this to an end.
Again, Madam Presiding Officer, allow me to thank all of the health care workers; all of the social support workers; all of the social protection workers, because that is what they do. That is what they do unlike what those on the other side are calling them - that is what they do. I would like to thank all of them for all of their hard work during this period. And because of that, we are all going to move into the next period in a better position improving our quality as we go forward.
Madam Presiding Officer, I thank you. [Desk thumping]
We have paid to TRHA suppliers, a total of over one hundred and sixty million dollars ($160m) in owing yes, because all of that was owing. And let me just say too, that one of the reasons why it is hard to get things - the consumables - is because we were not paying the bills, so the suppliers do not want to give us more stuff because we are not paying the bills. Those are the things that we have been working on over the couple months, to get it to that point, so that we now have a better relationship with those suppliers, and of course, we have the three year contracts, because another decision (it is the same kind of decision) that Boards have made, is to move away from giving people permanency as public servants in the Tobago Regional Health Authority, and give them contracts, give them short term contracts over the last how many years. So that is what we have been doing over the last ten (10) months, even without the Board - giving those hundreds and hundreds of temporary workers who are on month to month...
... happy that I did that, because even though I am also frustrated sometimes with how slowly we would have been moving things along, this document actually shows that they have actually been doing a whole lot of stuff over the period, and they have been doing phenomenal work. Now granted it is not perfect and there is always room for improvement, but we have for example, the ICU in preceptor training,where nurses are actually learning how to use these machines and stuff like that. That did not happen before. The neonatal resuscitation training, where practically everybody who has been part of the maternity ward and paediatrics’ and so forth, are there so that they now know how to resuscitate neonates - the little babies and so forth; that kind of thing.
Yes, I am actually happy that we finally have services happening at the Roxborough hospital, because I remember when the Prime Minister came up years ago and cut ribbon and all kinds of things; so yes, I am very happy [Desk thumping] that we are having actual services there. I know it is not perfect; I know we do not have in-patient services as yet, and I am actually sending a call out to some of the specialists who are out there, Tobagonians who might actually want to come home, because we realize it is actually a serious HR issue, where we are asking for specialist doctors for the different fields to apply, and then we are not getting the applications.We are not getting them in. So, if you are a Tobagonian out there and you want to come back, certainly join us. We have seen so many patients at the A&E now, which by the way, runs from Monday to Friday, 7.00 a.m. to 7.00 p.m.
I would skip through quite a bit of this and I would actually go to some of the things we spoke about earlier, as being able to provide - because a lot of these things are what the workers at the Tobago Regional Health Authority were really, really clamouring for.
We have seven hundred and three (703) gratuity payments that have actually been made for this period thus far, that is totalling over twenty-nine million dollars ($29m) of gratuity payments. So, remember before the elections, we used to hear all of the workers complaining that they did not get their gratuity. They are getting their gratuities. [Desk thumping]
We always hear them talk about how the TRHA owes so many people (and that is true). The TRHA owes so many people, because they have not been paying the bills and by the way, let me just put this in. You see that talk about those food vouchers that people were just giving away over in the Division of Health, Wellness and Social Protection - and for the last day of the fiscal year, for my Administrator to call me and tell me, “You know we owe all of the groceries; it is millions of dollars we owe the groceries.” [Crosstalk] Those same vouchers that they have been giving, we owe forthem; we have not paid for them as yet. [Crosstalk]
There is DR in front of my name, but I am certainly not at the hospital providing actual service. So if we are talking about the absolute horrible service that people are complaining about, then it is obvious that we are talking about the individuals who are actually providing that service, and as much as I would have loved that to be me, that is not me.
Madam Presiding Officer, but because of that, I have actually asked the Members of the Tobago Regional Health Authority to provide for us, what they think are some of the wins that have happened over the last couple months and I am actually ...
Thank you, Madam Presiding Officer.
Just shoot a call and say to your Colleagues, “This is absolutely critical”. I think and it is my view, speaking on your behalf, that this is something that needs to happen quickly, so we are asking for it to happen quickly. We would actually appreciate that. Now, we would appreciate that because I am actually very happy with the individuals who we have identified to be on the Board, and one of the reasons that I did not speak about it, is because I understand the process that we have to go through and I did not want to say - we are making an announcement when the process was not completed. There would be a big hoopla when the process is completed.
Now, let me take a little bit of the time though to do two things. One,before I forget - people have been messaging me. Given that we have not had a Board and given that the Minority Leader believes that the thousands of workers at the Tobago Regional Health Authority have been providing such absolutely horrible service to the people of Tobago, I asked them ...
...particularly this one, because the process for this one, as the Minority Leader rightly explained, is out of our hands. It now has to go to the Cabinet for them to make a decision and that we are waiting for.
Now, instead of coming here and saying that you want us to do it, but
it does not make sense because it is too late, maybe it is worth contacting your Colleagues in the Cabinet [Desk thumping] to have them. Now granted I do not think, because this Executive Council has actually had a pretty decent working relationship with the Cabinet, that there is anything malicious happening right now in terms of it being unduly delayed or anything like that, just because we are on different sides of the political fence, but maybe with some prodding, we will get it a little faster.
Now, the thing about the situation with the Board of Directors of the Tobago Regional Health Authority, is that okay, maybe I should step back. The THA Act says, that the Tobago House of Assembly is responsible for health care - the Secretary is responsible for policy. No, the Tobago Regional Health Authority (TRHA) Act does not speak about the Secretary or anything like that, but the RHA Act does say that as it relates to the TRHA, the Tobago House of Assembly is the entity that provides policy and so forth. Now, that is also very clear in the document. It is also clear in the fact that since we have come into existence, I have actually had to make it a point to speak with the Minister of Health (who by the way, we actually have a pretty decent working relationship with) and say to him, “I know that we have been having this total separation feeling of Tobago versus Trinidad, but what makes more sense, is for us not to be fighting each other. What makes more sense, is for whatever the Ministry of Health is agreeing on in terms of policy, let us include Tobago in those discussions, so that whatever the Ministry of Health is proposing, it is one that already takes the Tobago Regional Health Authority stance as part of the decision making.” So now for example, we have the CEO of the TRHA being included in meetings with the Minister, with the other CEOs in Trinidad and so forth, because we recognize that things were happening out there, that we would only find out about after the fact, when in fact, it would actually make more sense in terms
of actual application of what we are doing, for us to all be at the table and have the discussion, so that when it is being rolled out, it is rolled out properly, including what is needed for Tobago.
Now, speaking about CEOs - I think it is important to note that even though we have a whole period where there was about two (2) to three (3) years with no Board over the last how many years, one of the reasons why we have the issue with the quality of healthcare on the island, has to do with the fact that the office of the CEO for the TRHA, is actually one that has been a revolving door, so often. So nobody ever really got a chance to get in; sit down; buckle down; understand what is happening, and then actually implement what is needed to happen. Let me just give a couple examples.
We have:
One that was there, an actual CEO from August 2001 until about 2002;
An acting - and I am saying you have to pay attention to CEO versus acting because CEO means they have actually been hired and appointed and all of that). Right?
An acting CEO from 2002 July to 2003 January;
A CEO from 2003 to 2005 - coincidentally, the ‘acting’ became the actual CEO at that point;
2005 February to October 2005, another acting CEO;
2005 November to about 2007, a CEO was in place;
2007 July to May 2010, another acting CEO;
So you realize what is going on. All of them are different people except the first two, where I said the ‘acting’ went into the CEO.
2010 June to 2011-CEO.
August 2011 to February 2012 - acting CEO;
February 2011 to August 2014 CEO - not the same people.
June 2014 to May 2015 - acting CEO;
June 2015 to November 2015 - CEO.
That one came and went so quickly, we are not even sure what happened.
November 2015 to October 2016 - acting CEO;
November 2016 - acting.
October 2017 to June 2018 - somebody on the Board performing the duties of CEO;
June 2018 to August 2018 - acting CEO;
August to November 2018, this is a new one - an interim CEO;
November 2018 to June 2019 - acting CEO;
June 2019 to March 2020 - CEO;
Another interim CEO which is what we came into, and now we have a CEO who is there.
Now, anyone who is listening to that list would recognize that any organization where the leadership of the organization has changed so many times, is one that in and of itself, is going to be difficult to function, because you really do not know what will happen tomorrow. No one has been there long enough to even make a real dent into what is required.
I am not going to be very long, because the reality is, the process to get the Board is now out of our hands. The reality also is though, that even when there were Boards in place, there were some decisions that just did not make any sense. So for example, and I would just use this one example again, because it is already after 3.00 p.m. I do not want to be here for very long.
A Board made a decision that public service nurses moving up the ladder, doing all they had to do to move up the ladder, when they got to the point of being so good, that we could send them out in the districts - you know the District Health Visitors (DHVs), the ones in brown who we have so much respect for, a Board made a decision to takeaway all of the service of all of those nurses, and if you applied and you were interviewed and you were successful at the interview, and you want to become a District Health Visitor, you have to give up all your service and get a contract. That is a decision that was made by a duly constituted legal Board in the past of the TRHA. We are trying to figure out now, how we are going to reverse stuff like that, because it actually affects people’s lives and livelihoods.
So, I have said it publicly, that I wanted to honestly take time to find the people who are competent and who would make rational decisions, to place them on all of the Boards that are under the jurisdiction of the Division of Health, Wellness and Social Protection...
Thank you,
Madam Presiding Officer. Let me start by indicating that I think that we have actually done a pretty good job of the refurbishment that has happened in this House, and I know given the limited finances to do it, I am really proud of what we were able to accomplish in that period. [Desk thumping]
Let me also start by thanking those in the Tobago Regional Health Authority, who have been working tirelessly. We have come out of a time where most other sectors kind of had a break, but those in the Tobago Regional Health Authority sector did not have a break at all. They went through; they went through; they went through; they went through. They pushed through and in the middle of everything, we have been able to come out of this successfully. I want to publicly thank all of them for the hard work. [Desk thumping] I know that it is not perfect -1 know this. Almost every Monday morning, I jokingly with my colleagues, speak about all of the things that we need to fix and we need to change within the Tobago of Regional Health Authority. But coming into this exercise today, actually forced me to rethink how much work they have actually been doing and how well they have been functioning given the situation.
I would ask us to make up our minds what do we want to do. Do we want to take immediate action because we think immediate action would resolve an issue? That is in essence, what the motion is asking for. But then you ask, Madam Presiding Officer, for us to take immediate action, you then turn around and say, “Too little, too late; it is not going to solve anything”. So, maybe we need to rethink exactly what we are asking us to do, because if it means that he has already given up on the process, then maybe we should have rescinded this motion completely. In his mind through you, Madam residing Officer, it is too little, too late. You see, also through you, Madam Presiding Officer, the Minority Leader indicated that yes, the process which in essence was outlined - there were a couple inaccuracies, but in general, the process that was outlined, is the process, and this Tobago House of Assembly, this Executive Council has actually done that. The names that we have picked have already been sent and we really are just waiting for the Cabinet to do what they need to do, to get that done. That is fine, because what we are talking about, is how we actually influence peoples’ lives. Now I know that the word ‘illegal’ has been thrown about several times, and the thing about legality and illegality, is that it can easily be tested. Now what we are experiencing, is probably something that we are not used to; what we are experiencing is something that is not a conventional way of doing things, but if we really want to test the legality of the system, that can actually happen and there is no reason for us to not test the legality of what is currently happening, if we honestly believe that it is illegal.
One of the things that we came into, is something that is known as a TRHA Governance Plan - that was done. The date of the one that we have been working with, is actually 2011, and that TRHA Governance Plan is one that in essence, outlines how the TRHA is supposed to function as it relates to the Board; the CEO, as it relates to the Tobago Regional Health Authority, to the Tobago House of Assembly and all of that. All of those are outlined in the TRHA Governance Plan that is being used.
I would say though, that we are actually currently working on updating that TRHA Governance Plan, because while we have been thinking through what has worked and what has not worked, and why is has worked and why it has not worked, we recognize that within the Division of Health,Wellness and Social Protection, there are inefficiencies within the Tobago House of Assembly component of the management of health care on the island. So, one of the things you would hear me continually speak about, is the fact that we are restructuring the Division and that includes actually implementing a Department of Health.That Department of Health, Madam Presiding Officer, would in essence, do all of the background work to allow us to say, “These are our health concerns; this is the best way to fix these health concerns; TRHA, we are asking you to be a service provider”. So we can say very clearly to the Tobago Regional Health Authority, “These are the ten (10) things that we want you to do; we are giving you ten million dollars ($10m) to do them”,and at the end of the period, we say “We have done the monitoring and the evaluation of that; you have fulfilled your side of the bargain, and we are all happy”.
That part of management of health currently does not exist in the Tobago space and it is actually being developed as we speak, and as a result of that, this TRHA Governance Plan is being reworked to include those kinds of inclusions.
As the Minority Leader indicated, that Governance Plan is actually what outlines the limits in terms of what the CEO can spend and so forth, and that is what we have been following over the last couple months.The Minority Leader spoke as if to indicate that the only period where we did not have a Board of Directors for the TRHA, was that period where there was that situation between the Tobago House of Assembly and the Minister of Tobago Development or whatever. But in fact, over the last how many years, there have actually been one, two, three, four, five, six, seven periods where there were no Boards, and it may not have been the best situation and the quality of care may not have necessarily been the best at that time, but in those periods, there was not an issue of illegality either, so it is not just at this point. We have, going all the way back:-
March 2006 to July 2006;
July 2008 to April 2009;
March 2011 to August 2011;
August 2013 to March 2014;
April 2016 to June 2016; and of course,
July 2020 to September 2020.
Now when you add up all of those, that is actually close to about three years of no actual Board being appointed in the Tobago Regional Health Authority, before the Progressive Democratic Patriots (PDP) or ‘Farley andFriends,’ or now I understand it is, ‘Farley, Faith and Friends’ (It is okay, I could take that) has been operating. It is kind of coincidental that the people who said, ‘Farley and Friends’ and the people who are now saying, ‘Farley,Faith and Friends’, sound so similar, but that is a different story. [Desk thumping]
You know what happened to her? They told her that she had to fill out this form; she had to come back with a bank statement, her husband pay slip, and all kinds of madness - for five hundred dollars ($500.00). If this is how we are treating poor people, if this is how we are putting people first, then I do not want to see how you would be like ‘Burna Boy’ and put people last. Because if you all are putting people first by telling them - poor people coming to an office - and Madam Secretary, I am asking you to review that system. That cannot be right.
Thankfully, well I do not even know how to say the word, but I was told it was " s ekeye’ fig. I walked my district and I got two (2) hands of bananas. I cut them up and I had them in the office, so I was able to give her some "sekeye"fig, some people donated some small hampers that I had in the office and I was able to give her some hampers. I do not have money like the rest, so I could not give money, but she was able to get something by my office and I hope it filled that hole.
Madam Presiding Officer, this Administration campaigned on a promise to ‘fix dis’. The Member for Belle Garden/Glamorgan, had the most to say. Almost every other day, she is on TV and she is pronouncing and enunciating on all things health; had all the answers. The people believed in what she had to say, and they have put her in the seat, and what are they getting? We are getting a situation where we cannot get a Board. The Board is not there now to approve things to ensure the efficient delivery of the health service, and the whole thing is falling down. Talk to your different practitioners - talk to them, they will tell you it is a mess; it is total chaos. You have to fix that, Secretary. You have to fix that.
Madam Presiding Officer, it is my understanding that it took some roughing up from the Chief Secretary, which finally forced the Secretary of Health into action. Perhaps that might explain why it was the Chief Secretary who commented on the TRHA Board at ‘Mandate Monday,’ and not the line Secretary.
Madam Presiding Officer, I anticipate that the Secretary will come here in her usual way - very aggressive with her rebuttal and will attempt to pour cold water over this Motion, by indicating that the Executive Council has already submitted a list of recommended Directors for the Board of the TRHA. However, it is important for the Secretary to understand, that ‘too late, too late shall be the cry." Too late. The destruction has happened already and some of it, is irreparable. Some of the destruction that happened - irreparable. Madam Presiding Officer, the damage has been done to our health care system, and I feel it is too late, too late to do any kind of repair at this time.
I anticipate that the Secretary will also come to (play the broken record we know) tell us what the PNM did not do; what they did; how long they did do, because we hear it - we took twenty-one (21) years and we know the usual refrain. That could make a good Calypso now, but, at the end of the day, the people voted for change. It is a reason why I am alone standing here and must be seventeen (17) of you all over there. There is a reason why. So you do not have to tell us that again. We understand why we are here, but while we are here, we will be seeking the interest of the people and whether we stay here for four (4) years or for twenty (20) years, we will be here serving the people, because serving the people is what we know.
If at a point in time the people decide that you did not serve us well, that is their right to do. You who have the opportunity, you have got to serve better. You cannot serve worse, because if you are going to come and do the same thing or a little bit different from the same thing, or worse than the same thing, then you really did not change anything. So when you come here to tell us and remind us of everything that you believe the PNM did not do, the people know that already. So, if you are planning to do that, I would advise you, do not waste your time. Do not waste your time at all.
My information is, even if you come to try to compare the tenure of the PNM, when it comes to appointing Boards, there is no point. I am challenging you, when you come, to show me a time where the PNM would have allowed a Board to go for almost a year without being appointed.
I know there was a time (and I am sure that the Secretary should know as well) when the TRHA Board took a little bit of time because what we had was the THA Executive Council taking their position and taking action to appoint the Board, but you also had the Minister of Tobago Development,also believing that she could appoint a Board. The Cabinet had two (2) recommendations in front of them, and they had to seek legal guidance as to who was bona fide, who was then authoritative Body, who had the authority to appoint the Board, and that took some to-ing and fro-ing. There are some headlines here from the newspapers, “Chief Secretary to meet with Prime Minister to settle this matter.” So if you are going to come to talk about that, try again.
Madam Presiding Officer, I am wrapping up now. What we are
witnessing today, playing out in front of our eyes, is a classic case of poor leadership combined with bad management, on the part of ‘Farley, Faith and Friends.’
Madam Presiding Officer, as I conclude my contribution, I want to stress to my Colleagues, the importance of adhering to our Constitution and the rule of law. Our Constitution is that sacred vanguard that stands as a beacon of protection for the people, from its government. The day you have an Administration so comfortable ignoring and disregarding the laws of a country, the result can only lead to chaos, confusion and anarchy. It is in this context, I want to offer a general caution to my Colleagues in this House, and I am going to go very slowly, to let us all strive to follow the law.
Madam Presiding Officer, it was the former Prime Minister and President, ANR Robinson who reminded us that, ‘streams flow into river and river into sea \ meaning bad habits often lead to big mistakes, and the more they are repeated, the more dangerous they become. We are big and we have sense. The law is clear; the process is quite simple; there is absolutely no excuse, none whatsoever, for this inordinately long delay. Let us fix this now.
Madam Presiding Officer, I beg to move. [Desk thumping}
Just last week Tuesday, after I left the Lure Estate,(and I want to thank my Colleagues for inviting me to that lovely session up there. I had a good time cooking that oil down and it seems like it took favour with the people who attended as well) I met a young lady who was just inconsolable, (because I came down and went straight to my office for
‘Public Day’) and overwhelmed with tears, and her situation was that she took her last twenty dollars ($20.00) to come to town, thinking, like long time when the PNM was there, you could have just gone into the Division and tell them, “Things are hard, I need a little change to buy some groceries”, and there are vouchers already prepared and waiting to be given to poor people.
Thank you, Madam Presiding Officer,appreciated. The truth sometimes is a difficult pill to swallow, Madam Presiding Officer, but I would not be distracted.
So, Madam Presiding Officer, could this be the reason for in-patient services not being provided at Roxborough as a strategic priority? Could this be the reason for not having a proper ambulance service, and why whenever the ambulance is needed, there are no drivers? Why are pregnant mothers from the far East forced to have to wait on an ambulance service to come from town to take them down back to town? Why?
Madam Presiding Officer, but was this not one of the main reasons
we in the PNM, conceptualized and built this state-of-the-art, one hundred million dollar ($100m) health care facility in Tobago East, in the first place - so that people in the East of Tobago can get the same kind of medical care just as the people in the West of Tobago? That was the PNM’s vision.However, almost a year later, all we are getting from this Secretary, is only excuses after excuses; blame after blame and game after game.
Madam Presiding Officer, the Secretary of Health must tell us what is going on with the full operationalization of the Roxborough Hospital. It is a year later, what is going on? What is happening with the medical team that was interviewed, shortlisted and are awaiting a letter of offer? Why are they not hired? Is the TRHA recruitment being constrained by the fact that there is no Board to approve such appointment? Tell us.
Madam Presiding Officer, is this also the reason for the deplorable state of the dialysis service at the Bacolet facility? Madam Presiding Officer, I take no pleasure in declaring that the absence of the Board has comatosed the delivery of health care services on this island, no pleasure.Daily, I am inundated with calls and complaints from ordinary Tobagonians about the deplorable state of our health care service.
Persons from my district are saying to me that when they go to the hospital in the morning for routine check-ups, they do not reach back home until the next day. I know personally of a family who had an emergency and called for an ambulance, and was told that there are only two ambulances in service at the time and both of them were out, so the best option they had, was to put on their hazard lights and drive to the Scarborough Hospital at Signal Hill. Madam Presiding Officer, these are the realities of our citizens on the ground here in Tobago.
Madam Presiding Officer, as I was on my way to this august Chamber,I received a call from one of my beloved senior citizens from my electoral district, Ms. Wilma and she was reminding me, “When you go and make your contribution today, make sure and let the Secretary know that we pensioners are not get basic medication; we cannot get our pressure tablets”.That is what I was told to remind the Secretary of. Simple pressure tablets,the seniors cannot get.
I was also told that beds are a scarce commodity at the Scarborough Hospital and people are being sent home and sent home knowing that perhaps they will not make it. I am receiving calls from Tobagonians complaining that many of the machines are not working; some of the medical departments are short staffed; doctors are saying that they are frustrated; nurses are murmuring that they are ‘burnt out’ and the list goes on and on and on. It is total chaos under Faith.
Madam Presiding Officer, the sad reality is that these complaints are not isolated to the Department of Health, but seem to be a common trend throughout the Division of Health, Wellness and Total Destruction ... sorry, I mean Social Protection, of which the Deputy Chief Secretary of the THA leads. Madam Presiding Officer, poor people are suffering under this current Administration while millions are being carted off to South and Central Trinidad, to their UNC friends and financiers. Tobagonians are suffering.
Madam Presiding Officer, this judgement is instructive and can therefore be applied to the current TRHA, where given that there is the absence of a Board of Directors, and any decision taken by the CEO that would require Board approval, can in fact be deemed to be null, void and of no effect, and can therefore be challenged in the court of law. Madam Presiding Officer, another important area that we need to look, at is the question of the management of the performance of the CEO. In the absence of the Board, who is appraising the CEO’s performance? Who is holding this CEO accountable on behalf of the taxpayers? Is it that perhaps the Secretary is seeking to have infettered control of the CEO, and that perhaps, is the reason why it is taking so long to appoint the Board? Madam Presiding Officer, is there collusion between the current CEO and the sitting Secretary, to derail the gains of the Roxborough Hospital because she feels it was built by the PNM and perhaps the Secretary is trying to construct a scenario to appear as she came in and fixed it, and came in as the Knight in shining armour, who saves the day? We do not know, but these are valid questions at this time.
Madam Presiding Officer, could this be the reason for in-patient services not yet being provided at Roxborough? I am asking a question.
At this point in time, we want to know whether the Chief Executive Officer of the TRHA is operating with a signed contract, and this is a serious, serious [Interruption] [Crosstalk] ... that is the point.
The question is, whether he is properly hired and whether those
decisions he is presiding over are legal; whether they could stand up;
withstand scrutiny.
Madam Presiding Officer, I am reminded of the case David Alexander Murphy versus the Nursing Council of Trinidad and Tobago,where Mr. Justice Seepersad (the learned Judge) ordered that all decisions effected by or on behalf of the Nursing Council of Trinidad and Tobago, subsequent to April 19th, 2019, upon the expiration of the term of the appointment of the members of the last Council, are null and void and of not effect. So nothing that was done during that period, once the Council, which is like the Board of the TRHA, vacated their office, all decisions entered, all contracts entered were deemed null, void and of no effect. The question is, is this the case with the TRHA at this time? Is it that all decisions, all contracts, all authorized payments are indeed null, void and of no effect, and therefore, where does that leave us as an island? Where does that leave us? I hope that the Secretary would tell us when she comes.
Madam Presiding Officer, I am hearing hissing in the House and we have school students in the gallery. I am hearing hissing; someone hissed. I know children get disciplined for hissing.
I am moving on. [Crosstalk] But what we are seeing,is that this Secretary of Health, Wellness and Social Protection is failing to adhere to the law of the land, and this is going on for almost a whole year.
The Chief Secretary nonchalantly mentions this untenable situation of
the absence of a Board of Directors of the TRHA, as if it is no big deal.
However, we on this side of the House stand resolute in our conviction, that this is indeed a big deal. This is a serious matter, and this requires swift action.
Madam Presiding Officer, the Regional Health Authority Act outlines
some of the critical functions of the Board of Directors such as:
To provide efficient systems for the delivery of health care;
To operate; construct; equip; furnish; maintain; manage; secure
and repair all its properties;To facilitate new systems of health care;
To do all such things as are incidental or conducive to the attainment of the objectives of the Authority.
Madam Presiding Officer, simply put, the Board of Director is
important to ensure that health care practitioners and administrators are held accountable, there is no discrimination in the quality of service received,hospitals and other public health facilities will be equipped with the required staff and equipment, so that when the members of public visit a public health facility, you would receive quality care in a reasonable time. The operations of the TRHA is insulated or protected from direct political interference and control.
Madam Presiding Officer, another critical aspect of the work of the
Board, is the function of its subcommittees, the main ones being:
The Finance Committee which plans and manages the overall budget of the TRHA;
The Tenders Committee which evaluates and recommends award of contracts for goods and services;
Human Resource (HR) Committee responsible for overseeing recruitment of specialist staff and dealing with IR issues;
Audit Committee which monitors and evaluates risks and gaps in the various systems of health care delivery;
as well as:
Making the finances audited by an independent Body as to ensure that we have value for money and every red cent is accounted for.
Madam Presiding Officer, given that the TRHA is without a Board at this time, one cannot help but ask the question:
As it relates to matters requiring the approval of the Board, what process is being used to treat with those approvals? What is the process?
Madam Presiding Officer, this question is even more relevant now more than ever, because as I mentioned before Minority Councillor Petal Daniel-Benoit raised this matter - she asked the question and in the response given to us by the Secretary of Health, we were told that the Chief Executive Officer (CEO) has a limit and when the CEO’s limit is met, then the Administrator of the Division of Health, Wellness and Social Protection, provides covering approval, and when that limit is met, then the Chief Administrator signs off on approvals.
Madam Presiding Officer, I wish to indicate to this Honourable House, that I have sought legal advice on this matter, and I am advised that such an approach is improper, dangerous and ultra-vires, the Regional Health Authority Act for the CEO to be engaged in substantial expenditure outside of his delegated limit, without the approval of the Board. Therefore, the operations of the Tobago Regional Health Authority ought to be restricted to the approval of routine operational matters by the CEO in keeping with Section 10, subsection 6 of the Regional Health Authority Act and the THA, nor its agents can give the CEO of the TRHA direct instructions, since such instructions, and such actions would be contrary to the Act and would also be deemed ultra-vires. However, if it is one thing we know all too well, about ‘Farley and Friends,’ is that they all care little for the rule of law, and I will leave that part alone.
Madam Presiding Officer, it is important to note that the expenditure of the TRHA can easily exceed half a billion dollars ($0.5b) in any one financial year, and also account for approximately one-third of the entire THA budgetary allocation.
In the absence of a functioning Audit Committee and Board, the question therefore must be asked, who has been providing oversight of these funds? Further, the Chief Secretary and Secretary of Finance must tell us, whether he is comfortable with a situation where over half a billion dollars ($0.5b) of taxpayers’ money have been managed only by a Secretary and a CEO for the last ten (10) to eleven (11) months, without the scrutiny of any independent Auditing Body. Please tell us, and I hope that at some point
when the Chief Secretary listens in, he would speak to the Tobago public and indicate whether he approves of this kind of untenable situation.
Madam Presiding Officer, the Secretary of Health and the Chief Secretary must also tell us whether the CEO is operating in the position of CEO without a signed contract.
When she made that commitment to the House, is this a situation where the Secretary misled the House? It is quite fortunate that we are in another session, because I would have definitely brought this for the consideration of the Privileges Committee, because that was a clear commitment that coming out of her in about a couple weeks, a Tobago Regional Health Authority Board (TRHA) would be announced. So if she told us that a TRHA Board would be announced in a couple weeks, and we are now here sitting down in October, where I have to light some fire under her to get her to act...Madam Presiding Officer, sometimes I do wonder what is going on with my Colleagues. Sometimes I do really, really wonder what is going on on the other side.
Madam Presiding Officer, this Administration seems to have an insatiable appetite for breaking the law, insatiable. They love just putting the law aside and saying, ‘We are doing our own thing, because we are big and we are bad.’ I am pro Tobagonian, but as far as I understand it, we are still part of Trinidad and Tobago, and as far as we remain part of this Twin Island Republic, we are governed by the Constitution of Trinidad and Tobago. So it means that we cannot behove unto ourselves, powers that we do not have.
The Executive Council is not an Independent Body in its own right.The Executive Council and the Tobago House of Assembly are subjected to Section 75 of the Constitution, so it means that you are behoven to even the Cabinet as it now stands. You just cannot just come and do your own thing.You cannot just decide today, that you want to pay Board members whatever you feel like and you would disregard the State Enterprise Performance Manual. That is not how it works. There is a place for persons who continue to break the law and it is called the ‘Integrity Commission.’ It would hurt my heart to have to take Colleagues on the other side, to the Integrity ommission because the next thing, once they find you guilty, is ‘silver bracelet’, and I would not want to see anyone of you all cart out here in ‘silver bracelets.’ I would not wish that on anyone of you. So, I am warning my Colleagues, let us follow the law.
You see, the Secretary of Infrastructure, Quarries and Urban Development is doing what he wants with impunity, defying the Environmental Management Agency (EMA), flouting tendering procedures,blacklisting Tobago contractors...
and I go all over Tobago. Sometimes, I go in my plain clothes, sometimes I dress up nice. But what I have been hearing, the common thread I have been hearing all across Tobago - the people are saying to me, “You know this young lady, I had real faith in Faith, to transform this health care system in Tobago, because she sounds like she is bright.” But after eleven months of Faith at the helm, do you know what they are saying now? They say that they have lost all faith, that they no longer have faith in Faith. Sadly, that is what they are saying.
Madam Presiding Officer, simply put, this Secretary of Health, Wellness and Social Protection and by extension, this Executive Council have failed the people of Tobago, every single one of the thirty thousand plus (30,000+) residents; all those school children in the gallery today; she has failed the people of Tobago. She has failed because she has failed to do one of the most basic things that you can ask of any Administration, which is to put a Board. Get some names and put them on a paper and send it down to the Cabinet; the Cabinet send it to the President and you get a Board. Eleven months later, we are without a Board. I am going to tell this House the kind of mess you all have created - the legal, political and social mess you all have created, because you have an organization operating illegally. This is not how we fix things. We fix things by doing the right things. You can’t fix things by doing the wrong thing. And this Secretary who is now our Deputy Chief Secretary, has presided over a situation where we have the TRHA operating unlawfully, breaking the law.
Madam Presiding Officer, the Regional Health Authority Act Chapter 29:05, section 4 (2) is pellucidly clear - black and white - clear. It states that each of the Authorities listed at paragraph 3, which includes the Tobago Regional Health Authority, shall be managed by a Board of Directors. It did not say, ‘may,’ it did not say, ‘perhaps.’ It said, ‘must be managed by a Board’ - shall. Note carefully, Madam Presiding Officer, the Act did not mention the position of Secretary. Nowhere have they had Secretary; nowhere have they had Administrator nor Chief Administrator; not even the Executive Council is mentioned in the Act. It clearly specifies that the management of the Tobago Regional Health Authority is the sole responsibility of the Board of Directors.
Madam Presiding Officer, additionally, Clause 1 (1) and 1 (4) of the second Schedule of the Regional Health Authority Act, as well as Section 5 (2), are all relevant in informing the process to appoint the TRHA Board. I just spelt it out. You get the Secretary, she would find - if there are some positions that must be filled - you must have a legal person - an accountant, somebody from health care and that kind of thing, and you fill the Board.You carry the Note up to the Executive Council; the Executive Council approves; it goes three times; you get the confirmed Minute and you send it to the Chief Administrator. The Chief Administrator transmits - he could send it to the Office of the Prime Minister; he could send it directly to the Minister of Health and the Cabinet will sit - they will send it, and once they approve - they have no problem, no objection with your name, the Cabinet simply sends it to the President and the President will then issue instruments of appointment, and in the simple process, you get a Board. Yet to my astonishment, we are here having to deal with this today, because the Secretary just does not know her job. She cannot do her work and I have to come now to tell her about how to do her work, and it is vexing because we should not be here dealing with this.
We asked her in May, what is going on with the Board, we asked her?And do you know what she told us? That in a couple of weeks, we will have an announcement.
Thank you, Madam Presiding Officer. I beg to move the following Motion standing in my name:
“WHEREAS the Regional Health Authorities (RHA) Act, Chapter 29:05 requires that each Authority be managed by a Board of Directors;
AND WHEREAS this is necessary for the lawful, effective and
efficient operation of the health care system on the island;
AND WHEREAS this current Executive Council has failed for ten
months to initiate the appropriate processes to appoint a new Tobago
Regional Health Authority Board of Directors;
AND WHEREAS this represents a dereliction of duty and a flagrant
breach of the laws of Trinidad and Tobago;
BE IT RESOLVED that this House agrees that the Executive
Council should take immediate and appropriate actions towards the
urgent appointment of a Tobago Regional Health Authority Board of
Directors.”
Madam Presiding Officer, it has been eleven months; three hundred and twenty-one difficult days and a total of seven thousand, (yes, I calculated the hours) seven hundred and four gruelling hours since this PDP Administration has failed to appoint a Board of Directors of the Tobago Regional Health Authority, and this is in breach of the Constitution and the rule of law.
Sadly, while Farley, Faith and Friends are busy joyriding and feting,
Tobagonians are dying and the management of our health care services on the island of Tobago, is at an all time low.
Quite frankly, Madam Presiding Officer, as the Minority Leader, I make it my duty to traverse the length and breadth of Tobago, moving from Crown Point to Charlotteville ...