Equitable placement of doctors high on Health Ministry’s agenda

Jun 06, 2010 News

– Health Minister

Equity in the delivery of public health care is still high on the agenda of the Ministry of Health and much effort has been engaged in this regard, according to Minister of Health, Dr Leslie Ramsammy.
And this, the Minister said, will be achieved through the equitable distribution of doctors to all 27 of the country’s public health institutions. However, efforts in this regard have so far been quite a challenge for the Health Sector, the Minister revealed during a recent interview. “I am not yet comfortable that we are distributing them (doctors) equitably because at the moment some places have more than others.”
This situation, the Minister noted, is premised on a challenging state of affairs whereby “Guyanese doctors have a preference of going where they want to go…”

Minister of Health, Dr Leslie Ramsammy

And this situation persists even though there has been an increase in the amount of doctors being trained through the Guyana/Cuba Scholarship programme. According to Minister Ramsammy, medical students being trained through the Cuban collaboration must complete their internship at local facilities as part of their training. And unlike those students who undertake the medical programme at the University of Guyana, once they would have graduated, they would have also completed their internship.
“In spite of that, because they have been trained under a different system, we still insist on a rotation through the Georgetown Public Hospital Corporation (GPHC) or sometimes where other senior doctors are,” Minister Ramsammy noted.
As such, the Cuban trained students are exposed to an additional year of training before they are officially dispatched to various health facilities.
However, the Minister noted that it has been recognised that in many instances these doctors are forced to operate by themselves.
“If you send a doctor to Mahdia, they are not going to benefit from the presence of other senior doctors as in New Amsterdam or Georgetown and therefore we want to make sure that they get that additional training.”
However, Minister Ramsammy noted that one of the long term plans is to never leave the new doctors for prolonged periods where they will not benefit from interaction with senior doctors. As a result, he revealed that plans are about to unfold where the GPHC will be sending teams into the various far-flung areas where new doctors are stationed to aid a monitoring and support process.
Notwithstanding, the Minister confessed  that, “I am not yet satisfied with how we are placing them because the reality is that some places have more than others and that is because we continue to be challenged by doctors and their placement choices…”
The Minister recalled that the intensified medical programme in Cuba was expected to not only increase the number of doctors in the country but also to ensure that the ratio of the doctors in the population is improved. But according to Ramsammy, “we don’t want that improvement to be such that some areas are over populated and others still don’t have.”
According to him, for many years it was the Cuban doctors who were forced to carry the burden in the country’s remote areas, adding that it is now time that Guyanese doctors “take up the slack.”
Although there is greater emphasis on placement in remote areas, Ramsammy disclosed that there is still resistance where doctors still have an apprehension about going to different areas. “The irony is that some people from certain Regions don’t even want to go back to their own Regions, and I have said it clearly, I am not entertaining any request for a preferred location. Doctors will serve where we have un-served and under-served areas so that there is some equity.”
And even as the need for equity is being addressed, there is also the need to look at the demand for doctors at the Medical Out-patients Department of the GPHC where persons are made to wait for relatively long periods before being attended to, the Minister asserted.
For this very reason, he said that the GPHC has been demanding that some of the new doctors be placed there.
“My position is that we have the need for doctors but whilst I want to eliminate the long wait, we have to satisfy the demand where no doctor exists. It doesn’t make sense for us to put more doctors in areas where doctors are already present and leave out some areas, such as Wakenaam, Leguan, Port Kaituma, Mahdia and Matthews Ridge,  that are sometimes for long periods without doctors.”
According to the Minister, the main aim of the upscale in the medical programme is to ensure that there is a constant presence of a doctor at every public hospital.