There is a "tremen­dous short­age" of staff, es­pe­cial­ly skilled med­ical staff in­clud­ing both doc­tors and nurs­es, at the pub­lic health in­sti­tu­tions in this coun­try, the Sun­day Guardian has learnt.

The is­sue has reached "cri­sis" pro­por­tions through­out the coun­try re­sult­ing in a ra­tio as high as 22 pa­tients to one nurse cur­rent­ly ex­ist­ing at the San Fer­nan­do Gen­er­al Hos­pi­tal - as op­posed to a ra­tio of six pa­tients to one nurse sug­gest­ed by the World health Or­gan­i­sa­tion (WHO).

The sit­u­a­tion at San Fer­nan­do Gen­er­al, ac­cord­ing to nurs­ing staff there, has re­sult­ed "in long hours, ex­ces­sive over­time, tired work­ers, de­nial of le­git­i­mate leave" and this will "neg­a­tive­ly im­pact the qual­i­ty of health care to the pop­u­la­tion," the Na­tion­al Work­er Union (NWU) stat­ed.

"This is un­safe and puts both nurse and pa­tient at risk," the NWU says.

The staff short­ages are among a list of grow­ing con­cerns cur­rent­ly plagu­ing the pub­lic health sec­tor. Among the oth­er is­sues are drug short­ages at the Re­gion­al Health Au­thor­i­ties (RHAs), med­ical staff from To­ba­go stag­ing a sick­out over ar­rears and con­fu­sion over Yel­low Fever vac­cines.

No jobs for doc­tors

Even as the short­age of spe­cial­ists ex­ists, more than 150 na­tion­als who have al­ready com­plet­ed their in­tern­ship as doc­tors at the pub­lic hos­pi­tals who still re­main un­em­ployed.

These con­cerns were raised as the Sun­day Guardian be­gan an in­ves­ti­ga­tion in to this coun­try's pub­lic health care sec­tor.

"It is time we take the bull by the horns and find the way for­ward to deal with these is­sues," Chief Ex­ec­u­tive Of­fi­cer (CEO) of the North Cen­tral Re­gion­al Health Au­thor­i­ty (NCRHA) Ku­mar Boodram stat­ed.

The NWU sub­mit­ted a let­ter to the Dr Win­ston Welch-chaired com­mit­tee high­light­ing the sit­u­a­tion of staff short­ages in this coun­try's health sec­tor.

The NWU lament­ed that "mech­a­nisms must be put in place to fill the thou­sands of va­can­cies in the pub­lic health care sys­tem".

"Ac­cord­ing to the of­fi­cial sta­tis­tics, in the NCRHA there are at least 650 va­can­cies to be filled, and in the South West Re­gion­al Health Au­thor­i­ty (SWRHA) there are 3413 va­can­cies, 992 of them be­ing nurs­ing va­can­cies," the NWU stat­ed.

The sit­u­a­tion at the San Fer­nan­do Gen­er­al Hos­pi­tal has been made worse by the ar­rival of the San Fer­nan­do Teach­ing hos­pi­tal in Jan­u­ary 2014, the NWU stat­ed.

Mem­ber of Par­lia­ment for Fyz­abad Lack­ram Bo­doe said at least 150 doc­tors in his area are hop­ing to be hired.

"My in­for­ma­tion is that at this time there are over 150 na­tion­als, who hav­ing com­plet­ed their in­tern­ship and with the ex­pec­ta­tion that they would be en­gaged as House of­fi­cers by the RHAs are still un­em­ployed," Bo­doe said.

He ques­tioned why these doc­tors have not been em­ployed since Sep­tem­ber last year.

Dis­put­ed num­bers

For­mer health min­is­ter Dr Fuad Khan said the is­sue of staff short­ages in this coun­try's health sec­tor will con­tin­ue to per­sist un­til po­si­tions are cre­at­ed.

Khan said dur­ing his tenure as health min­is­ter he at­tempt­ed to ad­dress the sit­u­a­tion.

A Cab­i­net note was pre­pared to deal with the is­sue of the staff short­ages in the health sec­tor but Khan said he does not know what the lat­est de­vel­op­ment with re­gard to the sit­u­a­tion is.

Con­tact­ed for com­ment Chief Ex­ec­u­tive Of­fi­cer (CEO) of the SWRHA Anil Go­sine ad­mit­ted to a short­age at San Fer­nan­do Gen­er­al, but he said the ra­tio of 22 pa­tients to one nurse, which was quot­ed, was "too high".

A short­age ex­ists es­pe­cial­ly among reg­is­tered nurs­es, Go­sine said.

"We have al­ways had a short­age of reg­is­tered nurs­es in the health sec­tor of Trinidad and hence you would have found nurs­es be­ing brought in from Cu­ba and in the past you would have had from places like the Philip­pines in the 1980s and 1990s," Go­sine said.

Go­sine said there is a short­age of spe­cialised nurs­es in this coun­try in­clud­ing "the­atre nurs­es" and "in­ten­sive care nurs­es".

Pres­i­dent of the Trinidad and To­ba­go Reg­is­tered Nurs­es As­so­ci­a­tion (TTR­NA) Gwen­dolyn Loo­bie-Snag­gs said she does not have "up to date fig­ures".

Nurs­es and doc­tors

Ku­mar Boodram said there is al­so a dif­fi­cul­ty in re­tain­ing spe­cial­ist nurs­es at the NCRHA.

"We are still op­er­at­ing in an old es­tab­lish­ment but from then to now we have in­creased and ex­pand­ed our ser­vices. As we speak there is a pa­per that is go­ing be­fore the board of di­rec­tors for con­sid­er­a­tion for ad­di­tion­al po­si­tions. The prob­lem here does not lie in at­tract­ing the reg­is­tered nurs­es what we have is the in­abil­i­ty to at­tract and re­tain spe­cial­ly trained nurs­es like op­er­at­ing the­atre, neo na­tal and in­ten­sive care unit and even the dis­trict health vis­i­tors and there­in lies in our prob­lem. Get­ting the num­ber of bod­ies to fill the po­si­tions is a prob­lem," he said.

There is al­so a short­age of spe­cial­ist doc­tors at the Er­ic Williams Med­ical Sci­ences Com­plex (EWM­SC), he said.

"We have house of­fi­cers but when we get to neu­ro­sur­geons, car­dio­vas­cu­lar sur­geons, plas­mol­o­gists or neu­ro­sur­geons those spe­cial­i­ties and may by across all spe­cial­i­ties there in lies the short­age re­al­ly. The short­age does not ex­ist at the house of­fi­cer and the low­er lev­el," Boodram.

Boodram said while there are ap­proved po­si­tions ex­ist­ing there are on­ly a few peo­ple in those po­si­tions.