Mick­ela Pan­day

A health bud­get must be judged not sim­ply by how much mon­ey is al­lo­cat­ed, but by what that mon­ey de­liv­ers. Can pa­tients ob­tain the med­i­cines pre­scribed to them? Can fam­i­lies ac­cess time­ly treat­ment? Are hos­pi­tals equipped, staffed and func­tion­ing as they should? And when the sys­tem fails, does the Gov­ern­ment iden­ti­fy the cause, cor­rect it and re­port hon­est­ly on the re­sults?

These ques­tions do not as­sume every prob­lem can be fixed overnight. They de­mand an ac­count of what pub­lic funds de­liv­er and what re­mains un­re­solved.

For fis­cal 2026, Par­lia­ment ap­proved an orig­i­nal al­lo­ca­tion of TT$7.039 bil­lion for the Min­istry of Health. In June 2026, a fur­ther TT$517.3 mil­lion was ap­proved in sup­ple­men­tary fund­ing for the min­istry, in­clud­ing sup­port for Re­gion­al Health Au­thor­i­ties, op­er­a­tional re­quire­ments at ma­jor fa­cil­i­ties, out­stand­ing trade payables and debt ser­vic­ing.

For fis­cal 2027, the min­istry’s al­lo­ca­tion has risen to ap­prox­i­mate­ly TT$7.474 bil­lion. These fig­ures tell us what was ap­proved, not how much was ul­ti­mate­ly spent or what im­prove­ments re­sult­ed. Be­fore the pub­lic is asked to as­sess an­oth­er year of promis­es, the Gov­ern­ment must ac­count for what the pre­vi­ous al­lo­ca­tion and sup­ple­men­tary fund­ing de­liv­ered, what re­mains un­re­solved and how this year’s spend­ing will pro­duce mea­sur­able im­prove­ments in pa­tient care.

Dur­ing the Bud­get de­bate, Health Min­is­ter Dr Lack­ram Bo­doe ac­knowl­edged short­ages of med­i­cines un­der the Chron­ic Dis­ease As­sis­tance Pro­gramme and said steps were be­ing tak­en to ad­dress them. Re­port­ed short­ages have in­clud­ed breast can­cer med­i­cines ex­emes­tane, anas­tro­zole and letro­zole. For pa­tients with can­cer or chron­ic ill­ness, a short­age is not an ad­min­is­tra­tive in­con­ve­nience. It means anx­i­ety and un­cer­tain­ty about treat­ment at a time when de­pend­able care mat­ters most.

The min­is­ter has out­lined plans to strength­en phar­ma­ceu­ti­cal man­age­ment, ac­cel­er­ate med­i­cine reg­is­tra­tion, up­date the Na­tion­al On­col­o­gy For­mu­la­ry and es­tab­lish a cen­tralised ware­house. These steps may help, but a promise is not proof of suc­cess. When will they take ef­fect, and how will the pub­lic know whether short­ages are falling?

The min­is­ter al­so cit­ed ap­prox­i­mate­ly $346 mil­lion in wastage from ex­pired med­i­cines and sup­plies. That fig­ure de­mands a full ac­count­ing. What ex­pired, over what pe­ri­od, and where? What fail­ures al­lowed pub­lic mon­ey to be wast­ed while pa­tients strug­gled to ob­tain med­i­cines?

The me­dia-re­port­ed break­down con­tains an ap­par­ent in­con­sis­ten­cy: the year 2020 ap­pears twice, and the list­ed amounts do not rec­on­cile with the stat­ed to­tal. We should not guess at the miss­ing in­for­ma­tion. The min­istry should pub­lish the full break­down and ex­plain the fig­ure. In June 2025, the min­is­ter had al­ready iden­ti­fied weak­ness­es in in­ven­to­ry man­age­ment at NIPDEC and a per­sis­tent sup­ply-chain prob­lem. The pub­lic needs to know what has changed and whether wastage and short­ages are falling.

A cen­tral ware­house may help, but it can­not sub­sti­tute for ac­cu­rate fore­cast­ing, re­li­able in­ven­to­ry records and clear re­spon­si­bil­i­ty across the min­istry, NIPDEC and Re­gion­al Health Au­thor­i­ties. The Gov­ern­ment should re­port on med­i­cine avail­abil­i­ty, ex­piry loss­es and pro­cure­ment de­lays so that the pub­lic can judge whether the promised re­forms are work­ing.

These ques­tions are not ab­stract to me. I spent six hours fol­low­ing up on the case of a home­less man trans­ferred from Ch­agua­nas Med­ical Health Fa­cil­i­ty to Mt Hope. The ex­pe­ri­ence was heart­break­ing. It brought home how dif­fi­cult it can be to nav­i­gate the sys­tem when a vul­ner­a­ble per­son needs care and some­one must keep ask­ing ques­tions to en­sure the case is fol­lowed up. One ex­pe­ri­ence can­not speak for every fa­cil­i­ty and many health­care work­ers are do­ing their best un­der pres­sure. But no pa­tient’s dig­ni­ty should de­pend on some­one hav­ing the time or per­sis­tence to chase an­swers.

The same test ap­plies to hos­pi­tal projects. Dur­ing the Stand­ing Fi­nance Com­mit­tee, the Health Min­is­ter said the Gov­ern­ment in­tend­ed to open the Port-of-Spain Gen­er­al Hos­pi­tal Cen­tral Block dur­ing this fis­cal year. He al­so ac­knowl­edged that an in­ad­e­quate con­nec­tion be­tween the ex­ist­ing Ac­ci­dent and Emer­gency De­part­ment and the new build­ing had cre­at­ed dif­fi­cul­ties trans­fer­ring pa­tients who need ad­mis­sion. The pub­lic de­serves a time­line for re­solv­ing that prob­lem and up­dates on de­liv­ery.

Open­ing a build­ing is not the same as mak­ing a hos­pi­tal work. Pa­tients need trained staff, func­tion­ing equip­ment, avail­able beds and re­li­able sup­plies. Suc­cess is mea­sured by the care peo­ple re­ceive, not by an­nounce­ments.

The min­is­ter has said that non-com­mu­ni­ca­ble dis­eases ac­count for 62 per cent of an­nu­al deaths in Trinidad and To­ba­go. That makes pre­ven­tion, screen­ing and time­ly treat­ment es­sen­tial. The pub­lic should be able to see whether spend­ing im­proves ac­cess to care be­fore con­di­tions be­come emer­gen­cies.

The Gov­ern­ment is not be­ing asked to make every prob­lem dis­ap­pear be­cause bil­lions have been al­lo­cat­ed. It is be­ing asked to show what that mon­ey is de­liv­er­ing, where the sys­tem is fail­ing, what is be­ing done to cor­rect those fail­ures and whether its promis­es are pro­duc­ing mea­sur­able im­prove­ments. Where an­swers are miss­ing, the Gov­ern­ment must pro­vide them.

Health­care is a pub­lic ser­vice fund­ed by the peo­ple and meant to serve them. The pub­lic de­serves more than a bud­get fig­ure and an­oth­er list of promis­es. It de­serves ev­i­dence of progress, hon­est ex­pla­na­tions when tar­gets are missed and a health­care sys­tem that de­liv­ers the care peo­ple need, when they need it.

Mick­ela Pan­day is the Po­lit­i­cal Leader of the Pa­tri­ot­ic Front and At­tor­ney at Law