Danger in changing Medical Board Act

THE EDITOR: I have followed with great interest the accounts of the developments regarding the amendment to the Medical Board Act of Trinidad and Tobago in the press. I have not, however, seen any significant explanation of the implications of this amendment for the public of Trinidad and Tobago. Permit me, therefore, some space in your “letters to the editor” segment to enlighten the public regarding this issue.

Historically, for over 40 years the Council of the Medical Board of Trinidad and Tobago which made up a committee of elected members) has been responsible for issuing licences for doctors to practise medicine. In order for one to obtain a temporary licence, there are some criteria which must be met. They are: 1) The person must be a graduate of a university that is recognised by the General Medical Council (GMC) of England. 2) The person must be fluent in the English language. 3) The person should have at lest five years post-graduate experience, which is usually not insisted upon. Further, if one holds a temporary licence, he/she must be under the supervision of a senior consultant doctor.

The proposed amendment instructs that a “Panel” chosen by the Minister of Health will be given the power to issue temporary licences to doctors. This panel is not obliged to follow the above guidelines, which makes for a number of potentially harmful situations for the public. The GMC has a list of universities that issue medical degrees deemed to be of an acceptable international standard. A person who is a graduate of one of these universities cannot, therefore practise medicine in Trinidad without being subject to scrutiny and investigation by the Medical Board. The amendment makes no such provision, so any person can be registered to practise medicine in Trinidad and Tobago regardless of the quality of his degree. The public can take comfort in knowing that they will be going to see a doctor whose degree will not be accepted anywhere else in the world except TT. The ridiculous argument has been put forward by a senior ministry official that it is not necessary for a doctor in TT to be able to speak English, since there are already so many foreign doctors in the country.

All of these foreign doctors have been educated in universities where the curriculum is taught in English. They are therefore fluent in English. The amendment will encourage an influx of doctors who cannot communicate with their parents, which sets the stage for disastrous situations, including wrong diagnoses, incorrect treatment plans and undecipherable prescriptions for medication, all due to an inability to communicate in English on the part of these doctors. Any doctor currently holding a temporary licence cannot work without being supervised by a senior doctor. The amendment specifically states that the new doctors registered do not have to work under supervision, therefore if any emergency arises in which the doctors cannot cope, there is no one else available to help. The public therefore can and will be the victims of incompetence and inexperience without the safety net of a senior doctor to assist in serious cases. What could possibly be the justification of such piece of legislation? It is being said by some government officials that the need for this “Panel” is because of the current Medical Board not registering doctors, thus being responsible for the shortage of doctors in the health sector. The Medical Board has a registration rate of over 98 percent for foreign doctors, therefore it is quite clear that this is false.

It should be clearly known that it is the responsibility of the Government to encourage doctors to remain and practise in TT, as well as encourage doctors from abroad to enter the country and practise. They have clearly not been doing so by offering a third-rate health care system. With such a high rate of registration by the Medical Board, it can only be surmised that the need for an accessory panel is to register doctors who do not meet the criteria set out by the Medical Board, thus some or all of the outlined situations above are not only possible, but likely, thus causing the collapse of an already ailing health care system. In conclusion, it can be seen that the proposed amendment to the Act signifies the opening of the doors to disaster in the health sector. It should be noted that the ones who will suffer the most from this attempted quick-fix will not be the Ministers or the RHA officials...it will be the members of the public.

DR KHALID N ALI
Princes Town