Budget Speech DR Mahadeo - 20123152 10 Apr, 2012
Dr. Mahadeo: Thank you Mr. Speaker. First of all please permit me to extend my congratulations to you as Speaker of the House officially and to Ms. Backer as Deputy Speaker. Permit me to congratulate all the new Members of Parliament (MPs) in the House and in particular the two MPs from Region 6, my colleague, Hon. Member Jafarally and Hon. Dr. Ramayya. Congratulations and welcome to this House which could be entertaining at times. You could learn from it at times and a lot of times you will shake your head and say “what...” [Mr. B. Williams: ...am I doing here]
Mr. Speaker: No so-and-so’s.
Dr. Mahadeo: I want to wish each one of you well in your sojourn in this Hon. House. As I stand here to make my contribution to the debate on the National Budget for the year 2012, I wonder what the next few days will bring and the numerous twists that these figures presented in the Budget will be given. However, I must first congratulate the Hon. Minister of Finance for a well crafted Budget and an excellent presentation, a presentation like I said the last time was simple and full of information. It is a balanced Budget. I am sure the Hon. Minister and the Government would have liked to have a lot more in this Budget, but I want to remind us all that we have come a far way.
Year 2011 was one of successes in Region 6. I will elaborate on this together with, I am sure, my colleague Hon. Member Mr. Jafarally. Like in my last speech, I want to clearly say that we have not paved all the roads, nor have we built all the bridges. I will also say that we have had some shoddy work done by contractors; these we have noted and are working on. We have not done all that we would have wanted, but we did the best we could with the funds and resources that we had available.
I would like to state clearly that in Region 6 there have been consultations across the Region for the preparation of this Budged. Consultations were done at the level of the Regional Democratic Council (RDC), the National Democratic Council (NDC), the different departments, Health, Education, Agriculture, Drainage and Irrigation (DNI), et cetera. The residents of Region 6 were involved in the management of government institutions. They were given the opportunity to hold Government officials responsible and accountable.
The Regional Administration had for the year 2011 many community meetings. This does not include the community feedback meetings that we had in health and in education. I also want to say that after the Budget was presented we had meetings across the Region with members of the community and we got feedback, some of which I will relate later.
To get into some details, there was development work across the Regions. In every village work was done, not taking into account the makeup of the village. With Central Government’s help, works on 23 kilometres of road in Canje, West Bank Canje and Black Bush Polder have either been completed, and works are ongoing. Street lights were put up in 2010 and they are continuing to be put up in other areas in 2011 and even up to now. New lands for farming and rice cultivation have been opened up; this together with the new varieties of rice has helped Region 6 to produce more rice than ever in its history.
The Women of Worth (WOW) and One Laptop Per Family (OLPF) projects have made an impact on the lives of Berbicians. Four new health centres were constructed at Skeldon, Martrait, Whim and at Angoy’s Avenue. All health buildings where in some way renovated or repaired. An ambulance, a tractor and a slasher were bought.
I must mention here that there is new administration in Region 6. Mr. Armagon, Regional Chairman and team have promised to have the community more involved and to be held more accountable by the people. A more transparent administration is promised. He has like his predecessors, PPP Chairmen, opened his doors to all persons independent of political persuasions. The practice of involving the community to monitor the works being done by contractors will be expanded to include all contracts. The community will be encouraged to take ownership of these projects in their community and they will be encouraged to be the eyes and ears of the administration.
The next five years promises to be interesting. I must again mention like I did last budget that inspection of all works will be done by the works committee that is made up PPP and Opposition Members. Again, like last year, I would like to call on the Opposition Members that they need to make their objections and suggestions in the committees so that only good works can be passed for payment. This is what they were elected to do at the regional levels also. They must make the final assessment after the community would have made their contribution.
Another fight that needs to be mentioned is that there are a number of different contractors to whom works were awarded last year. So it is clear that works are given not to choice persons or companies, but it is the best contractor that gets the job.
I extend an invitation to the Hon. Members of the Opposition to visit with us when we go in the fields. For example, the Regional Chairman has statutory days when he visits Black Bush Polder areas, which is ever other Wednesday. I invite them to be part of the team and be there when the community makes its input, raise your issues in front of the people and join with us as we visit areas that you might consider to be your support areas, because works are done there also.
In the area of health care for 2010 we were all saddened by three maternal deaths in Berbice. For 2011, there was one such. We are still not satisfied. I want to state however that the cases investigated analyse, and in fact Mr. Speaker, like a member mentioned before me, any avoidable death is a death that we should worry about, not only for the maternity unit but for all cases, as such all deaths are investigated thoroughly and recommendations made and systems put in place.
Having said that I must say that the Berbice Regional Health Authority, which is the authority for health in Region 6, have a number of achievements which they can boast about. Once again I must acknowledge the full and unconditional support we received from the Ministry of Health. The fourth services agreement was in effect and we reported to the Ministry of Health again same. We were under continued guidance of the National Health Sector Strategy and the (Berbice Regional Health Authority) BRHA second three years business plan for all quarters in the year 2011, the BRHA topped the country with the scores of the services agreement when they were tabulated. Kudos to the hardworking staff of the BRHA!
In training, we completed the first ever psychiatric patient care assistant programme in Guyana and in the Caribbean. These 21 specially trained persons are now assisting in management of patients in the wards and chalets of the National Psychiatric Hospital. The once neglected National Psychiatric Hospital under the PNC has under the PPP/C been getting the kind of attention, starting with the then Hon. Minister Gail Teixeira in 1992 through to the present Minister Hon. Dr. Bheri Ramsara, that will once again make it a premier institution.
Of course we are not where we want to be as yet, but step by step we are getting there. The Psychiatric nurse practitioner programme was completed. It was the first of its kind in Guyana and was done in collaboration with Dalhousie University. What is more unique about this training is that it was done mainly online. The E-classroom was set up in the boardroom of the boardroom of the BRHA and this was used to conduct the classes. At the same time whilst this training was being done, with the help of Central Ministry, a new Acute Care building was started in 2011. This structure will be completed by the middle of this year and with help, our staff will provide a much better level of care to the acute cases with the better facilities that will be available.
The more modern medications that were available yearlong has helped to reduce the burden of diseases in the national psychiatric hospital and for psychiatric patients. The Pharmacy Assistant Programme in Berbice produced eight Pharmacy Assistants that have boosted the staff in the BRHA.
Mr. Speaker: Dr. Mahadeo, one second, could you assist me? There is a gentleman who is residing at the fence. Stand please. We have a resident of the National Assembly who needs to be at that hospital that you are speaking so glowingly about. You can assist me in getting him there.
Dr. Mahadeo: Yes Mr. Speaker, we can speak about it after.
Mr. Speaker: Thank you very much.
Dr. Mahadeo: There is a procedure that we go through. May I continue Mr. Speaker?
Mr. Speaker: Yes
Dr. Mahadeo: Voluntary Counselling and Testing sites (VCTs) from both the Government institutions and the Non-Governmental Organisations (NGOs) were given refresher training and they have been certified.
In terms of HIV a target of 12,000 tests were set for the BRHA for the month of testing. In fact we did 14,614 tests in 2011 and we effectively managed to test 12% of our population that contributed to 33% of persons tested for that period. I must point out that we managed to do tests for our population in all areas, Riverine, Hinterland, villages and towns on the Coast during the period of testing. For a true representative picture of HIV infection rate we have again done a real sample.
For blood collection, a target of 1,000 was set for the BRHA in our services agreement. We actually collected and sent to the National Blood Transfusion Service (NBTS) 1,067 units. We partnered with Churches, Mandirs, Masjids, health centres and NGOs and due to their efforts and those of the BRHA staff, 86.6% of the blood that was sent to the NBTS was from voluntary donors.
We had our second telethon for blood donation last year, again sponsored by the Little Rock Television Station. Speaking about using television for health, the BRHA has a half an hour (Local Education Authority) LEA informative programme every week on CCTV channel 19. The cost is born by the televisions station itself. This programme is, “Your Health in Your Hands”, and we have had very positive responses from viewers.
Extended Home Based Care Programme has been a real continuing success story. This is the programme that started out to bridge the gap between the hospitals and bedridden patients and taking care of those persons in need. We have extended the programme to include persons over the age of 75 who want to be on the register. It also now includes visits to some of the mothers and newborns. It also includes some of the psychiatric outpatients. This programme that offers monthly and quarterly medical services to the various communities has patients and clients in communities across the Region. The visiting team will include a doctor, a dentist, a community health worker and staff from the health centre. Last year we had 866 persons on our register, some of them were visited six times for the year. For this year so far over 500 persons have already been visited at their homes. The staff continued to deliver care with pride in their work and I publicly commend them.
In addition to the home-based care there are outreaches by medical teams to Hinterland and Riverine communities, regular outreaches to Orealla, Siparuta, Barakara, fortnightly outreaches to Yakusari done by the doctor and team from the Mibikuri Hospital. Monthly outreaches that we used to have at Mara Schepmoed Brothers on the East Bank Berbice were increased to fortnightly visits. There were also outreaches to Toko and Angoy’s Avenue. These do not include the special outreaches during floods and at the request of Regional Administration.
I must make mention here of the new engine which was given to the Orealla community. So now the community has its own boat and engine that is dedicated to health. There, the community has taken ownership of the facility. The management committee of the Orealla Health Centre that was set up has oversight and helps to manage this boat and engine.
Barakara was also given a boat and engine and they now have a Medex who lives there to service the community, along with a renovated health centre.
The dental department made significant progress. There has been a very active school programme. This was boosted by the introduction of the dental bus in a mobile unit to do works at the schools and also to service communities, the school children being priority. For this year so far 656 school children and 78 adults benefited. The adults are being seen during the school holidays. The procedures done by the dental team includes prophylaxis, floral application, fillings and minor surgeries. The team that operates the bus includes a dental surgeon, a Dentex and a dental technician. Congratulations to Dr. Chalwan’s team for a good job.
In our endeavour to be more accountable to the people we serve we had faced the community meetings at our health centres. At these meetings held at the different health institutions from health posts and health centres and hospitals, the staff reported on the work they did for the previous year to the community. They also informed the community on their plan for the next year and specified targets that they could be held against. In addition we also had general patients satisfaction surveys using questionnaires and interviews that were carried out at the different hospitals and health centres. The results of these surveys were analysed and presented to the board, recommendations were made and implemented. Our Complaints Department received 518 complaints, all of which were investigated and action taken.
For this year so far we have faced the community meetings at Baracara, Whim and Brothers Health Centre and we have started the new Patient Satisfaction survey. We continue to maintain our website and I again invite anyone who is interested to check it at www.rha6.gov.gy where you will see some of the works that the BRHA has been doing, our plans, our programmes and our reports.
2011 was a year in which we had some setbacks that we acknowledge. Some of these had been mentioned previously and they have been given great deal of publicity, including in Region 6 the issue with the Skeldon sugar factory. These we cannot and do not ignore, instead we have analysed and are dealing effectively with the issues. This is why I would like to thank the Ministry of Finance for putting the billions of dollars to help put the sugar industry strongly back on its feet, especially for the residents of Region 6 since we have three large sugar estates in Berbice.
I would also like to make mention of the $6 million that will be going to cushion the increase cost of electricity since it will go a far way in helping the poor to meet their bills. The increase in income tax threshold is another plus for the wage earners.
I now move on to the Maternal and Child Health (MCH) Department. Our vaccination coverage are in the nineties after complete tallying is done. An example of coverage is BCG – 97%, MMR 1 year – 99%, OPV – 93%. The Region received the award for best performance in the introduction of a new vaccine and I would want to publicly thank here Dr. Wolford for spearheading the vaccination programme. Because of this, Guyana received an award in Barbados for its vaccination coverage.
Again in Region 6, unlike the impression we would have had from the last speaker, the HPV vaccine was not only introduced in Georgetown, it was also introduced in Region 6. Sixty percent of our children have already received their first dose, that is, 665 of the targeted 1,164. One hundred and forty seven children have already received the second dose. This is in spite of the targeted campaign – I wrote this speech before I heard the last speaker – by some against the introduction of this vaccine. Mothers are coming forward to thank the Ministry of Health and the BRHA for the introduction of the vaccine after checking pre-reviewed sites and information coming from PAHO and WHO.
I know that Dr. Barnet who is the Head of PAHO in Guyana made several speeches about this vaccine. The vaccine that we are using covers all four of the viruses; two of them are very malignant. Cervical cancer in Guyana is one of the leading causes of morbidity and mortality for our young women.
When people speak against this vaccine, twenty five years from now when a child who is ten years old that should have gotten the vaccine but did not take the vaccine because of negative propaganda, is in her 35 – 50 develops cancer, these people who are speaking and discouraging them right now will not be there to help them. If you want to read about – the Hon. Minister Frank Anthony just showed me on his phone – check www.medscape.com or the PAHO website, you will find pre-reviewed information.
I listened to the Hon. Member making his remarks and I want to say that Minister Ramsaran never claimed that the Cubans do not speak English. I do not know where that information was gotten. This is misleading.
I would like to respond to a few things raised by the Hon. Member who spoke before me, one is about the percentage drop that we had in spending in health. We have had absolute increases in the budget. From year to year we have had absolute increase in health and that cannot be denied. The actual figures are increasing; therefore a lesser percent from a bigger budget becomes a larger absolute dollar value.
Listening to the last speaker, I was remembering the Jekyll and Hide Story, but in this case it was only the Hyde which came over, everything bad and everything negative. I did not hear him say anything about the new hospitals that were constructed at Diamond, Leonora, Suddie or Port Mourant. We need to consolidate so that what the Hon. Member said before me, that we need better bang for the dollar. We do not need to build new facilities, but to build on what we have.
The Hon. Member mentioned about emergency at Georgetown Public Hospital Cooperation (GPHC). Right now at GPHC, and I am sure if the Hon. Member is worker there he would know, but did not mention that there are postgraduate training programmes in emergency medicine, in surgery, in paediatrics and soon to start in obstetric and genecology. There is post graduate medicine right in Guyana with help from overseas universities. I am not sure that the Hon. Member is unaware of this.
A new theatre is right now being rehabilitated in GPHC. The Maternity unity will be having their own theatre that will be functional for maternity and obstetric cases. Although the Hon. Member mentioned issues at Linden he did not mention that for the year 2011 there were no maternal deaths. The supply of blood to the Linden Hospital Complex was improved and this allowed us to prevent maternal deaths. The Hon. Member made mentioned about training for ophthalmologists. I think he should be aware that we have one ophthalmologist that has returned and is presently working at GPHC, Dr. Sugrim. There are four more in training right now.
I would like to remind the Hon. Member that GPHC is not the whole health sector and not only doctors from GPHC should get post graduate training, but doctors across Guyana.
I do not know if Minister Ramsaran or Minister Ramsammy could tell me what was the number of cataract cases done before Operation Miracle at the GPHC. How many were done per year? [Dr. Ramsaran: Sixteen operations a year before Operation Miracle.] There was a backlog that was so long the Government had to put in place a special programme to get rid of the backlog. Now we do not have any backlog. What is so wrong if the Government takes persons from the different regions, pays all the cost, takes them to Port Mourant, gets the surgeries done, and takes them back home? What is wrong with that? Nothing is wrong with that.
I also want to remind this Hon. House that in the days before Operation Miracle a cataract surgery used to cost $200,000. It seemed as if there was a deliberate delay in getting these surgeries done so that people would have to seek it from the private institutions. Now, even at private institutions, the cost of the cataract surgery has come down to $25,000 and $30,000 because there is no backlog; it has all cleared up. We did not hear that! We did not hear that!
We heard about the Guyana Nurses Association making remarks about the training programme that is ongoing, and the number of persons coming in to be trained. I want to remind this House that it is the Guyana Nursing Council that certifies these things and that the Guyana Nurses Association has a representative on the Guyana Nursing Council. I also want to say that for the last midwifery examinations - we did not see this in the newspapers either – the New Amsterdam School of Nursing had 100% passes. I did not hear that from the Hon. Member. The Georgetown School of Nursing had a large percentage of passes.
In 1993 the then Hon. Minister of Health brought pictures to this Hon. House - I am sure that records could be found - and showed the state of the theatre at the GPHC, the only functioning theatre they had. The walls had fungus; it was black with mold. That is what accounted for the large number of post operation infections which occurred in 1993. Now check the theatre; it is very different. It is comparing chalk to cheese.
I would want to close by talking about the visits we made. In the post budget meetings we had some people demanded of me that I say some things in the National Assembly. They said they heard last year some Hon. Members sitting in the House saying that the Government needs to invest more in GuySuCo, needs to lend a hand to the industry, would not fail it since it is too big to fail, since it affects the livelihood of so many. They do not want to see criticised the moneys that would now be plugged into the industry. The people are watching; they are listening.
I was asked to remind this Hon. House at a meeting in Port Mourant that the minimal wage in 1990, and I know about 1990, because I started working as a doctor in this country in 1990. When I started working as a doctor in Guyana it was $1,027 at an exchange rate of US$1 to G$90. If we calculate that it comes up to US$11.41 as the minimum wage, not a pension. This would translate to $2,282 dollars today. I started working as a doctor with a salary of approximately G$3,000 per month in 1990, at an exchange rate of US$1 to G$90, this amount came up to under US$40 per month. Times have changed. I know that the People’s Progressive Party/Civic Government wants to give us more but with the limitations that we have - we have worked within our limitations - the budget is the output.
Congratulations Dr. Ashni Singh. I want to commend this budget, and to say that I fully support it. Thank you. [Applause]
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