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Why did CEO ‘reassign’ four doctors in midst of pandemic? 11 doctors write NCRHA Board

“[…] We have taken the decision to reach out to the board as we believe this is an issue of singular importance. Firstly, it involves the removal of the most experienced physicians in our country in the care of patients with Covid-19, at a time when their services are most desperately needed.

“[…] Given the impact of this decision not only in the NCRHA but in our entire country, it would be reckless not to pursue an independent assessment of why and how this action was conducted…”

The following letter to the Board of the North Central Regional Health Authority (NCRHA), regarding the supposed ‘rotation’ of four senior doctors by CEO Davlin Thomas, was signed by Dr Fareed Ali, Dr Nazim Boris Mohammed, Dr Barbara Rampersad, Dr Marlon Seenath, Dr Rheana Sieunarine, Dr Robbie Rampersad, Professor AVC Rao, Dr Camille Greene, Dr Curtis Young, Dr Sushil Devarashetty, and Dr Paramanand Maharaj:

Photo: North Central Regional Health Authority (NCRHA) CEO Davlin Thomas (front left) poses with staff at the Caura Hospital.
(Courtesy NCRHA)

To Members of the Board of the North Central Regional Health Authority: Steve De Las, Elvin Edwards, Randolph Clouden, Yvonne Bullen-Smith, Marie Ayoung-Chee, Stewart Smith, Dr Maria Bartholomew, Dr Keith Clifford, Anita Sohan, Kimoy Thomas, Kadeem Graham.

Dear Board Member,

We are writing to express our concern regarding recent events regarding our colleagues at the Couva General Hospital and to request urgent action be taken to address these issues.

(Background)

On Wednesday 19 May 2021, the sudden and unprecedented decision was taken by the North Central Regional Health Authority (‘the Region’) to remove four senior physicians from their positions at the Couva Hospital and reassign them to various other institutions. 

When the Region was approached about the curious timing and unusual manner of this reassignment, the response was twofold: the CEO NCRHA in a news interview on Thursday 20 May 2021 and the NCRHA via a press release dated Thursday 19 May 2021 both took the position that the removal was rather a ‘rotation’ requested by the then chief of staff at Couva Hospital, Dr Don Martin.

Photo: NCRHA director of health Dr Malachy Ojuro.
(via NCRHA)

On 21 May 2021, Dr Martin unequivocally refuted this claim during an interview with the Trinidad Express and instead noted that it is ‘critical’ that the existing team remains in place. A copy of this news report is attached hereto for your ease of reference.

The CEO NCRHA in an interview then attempted to ‘clarify’ the Region’s statement, but significant and disconcerting discordance still persists between the two narratives.

The four doctors who have been ‘rotated out’ comprise of Dr Martin, Dr A Maccum, and Dr K Kernahan (the three most senior doctors at the institution) and Dr S Mohammed (the only pulmonologist).

We have taken the decision to reach out to the board as we believe this is an issue of singular importance. Firstly, it involves the removal of the most experienced physicians in our country in the care of patients with Covid-19, at a time when their services are most desperately needed. This was among the issues identified by Dr Martin in the interview already referenced.

This current wave has been acknowledged by the Ministry of Health as our worst to date and our nation is under a state of emergency. We find it concerning in the extreme that the NCRHA has take the decision to remove the physicians at this time.

Photo: A woman swabs for Covid-19.

The other point of concern refers to the circumstances and process of the action taken. Why were these doctors removed? Were their preferences taken into consideration?

The wider appearance, including the inconsistent and confusing explanations proffered by the Region suggests that these physicians were removed without clear or any justification, against their will and with no thought as to the adverse impact on the wider public.

The NCRHA and Dr Martin’s positions are clearly contradictory. The unfortunate removal of the four senior physicians has already attracted wider adverse public comment. It has been the subject of criticism from a current member of parliament as well as by the Trinidad and Tobago Medical Association (TTMA) and the Trinidad and Tobago Registered Nurses Association (TTRNA).

The criticism of the latter two medical associations were given publicly and reported in the Trinidad Express of 22 May 2021. A copy of the news report is also attached for your ease of reference.

Given the impact of this decision not only in the NCRHA but in our entire country, it would be reckless not to pursue an independent assessment of why and how this action was conducted. We owe it to the physicians who are nothing short of national heroes, and we owe it to every citizen of Trinidad and Tobago.

Photo: NCRHA CEO Davlin Thomas.
(via NCRHA)

We are aware that this issue has become heavily publicised. As consultants and heads of department working in the NCRHA, we are not in the habit of engaging in matters that do not directly impact our patient care. We must make the point that destabilising the delivery of health care to patients with Covid-19 has the potential to affect all of our patients and therefore is of direct relevance and extreme importance.

Furthermore, in our review of the information available to the public, we are quite concerned about the treatment of our colleagues and the possibility of defining a new status quo: is this how we ourselves can expect to be treated by the Region in the future?

In light of the above, we are insisting on the following:

  1. That the board take immediate action to conduct an independent and transparent inquiry into why these physicians were removed and why the action was conducted in such a curious and undesirable manner. If wrongdoing is identified, a clear accounting delivered to the individuals responsible.
  2. An apology to the physicians who were removed and an offer for immediate reinstatement so as to reduce any adverse impact upon patient care.
  3. Clear feedback from the Region as to how it intends to engage with medical staff moving forward with reassurance that this sort of episode will not be repeated.

As medical professionals, we continue to act in what we consider to be the best interest of providing public health care at a fraught and difficult time in our nation. We write this letter to the members of the board in the belief that they, as fiduciaries of the Region, share these values and will thus be motivated to investigate what appears to be a serious breach of the Region’s responsibility to prioritise patient care and secure the wider public interest.

Photo: Medical staff at the Arima General Hospital.
(via NCRHA)

We look forward to your urgent action action and to any dialogue which may be desirable and hope that we can look forward to the urgent correction of what appears to be a very serious default.

Yours respectfully,

  • Dr Fareed Ali, acting head of cardiovascular services,
  • Dr Nazim Boris Mohammed, acting head of medicine,
  • Dr Barbara Rampersad, head of paediatric surgery and neurosurgery,
  • Dr Marlon Seenath, head of general surgery,
  • Dr Rheana Sieunarine, head of anaesthesia and intensive care,
  • Dr Robbie Rampersad, acting head of radiology,
  • Profession AVC Rao, head of diagnostic laboratory services,
  • Dr Camille Greene, HOD paediatric medicine,
  • Dr Curtis Young HOD specialty surgery,
  • Dr Sushil Devarashetty, head of department PICU,
  • Dr Paramanand Maharaj, former HOD radiology/consultant radiologist.

Editor’s Note: The NCRHA’s communications department declined comment when asked for a response to the allegations.

Click HERE to read response from NCRHA CEO Davlin Thomas, and the counter to that from TTRNA president Idi Stuart.

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8 comments

  1. Really? Where was their public inquisition when Dr. Avinash sawh’s rant about african trinidadians was made public? How many indian RHA CEOs are ever publicly challenged in this manner by indian doctors? There exists a perception amongst the citizenry, that indian, unc doctors never go against their co-ethnic colleagues when they are clearly wrong, but seem only too eager to be sanctimonious and publicly critical of africans in positions of authority, including the PM and the PNM administration,. Could this issue be a not too subtle example of that?

  2. Why must there always be controversy in respect of management and management decisions/actions in Trinidad & Tobago? Is it that our general concept/style of management is flawed?