“[…] Short-term contract labour has been in widespread use throughout the Regional Health Authorities in Trinidad and Tobago ever since the establishment of the Regional Health Authorities (RHAs) in the 1990s… Short-term contract workers obviously suffer anxiety over their job security and are at a disadvantage when it comes to accessing mortgage and other loans and credit facilities
“[…] How can workers who are not comfortable when it comes to their quality of life be expected to provide quality health care for members of the public?”
The following Letter to the Editor, which discusses the abusive short-term contract system in use in the RHAs, was submitted to Wired868 by Gerry Kangalee, national education and research officer of the National Workers Union:
The National Workers Union (NWU) notes with interest and with concern the decision by the Tobago House of Assembly to offer three-year contracts to workers of the Tobago Regional Health Authority (TRHA) who are on so-called fixed-term contracts, some of which are three-month, six-month, one-year and two-year contracts.
For those not in the know, this offer does not just apply to registered nurses who were hired to man the parallel health system. Short-term contract labour has been in widespread use throughout the Regional Health Authorities in Trinidad and Tobago ever since the establishment of the Regional Health Authorities (RHAs) in the 1990s.
It applies to all monthly paid classifications in the health system. This horrendous system affects both workers with professional qualifications and those without. This includes enrolled nursing assistants, registered nurses, doctors, laboratory technicians, orderlies, administrative personnel, phlebotomists, radiographers, pharmacists, dietetic and nutrition personnel, health, safety and environment personnel and medical social workers.
This is an insidious form of corruption that saps the morale of thousands of workers in the RHAs and has a direct bearing on the backward master-and-servant syndrome that pervades industrial relations in the RHAs.
It relates to the ridiculous job appointment system in the RHAs which has, as its base, what are called cabinet- approved positions and board-approved positions. Cabinet-approved positions are so-called permanent appointments and board-approved positions are short-term contract appointments.
These short-term contracts may be month-to-month contracts, six-month contracts, one-year contracts, two-year contracts and three-year contracts.
The short-term contract system is being used as a device to escape management’s obligations to workers. While a fixed-term contract has a starting date and an end date, there are workers in the system at all levels who have been subjected to continual roll-overs of their short-term contracts and who have been employed continuously for 15 or more years.
In fact, these are permanent workers who are being deprived of benefits that should accrue to them. Incredibly, some categories of permanent staff who are offered promotions are told that they have to resign their positions and go on short-term contracts to accept the promotion.
Short-term contract workers obviously suffer anxiety over their job security and are at a disadvantage when it comes to accessing mortgage and other loans and credit facilities. They cannot properly plan the future of their families or make significant investments and they are not entitled to be members of the Regional Health Authorities’ Pension Plan.
Even if they eventually become ‘permanent’ and eligible to join the Pension Plan, the service they had before they became permanent will not be counted as service in the plan. It must be noted that the formula for calculating workers’ pensions is based on a worker’s final salary and his/her years of service.
The horrendous contract system must be done away with in the RHAs. How can workers who are not comfortable when it comes to their quality of life be expected to provide quality health care for members of the public?
Management of the RHAs is based on political allegiance and not on providing a first-class health service to the citizens. The industrial relations are abysmal and lead to low morale and frustration on the part of employees who are not connected to the party in power.
In such an environment, nepotism reigns unchecked; unqualified personnel are put in positions of responsibility which they cannot handle, promotions are denied to deserving workers because they are not management’s favourites, victimisation flourishes and the provision of health care deteriorates with each passing day.
This situation has been left unchecked because of the lack of recognised majority unions in the health system with the exception of the daily paid workers who are represented by the National Union of Government and Federated Workers (NUGFW) and doctors in the South West Regional Health Authority who are represented by the comatose Medical Professionals Association.
The situation described here is the norm in the public health system and has only been intensified with the onslaught of the pandemic. While the focus of the country is on the near collapse of the health system due to the pandemic, if one looks below the surface, it must be admitted that the pre-Covid health system has been teetering on the brink of collapse for quite some time. The Covid situation has now pushed it over the edge of the precipice.
This horrendous short-term contract system must be abolished as a matter of priority as a first step to providing the suffering masses of this country who use the public health system with some measure of relief.
After all, according to the September 1978 Alma Ata declaration coming out of the International Conference on Primary Health Care, which was co-sponsored by the World Health Organisation, health ‘is a fundamental human right and […] the attainment of the highest possible level of health is a most important worldwide social goal…’