A doctor’s perspective on healthcare in St Kitts – Nevis: Part 1

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It is an age-old belief that nobody can tell your story the way you can, please allow me to further shed some light on the situation at hand from the standpoint of a medical doctor, in a three-part series.

By Guest Contributor

The recent up-stir has paid some well-deserved dividends to the nurses and none can argue that it was long overdue. But that does not go nearly far enough to highlight or remedy the infinite injustices within the healthcare sector of this beloved country. Now that the nurse’s salary equates to and in some instances exceeds that of our doctors, a bad situation may have only been made worse. By failing to institute a comprehensive salary review across the board, the government has once again proven its disdain for the medical doctors and the other healthcare workers in the Federation.

That is a reasonable assumption to make, given that Delores Stapleton-Harris, permanent secretary in the ministry of health and a former nurse, is known for treating the concerns and complaints of doctors as the proverbial can being – kicked down the road. Her actions thus far and words “fight for yourself” uttered to the nurse who asked about the doctors at their recently held meeting proves that she may have resolved to be the permanent secretary in the ministry of nursing and not health.

For years, sons and daughters of our soil have been leaving this island to pursue studies in the field of human medicine, only to return home and be told that the system is already saturated with doctors. And that, there is no space or funds available to employ said doctors. As such, for consecutive years, doctors, upon return have been asked to volunteer at the hospital or work for free until they can find a space in the budget, often referred to as a vacant/unfilled position in some other department, whether it be from agriculture or perhaps for the department of education.

In essence, doctors are being made to believe that they are being paid against “borrowed money” from positions other than that of a medical doctor and some of which only up until recently have been paid by the People Employment Program (PEP) – a government initiative designed to create empowerment opportunities for unemployed nationals; a “courtesy” extended that was later demanded to be repaid.

This also means that despite our growing population owing in part to our Citizenship by Investment (CBI) program, foreign Universities on the island, and the increasing complexities of diseases and advancement in care, our government has not seen the wisdom to increase the number of spaces allotted to doctors.

Therefore how does a system “saturated with doctors” explain the poor state of healthcare in St Kitts and Nevis? Let me explain.

The lengthy wait times at the emergency room; the doctor-less Pogson and Mary Charles hospitals, the high incidence of hypertension, kidney disease, and strokes that has been spiraling out of control and the revolving door of repeated and frequent hospital admissions. Still, the medical chief of staff Dr Cameron Wilkinson has consistently and emphatically made the point that returning doctors are not entitled to a job by their government.

Now, while one may agree that the government does not necessarily owe doctors a job, wouldn’t a more progressive approach to make our return; including the Cuban scholarship program part of a national developmental agenda? Instead, young doctors are thrown into a poorly organized, mismanaged clinical enrichment program run by Dr Wilkinson and enforced in a sycophant manner by his hanger-on – one, Dr Natalie Osborne.

The program leaves much to be desired and not even a certificate of completion can be awarded at the end. Its as if it never happened. True, there are endless benefits to be derived from a period of familiarization and up-skilling before being allowed un-supervised practice, however, it should provide mentorship and an opportunity to build trust with senior colleagues and the public to sharpen skills and strengthen areas of weakness. Instead, this 12 months program appears to serve as a delayed appointment and a means to justify replacing a well-deserved salary with a mere stipend – often having to wait for months before receiving anything at all.

Returning doctors have been reduced to a pay scale of K33 when a rightfully appointed medical officer is to be paid against a pay scale starting at K39. Even at that level, except for Dominica, places St Kitts and Nevis at the lowest paid salaries for medical professionals – a country that has one of the highest GDP in the Caribbean. To offer some more context as it relates to pay scales, being paid at K33 places a doctor even below the pay of a staff nurse.

Furthermore, to ensure that salaries are not contested, the ministry has for years without explanation, refused to formally appoint doctors, to the effect that some government paid doctors are not even acknowledged as civil servants. To add insult to injury, it appears to be the practice within the ministry of health to use these appointments and pay scales promotions as a tool to reward blind loyalty and subservient conduct.

Such that, it is not uncommon to find two doctors, with the same qualifications and same years of experience, working at different pay scales; one appointed, while the other is not. The only real difference being their relationship and connections with the powers that be.

Doctors in St Kitts and Nevis have been forced to subsidize their “stipend” by any means possible, even if it means picking up shifts at a fast food joint to make ends meet. And these are the very same doctors placed on the frontline in light of the COVID-19 pandemic as sacrificial lambs, in a system that places no value on them and their education.

To be continued…

4 COMMENTS

  1. As a nurse I feel the hurt and pain of my colleagues because that’s who they are. I hope that the PS, Dr. Wilkinson and all the others who are placed in position to correct such injustices take this opportunity to do so. No longer will intelligent citizens of this island sit and allow authorities to abuse their position. I am a nurse by choice. The doctor worked hard, took many years of sacrifice to obtain their title, therefore they should be respected not by thank you – but with money.

    So why did Dr. Wilkinson “lie” to the nation and reported that they are 16 doctors at the emergency department at the main hospital (JNF). Doctors you all have my support, together we can create a better health care system.

  2. The tyranny of this administration needs to go. If you’re not an advocate for better health then I think you shouldn’t be involved in it. Pay the doctors. They have wonderful ideas. Listen and find solutions to get around them if there are obstacles…This is not rocket science. Simple solutions for problems. Fix them.

  3. This is only part one and people are already in shock at the treatment of medical professionals. Summarily, the deterioration of healthcare at JNF sits squarely on the shoulders of Cameron Wilkinson. That’s why even with a change in government, there was no change in healthcare quality. He is the one that needs to be traded out more than anyone else. He has been the most “serial oppressor of Kittitians” since the days of slavery and colonialism. He has kept the system backwards and well behind neighbouring countries, some of which are behind us in every way shape or form – except health. He has kept the salaries of ALL medical staff well below global and regional standards, which has caused mass migration of our best and brightest minds who weighed their options and decide that they are simply too intelligent to allow him to belittle their value.

    He used the stem call scandal as his first scapegoat to survive in the Unity government when he went out of his way with the general public to save his administration. Now he is using coronavirus as scapegoat number two, thrusting himself forward in positions and conversations in which he has no place, especially since he is a surgeon and not an internist – but it won’t work this time.

    No matter how much he tries to turn himself into a medical celebrity and no matter how many nights he calls himself a “hero” and shamelessly showers himself with praise. His “nasty” attitude and behaviour is now well-known nation-wide and he is definitely soon going to follow his partner … Sonia Daley Finley on the “chopping block”.

    Only his will be more severe and have much more public exposure of his decades of “… oppression and wicked deeds”. And at the age of 58, the same age his former colleague Patrick Martin to be “forcibly removed” as chief medical officer for being “over the retirement age,” it is only fitting that he “gets the exact same treatment”.

    Cameron Wilkinson if you are reading this it is best that you resign and get out of the way of progress … Everyone has had enough of you.

  4. Same people who always in front of the media getting praises that they are heroes, Wilkinson and Laws, You two are no heroes.. The Doctors on the frontlines are the real heroes. Public should know that. These two should be looking after their staff, their brothers and sisters in uniform but instead put their fellows to the ground and let them rot. Punish them both.

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