“[…] Short-term contract labor has been widely used in Trinidad and Tobago’s Regional Health Authorities since the creation of the Regional Health Authorities (RHAs) in the 1990s…Short-term contract workers obviously suffer from anxiety about their job security and are short-term. a disadvantage when it comes to accessing mortgages and other loans and credit facilities
“[…] How can workers who are uncomfortable with their quality of life be expected to provide quality health care to members of the public?
The following letter to the editor, which discusses the abusive system of short-term contracts used in RHAs, was submitted to Wired868 by Gerry Kangalee, responsible for national education and research of the National Union of Workers:
The National Union of Workers (NWU) notes with interest and concern the decision of the Tobago Legislative Assembly to offer three-year contracts to workers of the Tobago Regional Health Authority (TRHA) who are on so-called fixed-term contracts, some including three-month, six-month, one-year and two-year contracts.
For those who are not in the know, this offer does not only apply to registered nurses who have been hired to manage the shadow health system. Short-term contract labor has been widely used in regional health authorities in Trinidad and Tobago since the creation of regional health authorities (RHAs) in the 1990s.
It applies to all monthly paid classifications in the healthcare system. This appalling system affects both skilled and unskilled workers. This includes registered practical nurses, registered nurses, physicians, laboratory technicians, patient care workers, administrative staff, phlebotomists, radiographers, pharmacists, dietetics and nutrition staff, health care staff , safety and environmental and medical social workers.
It is an insidious form of corruption that undermines the morale of thousands of workers in RHAs and has a direct impact on the backward master-servant syndrome that permeates industrial relations in RHAs.
This is the ridiculous system of appointing positions in the RHAs that is based on what are called cabinet-approved positions and board-approved positions. Cabinet-approved positions are referred to as permanent appointments and Board-approved positions are short-term contract appointments.
These short-term contracts can be month-to-month contracts, six-month contracts, one-year contracts, two-year contracts and three-year contracts.
The system of short-term contracts is used as a means of evading management’s obligations to workers. While a fixed-term contract has a start date and an end date, there are workers in the system at all levels who have been subject to continuous renewals of their short-term contracts and who have been employed continuously for 15 years or more.
In fact, they are permanent workers who are deprived of the benefits that should be theirs. Incredibly, some categories of permanent staff who are offered promotions are told that they must resign from their positions and enter into short-term contracts to accept the promotion.
Workers on short-term contracts obviously suffer from anxiety about their job security and are at a disadvantage when it comes to accessing mortgages and other loans and credit facilities. They cannot adequately plan for their family’s future or make major investments, and they are not eligible to participate in regional health authority pension plans.
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 should be noted that the formula for calculating workers’ pensions is based on the last salary of the worker and his years of service.
The horrible system of contracts must be abolished in the RRS. How can workers who are uncomfortable with their quality of life be expected to provide quality health care to members of the public?
The management of RHAs is based on political allegiance and not on the provision of a first-class health service to citizens. Industrial relations are abysmal and lead to low morale and frustration on the part of employees who are not tied to the ruling party.
In such an environment, nepotism reigns unchecked; unqualified staff are placed in positions of responsibility which they cannot assume, promotions are refused to deserving workers because they are not management favourites, victimization increases and the provision of care health is deteriorating day by day.
This situation has gone unchecked due to the lack of recognized majority unions in the health system, with the exception of daily workers who are represented by the National Union of Government and Federated Workers (NUGFW) and doctors of the South West Regional Health Authority. who are represented by the Coma Health Professionals Association.
The situation described here is the norm in the public health system and has only gotten worse with the onslaught of the pandemic. As the country focuses on the near collapse of the healthcare system due to the pandemic, if one looks below the surface, one must admit that the pre-Covid healthcare system has been on the brink of collapse for a time . The Covid situation has now pushed him to the edge of the precipice.
This horrible system of short-term contracts must be abolished as a priority as a first step in bringing some relief to the suffering masses of this country who use the public health care system.
After all, according to the September 1978 Alma Ata Declaration of the International Conference on Primary Health Care, co-sponsored by the World Health Organization, health “is a fundamental human right and […] the attainment of the highest attainable standard of health is a most important global social goal…’