Inquiry finds Health in “state of warfare”

By Mata'afa Keni Lesa ,

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HEALTH DRAMA: The Minister of Health, Tuitama Dr. Leao Tuitama, has work to do to bring the warring parties between the Ministry of Health and the National Health Services together.

HEALTH DRAMA: The Minister of Health, Tuitama Dr. Leao Tuitama, has work to do to bring the warring parties between the Ministry of Health and the National Health Services together. (Photo: Misiona Simo/Samoa Observer)

The leaders of the health sector in Samoa exist in a “state of warfare.” 

And unless “reconciliation” takes place immediately between leaders of the “warring occupational groups”, especially doctors and nurses, members of the public whose lives depend on the sector, will continue to be victims. 

But it’s not just that. Health workers who are merely trying to perform their duties will continue to be trapped in this vicious cycle while “the war” rages above them.

This is the gist of a report by a Commission of Inquiry appointed by Cabinet to review the proposed merger between the Ministry of Health (M.O.H.) and the National Health Services (N.H.S.). 

The report titled “A Pressing need for Grace”, which casts doubt on whether the merge can proceed under current circumstances, has been submitted to Cabinet for their deliberation.

 “A fundamental change in attitude of all Health sector workers is the Commission’s own prescription for the terminal condition which the sector is currently manifesting, an attitude of selfishness and mala fides (bad faith) which lies at the heart of the conflicts and disagreements which has paralyzed the service for many years,” the report reads. 

“The Commission strongly recommends the conduct of a formal process of reconciliation between the leaders of the warring occupational groups. 

“(There is also) a need for a nationwide resetting of health sector goals where the best interests of patients and the needs of the public, dictate the form of health administration we have, (and not groups of privileged self- centered office bound jet setting combatants), whilst the vast majority of ill- treated underpaid staff continue to work hard and do the best with what they have, whilst ‘the war’ rages above and around them.”

Chaired by former Attorney General, Taulapapa Brenda Heather-Latu, the Commission members include the Vice Chancellor of the National University of Samoa, Fui Dr. Asofou So’o and former Chief Executive Officer of the Public Service Commission, Fa’amausili Dr. Matagialofi Lua’iufi.

“There is a fundamental lack of effective leadership over and within the health sector, which is now in a critical state of dysfunction and has been torn asunder by sector wide hostility, suspicion and conflict,” the report says.

“This woeful state of affairs has been allowed to continue, and indeed flourish through a lack of attention and an unwillingness at the highest level to stamp out the destructive behavior and arrogant behavior of certain sector health leaders and their followers.” 

The Commission of Inquiry expressed serious concerns about the “existing discord between senior officers within M.O.H. and N.H.S.”, which compromised the ability of the health sector to function. 

“The use of the health sector as a ‘battlefield’ amongst senior health professionals, and the long standing conflict between Doctors and Nurses, is an abuse of their privileged position and a chronic waste of public resources,” the Inquiry found.

“(This comes) at a time when the public still languish for long hours to see the few overworked doctors and nurses at TT Hospital in Apia (which is apparently a luxury if you live in Savaii where there is no registered doctor available at any time).

“(This is also happening in) a system where there are still shortages of basic supplies, and is both disgraceful and symptomatic of managers who have misplaced their sense of responsibility, and misused their time and public resources to fuel conflict rather than focus on whether the public have access to efficient, clinically safe and humane care and treatment. 

THE PEOPLE WHO SUFFER: The Commission of Inquiry reminds that the lives of Samoans who use the health sector matter. Photo: Misiona Simo.
THE PEOPLE WHO SUFFER: The Commission of Inquiry reminds that the lives of Samoans who use the health sector matter. Photo: Misiona Simo.

“Little kindness is evident from these stony faced, obstructive and aggressive senior members of the National Health Services workforce, some of whom, we are told, consider undertaking basic tasks in the wards demeaning and beneath their dignity, and shame the very professions to which they belong.”

The Commission also found a number of other problems. 

One of them is the diversion of core funding for health services to fund “excessive administrative or bureaucratic processes and positions.”

These include duplicated non-technical roles and a multiplicity of mid-management positions, which the Inquiry found to be a “a fundamental misuse of the extensive public resources and aid assistance allocated to the Health sector.

The report points out that this should be closely monitored to ensure “all Health expenditure contributes to either, the effectiveness and efficiency of actual clinical and hospital services or public health programs, or the delivery of adequate health services beyond the Apia urban area, including MT2 Hospital at Tuasivi and all rural areas in Upolu and Savaii.”

The Commission hearings started on Tuesday 15 May 2018 and finished on Friday 18 May 2018. They heard submissions from N.H.S., M.O.H., N.H.S. Nurses, Samoa Nurses Association, Samoa Medical Association, P.S.C., Public Servants Association and the Allied Health Workers. They also heard from individuals.

In their report to Cabinet, the Commission concluded: 

“The many professionals in the health sector (public or private) routinely offer their time, skills and experience in a committed and diligent manner and serve the people of this country with selfless dedication. To do so with kindness and compassion however separates the ordinary health professionals from those who are extraordinary, and these are the health professionals who are the most highly respected in our community and much beloved by patients and their families.

“The reference to the need for ‘grace’ earlier in this report is the absolute conviction and belief by the Commission that until health workers carry out their functions duties and responsibilities according to a set of values, which put the patients’ care and welfare above all other matters personal and institutional, then the current state of warfare will simply continue unabated and absolutely no organizational structure in any form will produce the health outcomes which our community is paying for, or which the people of this country should demand and deserve.”

The Samoa Observer will begin to publish the report on Sunday. Today we are also publishing a summary of the findings as well as the foreword of the report.

See stories:

 There’s a pressing need for Grace in health sector

What the Inquiry found


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