Let this be the last of these multi-million tala experiments that don’t work

Another new era in the history of the health sector in Samoa started last week.

With Parliament passing the law to merge the National Health Services and the Ministry of Health, Samoa in a sense is back to square one. 

We say this because before the Government spent several millions of tala to separate the entities more than 10 years ago, everything was under the one umbrella of the Ministry of Health.

So what happened? In short and according to Prime Minister Dr. Tuilaepa Sailele Malielegaoi in Parliament last week, the decision to separate and then re-merge the bodies proves that theory is one thing and practicality is quite another.

When the issue of separation was discussed, Tuilaepa said it looked quite attractive on paper, and the consultants who offered the recommendation were confident that the separation was working fine elsewhere – and therefore it should be the same in Samoa. 

The result is quite obvious isn’t it? We don’t need to tell you what happened.

Suffice to say if it were successful, we wouldn’t be having this discussion today. Which means the mere fact we’ve gone back to square one is quite a telling indication that it was a big failure, and a fat waste of millions of tala at that too.

So where to from now? And what are we to expect?

Well on the Sunday Samoan, an interesting letter to the editor was published on page 13 under the headline “Reformed Ministry of Health needs to return to basics.” Written by one “Johnny Cash,” it offered excellent insights on the merger that is worth repeating.

“No doubt the reformed MOH has a plateful of health problems to deal with, not the least being non-communicable diseases which is bankrupting the country… diabetes, high blood pressure, stroke and cancer being the leading causes of illness and death,” the letter reads.

“The reformed MOH needs to return to the basics and hopefully the new top-level reshuffle of service delivery will attempt to address the fact that the major contributors to these serious health problems are obesity, sugary drinks, smoking and inactivity. 

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“The split of the service arm of the MOH into curative and public health – and the revival of the Women’s Village Committee – will in my opinion go a long way to address these problems. The key to effect these important changes are the workers – good people at the top and a strong, robust and well trained health workforce particularly the doctors and nurses. Good luck!”

Wonderful thoughts and good luck is certainly needed.

This is especially after the report by the Commission of Inquiry, which was appointed by Cabinet to review the merger, highlighted the sorry state of affairs in there. We’ve heard stories about the power struggle between personalities and senior figures in the sector for a long time, but what we knew was more or less scratching the surface type of stuff.

We did not know the sector was in a “state of warfare.” Fuelling the warfare is the strained relationship between the doctors and nurses.

 “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.”

The report said a lot more but we will stop here. You get the picture though.

Now last week, another story titled “Minister optimistic as new era in health services begins”, was published. This time, it followed the first unification meeting where health workers were addressed by the Minister of Health, Tuitama Dr. Leao Tuitama.

“I have high hopes that this unification will help us work together to improve the health care for the people of Samoa,” Tuitama said. 

“That is why I applaud the hard work carried out by everyone within the Ministry. The feeling is more of excitement than of doubt, mainly because we all know what we are stepping into, and it has been such a long time since we have planned this.”

The Minister’s optimism is great. 

As for his claim that “we all know what we are stepping into,” we sure hope they do. So much money – that should be spent on primary health care and saving lives – have been wasted on these administrative decisions. The people responsible should be held accountable and made to pay for their expensive mistakes. 

Let’s hope they’ve got it right this time around.  Or in the words of our letter writer Johnny Cash, “good luck!”  

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