Medical aid by the state

On March 2nd 2015 after the disclosure of medical aid by the state to senior PPP/C officials including $2.1m in cosmetic dentistry for then Minister Pauline Sukhai, the newly formed APNU+AFC coalition quite rightly expressed its outrage. In a statement, it said it was appalled at the recent revelations – courtesy of the media – of senior officials, including ministers of the minority PPP government using public funds to the tune of millions for “vanity medical procedures.”

It said that while Guyanese suffer with a poor public healthcare system Ministers Sukhai and Jennifer Webster among others had been found to have spent millions of dollars on procedures which have not been deemed to be critical or life-saving.

The coalition added that at the same time that PPP officials were haemorrhaging monies from the public coffers on their teeth and other “narcissistic” procedures, ordinary Guyanese who are faced with large medical bills were being turned away from government offices when they sought public aid.

Importantly, it said that APNU+AFC was committed to “responsible and equitable distribution of funds for medical procedures for all Guyanese and also to a comprehensive overhaul of the healthcare system.”

As is so typical, after it entered office, APNU+AFC did not live up to its word.  Earlier this month, Stabroek News reported that secret Cabinet documents were issued for $6m in medical treatment for former magistrate Fazil Azeez for stem cell treatment in Cuba for a spinal injury. There would be no objection per se to Mr Azeez being allocated $6m by the state for what was a grievous and crippling injury. It is really a question of whether there is a framework governing allocations by the state for medical assistance, whether a family in desperate need in some far-flung place can access such help and the openness that should accompany such a system.

First, if the APNU+AFC government was seriously interested in fairness and transparency, then the assistance for Mr Azeez would not have been by way of a secret cabinet document. Where taxpayers’ money is being expended in a discretionary manner and in relation to a request not catered for under a statutory body, it is imperative that full information be available to the public. This was not the case at all and betrays the intent by this government to deceive the public. It was made worse by the disgraceful unwillingness of Minister Harmon to answer questions on the allocation. Mr Harmon might be Cabinet Secretary and hold a host of other positions but that doesn’t empower him to disregard legitimate public examination of the government’s decisions. Such examination is even more important in instances where the government arbitrarily decides on what is a secret matter.

Second, the decision to provide the medical assistance and classify this matter as secret may well have to do with the believed circumstances of Mr Azeez’s shooting and his friendship with Prime Minister Nagamootoo extending to the days of the Guyana Broadcasting Corporation under the PPP/C government when the PM was the Minister of Information. Indeed, in August the state-owned Chronicle published a photo of the PM visiting Mr Azeez and included in the caption was the nugget that Mr Azeez had been shot shortly after he had declared support for APNU+AFC, a clear effort to create a linkage between the shooting and Mr Azeez’s reported declaration of support for the coalition. There has never been any proof that Mr Azeez’s shooting was political or had anything to do with his declaration of support for APNU+AFC. Even if it had been proven, that does not provide any ground for the arbitrary assigning of taxpayers’ funds to Mr Azeez’s medical cause. If APNU+AFC or the PM feel in anyway responsible for what happened to Mr Azeez due to their belief that the shooting was connected to his declaration of support then they must use their own resources, not taxpayers’ money.

Third, if friends of the government or others can make secret appeals for medical help and this is granted by way of a secret document how can that be a fair and equitable process as APNU+AFC had promised before entering office? How does the father at Eteringbang whose daughter has a serious illness and who doesn’t have the means gain access to $100,000? How does the mother at Kato who has a child who desperately needs airlifting to a coastal hospital benefit from this government fund? The media routinely carry desperate appeals for medical  assistance where it is doubtful that the government contributes substantially and even then there is interminable bureaucracy for stressed families. Hopefully, the assistance to Mr Azeez will have the benefit of forcing the government to publish and to update on a continuous basis all the medical help that has been provided to citizens and the process that was involved. The government through its multifarious information arms and media must also reach out across the country to let people be aware of how those who are in desperate need can access this fund.

Fourth, there must be reasonable guidelines governing allocations under this scheme. The PPP/C stewardship of its own allocations was severely problematic. The $2.1m allocation to Minister Sukhai for dentistry was appalling. The $116m outlay to former government minister and senior PPP/C official Navin Chandarpal for cancer treatment raised a number of other issues. What is the upper limit for any expenditure? Surely $116m is beyond the ability of the state and cannot be justified. In the case of Mr Azeez, his allocation will cover stem cell treatment which is a technically challenging and experimental area and there is no guarantee of success. Should allocations be focused mainly on life-saving treatments? What proportion of the sum required should be provided by the state to those who have the means or can raise assistance from other sources? These are the issues that have to be worked out and it is now expected that the government will publish the guidelines covering medical assistance.

As in many other areas: the integrity commission, the code of conduct, the local government commission and constitutional reform, the government has failed to deliver good governance. In the case of Mr Azeez, the PM and Minister Lawrence must provide a public explanation of the decision to fund.




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