Day four of the 2024 Budget Debate became a heated affair yesterday when Shadow Health Minister, Dr Karen Cummings and Health Minister, Dr Frank Anthony lambasted each other over the performance of the sector under the APNU+AFC and PPP/C administrations.
Dr Cummings lashed out at the current government for what she said is its uncaring attitude demonstrated towards nurses which has caused these public servants to migrate to countries such as the United Kingdom and the United States for better working and living standards.
The medical doctor said that the constant migration of nurses has resulted in a nursing crisis in Guyana.
According to Dr Cummings, more than 300 nurses have resigned from Georgetown Public Hospital (GPH) since January 2022.
She noted that the GPH, which is Guyana’s primary medical institution, has been hard-hit by a high number of nurse resignations in recent years and according to well-placed sources at the institution, at the end of 2022, close to 215 nurses had resigned from the hospital.
Dr Cummings, who has been active in the medical field for over 27 years, noted that migration to greener pastures seems to be the order of the day, as there is a mass exodus of healthcare professionals with many nurses taking up attractive packages offered by healthcare entities in the United Kingdom and the United States.
“Several nurses who moved to the United Kingdom this year have indicated that their current salaries are double and triple the amount they were paid while working here. In addition, the relocation packages offered by the foreign hiring firms also cater for the well-being of the nurses’ families.”
Against this backdrop, the Ministry of Health has implemented several measures to curb this leakage, including hiring from Cuba, increasing the training of locals, and salary increases. She stated that addressing this shortage of nurses by bringing in foreign nurses is quite unacceptable.
However, Dr Anthony told the National Assembly, “With the three public nursing schools that we have, that is Georgetown Hospital, Linden and New Amsterdam, we were only able to train about 200 to 250 nurses per year… We… started a programme last year which is a hybrid programme where we have brought in at least 1,100 nurses for training, and they have started that training and they have three years to complete that course and while they are doing a lot of the theory online, we are bringing them in to do the practicals because we have simulation centres that early next year we are setting up.”
According to Anthony, at least six centres will be set up to ensure the nurses in training can carry out their practicals and next year the government is hoping to recruit another 1,000 to 1,200 people for training and as such applications will be opening soon.
The subject minister informed the House that nurses’ salaries, under the APNU+AFC government from 2015 to 2020, were increased by about 33%. However, he noted that since 2020, when the PPP/C returned to office, salaries have increased by about 71%.
Dr Anthony also pointed out that Guyana is not the only country faced with outward migration of skilled labour
Global phenomenon
“Migration of nurses is a global phenomenon… but what is important is what we do.”
The Minister announced at a press briefing held on December 29, that some 80 Cuban nurses were recruited in 2023, and another 200 nurses from Cuba are likely to be in Guyana in early 2024 with the ministry actively working to recruit more nurses from other countries.
A three-month course is being carried out to assist the incoming nurses from Cuba with their integration into the country’s workforce.
But Cummings maintained that the expansion of post-graduate training at GPH will not address this issue fully.
“One of my colleagues, honourable member, Roysdale Forde, decried the move. Forde noted that ‘the government has failed to improve the working conditions of local healthcare providers but is ready to import nurses to fill the shortage in the system.”
Forde had noted that the approach by the government to address this extremely worrying shortage could only lead to a further diminished number of nurses causing a “diminution” of that important sector of society.
Dr. Cummings also upbraided the minister for directing his attention to the construction of modern hospitals, when there are several shortcomings at GPH and healthcare centres in several communities. She charged that many citizens have decried the sub-standard services offered by primary healthcare institutions, while the government is spending billions of dollars on building state-of-the-art hospitals.
The APNU+AFC health spokesperson said that while she doesn’t have a problem with government building modern hospitals, the standard of primary health institutions must be developed.
To these remarks, Dr Anthony responded.
“Mr Speaker, our government has given us in the Budget narrative, a plethora of health facilities that will either be upgraded or expanded throughout the country to improve health service delivery to the Guyanese populace.”
He posited that a sum of $10.3 billion has been allocated for the construction of a paediatric and maternal hospital in Ogle; $6.2 billion for the New Amsterdam Hospital, and the construction of regional hospitals at Bartica, Suddie, West Demerara, Kamarang, Kato and Moruca, to the tune of $10 billion and $1.5 billion respectively.
“Let us sensibly ask ourselves where the human resource would come from to ensure that these spendings improve the health services deserving of our people,” the minister queried.
“Development must be coordinated and integrated and is more than the throwing of monies at our problems or wishful thinking,” he added.
However, while she commended the government for improved health infrastructure, Dr Cummings reminded that these facilities cannot function with inadequate nurses.
“We cannot afford to have citizens rushing to hospitals which do not have the personnel to assist them.”
“That is both a waste of money and a recipe for disaster. Each hospital must be adequately staffed to meet the needs of the community it serves. Mr Speaker, we recognize that building new hospitals increases access to care, but that assumes that there are adequate nurses and doctors to administer that care.
“We know that Guyana has been going through a personnel crisis, with nurses and doctors leaving in droves. Failing to acknowledge the root cause of this crisis, which is the need for competitive wages, the government has imprudently announced 6 new hospital projects,” the shadow health minister posited.
Cummings on nurses’ strike and govt’s appeal
Despite a ruling by Justice Nareshwar Harnanan in November last year that deductions illegally made from striking Linden nurses in 2021 be repaid by December 31, 2023, the state has not complied and it says it will appeal the decision.
The state says it will also seek a stay of the ruling. Its non-compliance with the judge’s decision could lead to contempt of court proceedings.
Since the judge’s ruling on November 2, 2023, the nurses’ representative, the Guyana Public Service Union (GPSU) has sought to have the deductions repaid to no avail.
The GPSU was the claimant in the case and the Permanent Secretary (PS) in the Ministry of Health and the Attorney General were the defendants.
Against this background, Dr Cummings said that nowhere was the government’s behaviour more disheartening, than when it appealed this decision.
“This government has no respect for the judiciary and certainly no respect for these nurses. They are not on the side of our healthcare workers,” she vehemently noted.
Dr Anthony was however silent on the subject.
