Building a Strong, Resilient and Sustainable Health Care System for Present and Future Generations, “Brick by Brick.”
Mr. Speaker, Honourable Premier, Ministerial and Cabinet Colleagues, my fellow elected members from this great PNP Party, members across the aisle, strangers in the gallery, my fellow Turks and Caicos Islanders listening via the internet and RTC, good afternoon.
Mr. Speaker, I would like to quote a scripture from the Old Testament Book of Proverbs 24:3-4: “By wisdom a house is built, and through understanding it is established; through knowledge its rooms are filled with rare and beautiful treasures.”
Mr. Speaker, I would also like to quote a scripture from the New Testament –Mathew7:24 & 26 "Therefore everyone who hears these words of mine and puts them into practice is like a wise man who built his house on the rock."… “But everyone who hears these words of mine and does not put them into practice is like a foolish man who built his house on sand.”
Mr. Speaker, I will be focusing on the Ministry of Health and Human Services achievements during the past year. However, much of the focus this year will inevitably be on the principles of Primary Health Care and how we intend to strengthen our Renewal Strategy which is in line with our theme: Building a Strong, Resilient and Sustainable Health Care System for Present and Future Generations, “Brick by Brick.”
Mr. Speaker, please allow me to say thanks God Almighty, my family, and to the people of our Beautiful by Nature TCI. I would also like to take this opportunity to thank and commend the staff of my Ministry for their unwavering support, commitment and resilience displayed over the past year to ensure the achievement of our goals and objectives in line with our vision of a healthier and empowered people throughout the life cycle in communities conducive to healthy living.
Mr. Speaker, I am delighted to rise and provide an account of my stewardship over the past year.
Mr. Speaker, Barack Obama once stated, and I quote “A budget is more than just a series of numbers on a page; it is an embodiment of our values.
Mr. Speaker, the Ministry of Health and Human Services Mission is to “provide high-quality health services to the people of the Turks and Caicos Islands (TCI) through the hard work and commitment of dedicated professional care providers and policy makers, in partnership with communities and organisations”.
Mr. Speaker, during the Financial Year 2023 / 2024, the Ministry of Health and Human Services received an approved sum of $87,301,202.00 in recurrent expenditure, and $2,535,000 under the development fund.
Mr. Speaker, whilst the road to this present date has not been easy, we are thankful that by the Grace and Mercies of our Lord and Saviour Jesus Christ, the Ministry of Health and Human Services was able to utilize $85,572,295.00.
Mr. Speaker, the Ministry of Health and Human Services comprises the following Departments and Units: the Dental Department, Primary Health Care Department, Health Promotion and Advocacy, Behavioral Health Services, Public and Environmental Health Department, Aged Care and Rehabilitation, Contract Management, Health Emergency Management, National Public Health Lab, National Epidemiology and Research, Emergency Medical Services; and the following Statutory bodies - Health Regulatory Authority, Health Professions Authority and the National Health Insurance Board.
Mr. Speaker, Jim Rohn once stated “The major value in life is not what you get. The major value in life is what you become”.
Mr. Speaker, as a government, we have a mandate to ensure that the Primary Health Care Department continues to develop a vibrant and sustainable Child Health Immunization Program. Mr. Speaker, I am a firm believer that we have not only achieved our mandate but surpassed our objectives. Through the hard work of the Primary Healthcare Department the TCI won the Henry C Smith Immunization Award for improvements achieved in vaccination rates for children under the age of 5 years at the 37th Meeting of Caribbean Immunization Managers Meeting in Belize City, Belize on 31 October 2023. These gains are significant for the protection of the population against the re-emergence of vaccine-preventable diseases.
Mr. Speaker, I am also pleased to report that the Primary Health Care department can also highlight its success with regards to the Migrant Health System. Mr. Speaker, this has been an area whereby numerous concerns were raised in the past regarding the processing time for Migrant Health Certificates. Mr. Speaker, to-date the Migrant Health Program is now fully digitalized, and once information is uploaded and all documents are in order, and, there is no outstanding information needed, approvals can be granted within two-three days.
Mr. Speaker, in order to achieve any goal, you must have a guide or a roadmap. For the Ministry of Health and Human Services Mr. Speaker, our roadmap is the National Health Sector Strategic Plan 2024-2027, which has been approved by the Cabinet of the Turks and Caicos Islands. Mr. Speaker, this plan will serve as thee roadmap providing guidance, and direction to all stakeholders involved in improving the health, and wellness of the population of the TCI, whilst at the same time assisting the government in achieving its health goals, and bringing activities into alignment with the vision, mission, and core values of the Ministry, and the Vision 2040 document. Mr. Speaker, the official launch of the Plan is scheduled for 14th May 2024.
Mr. Speaker, please allow me to now turn my attention to Human Resources for Health and Training:
Mr. Speaker, it is extremely important to highlight our recruitment efforts, particularly within the Health Sector where globally TCIG is competing to attract health professionals, when the demand is great, and 1st world countries such as North America and Europe seem to dominate the market.
Mr. Speaker, the Ministry’s human resource capacity has been further strengthened as a number of key positions were successfully filled during the 2023/2024 financial year.
Mr. Speaker, I am even more pleased to announce that all of the positions below have been filled with local certified talent:
Deputy Chief Medical Officer, Chief Medical Technologist (2) Deputy Chief Environmental Health Officers, (1) Training Officer - Health Disaster Education and Training, (2) Senior Program Officers – in the Health Promotion and Advocacy Unit (HPAU) and 2 (Temporary) Vector Control Officers.
Mr. Speaker, whilst we are overjoyed regarding the aforementioned recruitment efforts, we encourage other locals to apply for the vacancies which will be advertised within the coming days.
Mr. Speaker, it is equally important to highlight our successful training initiatives.
Across multiple Departments and Units, a number of staff received training in the following areas.
Mass Casualty Management
Infection Prevention Control (IPC)
Port Health Officers Certification – and Mr. Speaker, I must pause here to highlight the significance of this program. The Port Health Unit comprises 100% local talent. Mr. Speaker this is commendable. Mr. Speaker, I also take this opportunity to further encourage our Port Health Officers to enrol in the training program at the TCI Community College.
Food Handlers Training – Mr. Speaker, with the reimplementation of the Food Handlers Training, I commend the Department of Environmental Health for training 235 persons thus far. Mr. Speaker, we are also taking the approach of train the trainer, which will build further capacity.
Vector Control Training -mosquito surveillance capacity building via CARPHA/PAHO/UKHSA
Water and Wastewater Operator Training (University of Technology, Jamaica)
Over 120 persons trained in basic mental health support/psychological first aid.
An Emergency Vehicle Operators Training Course training for Emergency Medical Services staff.
Moving on Mr. Speaker:
Mr. Speaker, as a Boy Scout – we were always taught to be prepared. Mr. Speaker, the Ministry is continuing its efforts to further strengthen emergency preparedness, and its response capacity, and capability. As such, the following initiatives were undertaken:
The Caribbean Public Health Agency (CARPHA) follow-up Missions on Virtual Trainings in Integrated Vector Management (IVM) and Insecticides Resistance Testing (IRT) within the Turks and Caicos Islands. The aim of the IVM approach was to contribute to the achievement of the global targets set for vector-borne disease control, by making vector control more efficient, cost effective, ecologically sound and sustainable.
The Ministry of Health and Human Services (MOHHS) in its ongoing planning, preparedness, and response aims to effectively manage the risk of outbreaks of cholera, and other communicable diseases on the islands, especially in the prisons and informal migrant settlements. Mr. Speaker, the Department of Environmental Health conducted a water, sanitation and hygiene (WASH) assessment on the islands of Grand Turk and Providenciales in collaboration with the Pan American Health Organization/World Health Organization (PAHO/WHO). This assessment exercise was geared to improve WASH in these areas to reduce the risk of outbreaks, which would also impact the wider population.
The National Public Health Laboratory has been further strengthened through the donation of the BioFire Film Array Assay Technology by the UKHSA and was introduced during the first quarter of 2023. This PCR Technology has improved local testing capacity significantly. This allows for the timely identification of pathogens to facilitate the necessary response to prevent further disease spread.
Mr. Speaker, the Environmental Health Department also conducted a training on Water and Wastewater Legionella which saw approximately 36 persons being trained and certified. This number included public servants and persons from the private sector.
Mr. Speaker, as I focus my attention on our regional and international partnerships, initiatives and achievements, I wish to highlight the following which provide a few examples of how we have leveraged these to make positive changes in the health sector:
Dental Services
The department strengthened its partnership with Great Shape Inc-1000 Smiles, Sandal Beaches Foundation by once again collaborating in offering free basic dental services to the residents of the Turks and Caicos Islands:
Over 1710 patients received free dental treatment including dental restoration, extraction, dental cleaning, sealants, fluoride application, root canal treatment, dentures, diagnostic radiology, and follow-up treatment. This collaboration saw the expansion of this service to the islands of North Caicos and Grand Turk.
Tourism Health Program (THP)
· Relaunch and revitalisation the Tourism Health Program in collaboration with CARPHA to ensure a healthy tourism product.
TCI was the first Caribbean country to launch the THP in 2016, through this we had a technical visit by CARPHA and a THP steering committee was developed which includes Experience TCI, TCHTA & MOH
Through this initiative The Beaches Hotel received the Healthier Safer Tourism Award 2023. It is a regional award which is a measurable and verifiable travelers’ health assurance and recognition award for tourism entities implementing proactive health monitoring and safety measures.
The UKHSA has conducted technical visits to support vector control as the Vector Control Unit continues to respond to dengue, support on cholera preparedness and response as well as conducting a Migrant Health Needs Assessment to address the health vulnerabilities in this population which may impact the wider population.
Mr. Speaker, as we continue our focus on Primary Health Care initiatives, the Ministry has embarked on the implementation of the HEARTS initiative in collaboration with the Pan American Health Organisation. The initiative seeks to integrate seamlessly and progressively into an already existing health delivery services to promote the adoption of global best practices in the prevention and control of cardiovascular diseases (CVD) and improve the performance of the services through better control of high blood pressure and the promotion of secondary prevention with emphasis on the primary health care. The TCI is joining 32 other countries in the region which are implementing and expanding this initiative.
Mr. Speaker, please allow me to turn my attention to the Emergency Medical Services Department (EMS). Mr. Speaker, EMS has successfully launched the Electronic Patient Care Report (ePCR) which represents a significant leap forward in our efforts to enhance patient care, streamline operations, and leverage technology for the betterment of our citizens' health.
As part of the Ministry of Health’s strategic objectives, we are committed to the digitization of our services provided, as well as the day-to-day operations.
I am pleased to announce that with the implementation of the E-PCR we have now joined the international community in keeping with industry best practice, and decreasing the carbon footprint on our planet.
The introduction of the ePCR system signifies our commitment to embracing innovation in healthcare delivery. For this new financial year, we plan to continue to innovate in other areas using electronic platforms to improve service delivery.
Mr. Speaker, as we continue on with EMS, I am pleased to announce that 2 Ambulances have arrived in country with a third due to arrive at the end of this month. Whilst these three (3) new ambulances will assist in enhancing our capacity to effectively respond to emergencies throughout the islands. Mr. Speaker, my Ministry through this good, good government is in the process of finalizing a project agreement for SEVEN (7) new ambulances Mr. Speaker – MORE in 2024.
Mr. Speaker, the Cooler for the South Caicos Morgue has been purchased and is currently in transit to the shipping company. South Caicos, the Cooler is expected to be in South Caicos by the end of April, 2024.
Mr. Speaker, I am proud to announce a historic moment with regards to the Nursing profession of these beautiful by Nature Turks and Caicos Islands. Cabinet approved the amendment to the Health Professions Ordinance and Regulations, granting the Nursing and Midwifery Professions Council the authority to approve the basic Registered Nursing curriculum offered by any tertiary institution, and be the authorized body to administer the examination for nursing registration and licensure within the Turks and Caicos Islands. The Council is working to ensure that all of the components required to ensure a successful outcome for the Nursing Program is supported by the Ministry of Health. Mr. Speaker, this initiative could not have been possible without the collaboration of all stakeholders – The Ministry of Health and Human Services, the Ministry of Education, the TCI Community College, the Health Professions Authority, and the TCI Hospitals.
Mr. Speaker, Primary Health Care, which also encompasses Oral Health and Behavioral Health, which is the cornerstone of any health care system, remains a focus of my Government, to ensure a healthier population.
My Ministry will focus on strengthening this area through revisiting and revitalizing the Primary Health Care Renewal Strategy to ensure access to quality patient centered care throughout the TCI.
Mr. Speaker, Health Promotion is key. As such, Mr. Speaker, the Ministry of Health remains steadfast in its commitment to raise awareness among our people in relation to health and wellness, and empower them with providing information to take control of their health. The Ministry through conferences such as the Men’s Health, and the first ever Women’s Health Conferences, as well as the 9th Annual Mental Health Conference under the theme, “Mental Health is a Universal Human Right.” Mr. Speaker, the Health Promotion and Advocacy Unit will also be launching “Check Your Numbers - Know Your Status Campaign”. These conferences as well as other screening initiatives, have been held to directly engage with the general public to provide essential health information. You can expect to see greater outreach this coming financial year, and I encourage more persons to take advantage of these opportunities.
Additionally, Mr. Speaker, the Health Promotion and Advocacy Unit, in collaboration with the National Epidemiology and Research Unit, has commenced work on the framework for the Cancer Screening Program, and Register.
Mr. Speaker, as we continue our efforts to regulate the Health Sector, I am pleased to state that the Health Regulation (Amendment) Ordinance 2023 was assented by the Governor and published in the Gazette on October 9, 2023. The Health Regulations Authority (HRA) serves as a vital regulatory body dedicated to safeguarding healthcare consumers, ensuring a safe working environment for healthcare professionals, and maintaining high standards of healthcare delivery. The passage of this legislation is not only timely but critical in that it enhances the HRA’s capability to effectively monitor and enforce compliance with health regulations across the Turks and Caicos Islands. Additionally, Mr. Speaker, the HRA’s Board has been approved, and will come into effect 22nd April, 2024.
Mr. Speaker, continuing on, the Health Professions Authority has embarked on a digital transformation system for the operations of the Health Professions Authority (HPA) to improve application processes and turnaround time. This innovative technology has seen an increase of 29% in renewals over the previous year. Emphasis has also been placed on developing and hosting continuing education sessions for health professionals to promote high standards of education and training, and in the interest of protecting the health of the public, as required by the Ordinance.
Mr. Speaker, continuing on, the Health Professions Authority has embarked on a digital transformation system for the operations of the Health Professions Authority (HPA) to improve application processes and turnaround time. This innovative technology has seen an increase of 29% in renewals over the previous year. Emphasis has also been placed on developing and hosting continuing education sessions for health professionals to promote high standards of education and training, and in the interest of protecting the health of the public, as required by the Ordinance.
Mr. Speaker, the National Health Insurance Ordinance was amended on November 14th 2023. These amendments are designed to pave the way for the implementation of the National Insurance Shared Services (NISS) project, a collaborative effort between the National Health Insurance Board (NHIB) and the National Insurance Board (NIB). The amended Ordinance enhances our ability to provide greater efficiency, accountability as it relates to compliance and collection of contributions.
Mr. Speaker, the National Health Insurance Ordinance was amended on November 14th 2023. These amendments are designed to pave the way for the implementation of the National Insurance Shared Services (NISS) project, a collaborative effort between the National Health Insurance Board (NHIB) and the National Insurance Board (NIB). The amended Ordinance enhances our ability to provide greater efficiency, accountability as it relates to compliance and collection of contributions. Mr. Speaker, I am also pleased to state that on Wednesday, 10th April, 2024 the MOU in relation to the shared services was signed, and Mr. Speaker, I congratulate the visionary of this great PNP Party, the Honourable Premier – Charles Washington Missick.
Mr. Speaker, permit me to turn my attention to the PPP Project Agreement in relation to the management of the hospitals. Mr. Speaker, A firm of specialist consultants has been working with TCIG to improve the contract management of the Hospital PPP contract since July last year. This has already resulted in the strengthening of governance and reporting. The private sector provider is being held to account and a number of key areas of the contract have been identified as requiring improvement. TCIG is now making use of the contractual remedies available to it and this includes financial deductions where appropriate.
The programme of work on the PPP continues and this year will also see the commencement of clinical reviews across a number of key areas of health provision. We anticipate that this will further translate into improved services and a better patient experience. Finally, this work will also include a review of the way in which both TCIG and the private sector record and manage health data so that health outcomes can be tracked over time to ensure an efficient and effective long-term future for health delivery.
Mr. Speaker, the Ministry of Health and Human Services is cognizant of the fact that we have an aging population, and so Mr. Speaker, I therefore turn my attention to the Aged Care and Rehabilitative Unit. Mr. Speaker, my government made a commitment to introduce these services in the twin islands, Mr. Speaker, I am pleased to state, that my government has not only identified a location for the services, but to state that a building has been purchased to house our vulnerable citizens in the twin islands. THANKS PREMIER. Honourable Musgrove go celebrate!!!!
Mr. Speaker, last and by no means the least, as the Minister with responsibility for Solid Waste, I am extremely excited to announce that a new three-year contract has been awarded to TCI Green Ecological Corporation Ltd, (which is own and operated by the Gibson brothers, our sons of the soil) to manage the waste disposal site on the Island of Providenciales. The contractor commenced operations on at the site on March 5th 2024. This is a testament to our ongoing commitment and perseverance to ensure that the landfill site is managed effectively and appropriately in order to reduce any harmful impacts on our environment and the health of our residents and tourist alike.
The Environmental Health Department also conducted a series of fire extinguishing exercises during the year. These activities, involving participation from the Fire and Rescue Department, were a success and highlighted the amount and type of resources that are needed to continue further exercises to quench the hotspots throughout the site.
Mr. Speaker, the Environmental Health Department has also embarked on a Recycling Program. Mr. Speaker positions for the program have been advertised and recruitment is ongoing. Through GITESTA funding the equipment needed for the program will be procured.
Mr. Speaker, as we look to the future, my Ministry has ambitious plans for the new financial year to further strengthen our ability to regulate the health sector as well as deliver on key services and plans.
Mr. Speaker, the draft estimates before us today speaks to $93,156,647.00 Recurrent Expenditure, and $1,605,000 Development/Capital Funding. Mr. Speaker, it important that we continue our efforts in the fight against the spread of Dengue within our country, as such, my government is investing over $1m in Street Cleaning, and an additional $1m is being invested in the Ministry of Health and Human Services in the area of Community Enhancement.
Mr. Speaker, the Ministry of Health and Human Services through the provisions of the draft estimate will continue to work with partners to strengthen health care capacity and delivery through training, development of plans, and using data to inform decision making.
Implementation of National Health Sector Strategic Plan 2024-2027
Develop legislative framework to support the adoption of Health in All Policies (HiAPS) Plan
Update the Primary Health Care Renewal Strategy – Mr. Speaker, permit me to pause here – to emphasize that the Ministry of Health will be onboarding An Internists who will conduct visits to the islands of Salt Cay, South Caicos, and North and Middle Caicos to provide management to our clients. Mr. Speaker, brick by brick, and person by person we will strengthen the Health Sector.
Develop the Noncommunicable Disease Policy – and Mr. Speaker, to work in collaboration with the Director of Health Promotion and Advocacy, the Ministry of Health will be onboarding a Nutrition Consultant.
Develop an action plan for prevention and control of Cancer.
Develop a comprehensive public education campaign to promote healthy eating, and physical activity in schools, workplaces and communities.
Develop a Healthy aging policy and action plan
Mr. Speaker, the Capital Program for the Financial Year 2024/2025 makes provision for:
A Mobile Clinic for the community of Blue Hills, Providenciales. Mr. Speaker, the Mobile Clinic will complement the services of the Blue Hills Clinics by way of making services more accessible in Blue Hills Communities;
A vehicle for Health Promotion and Advocacy-Providenciales; and
Repairs to the Sylvia Melhado Wellness Center, Grand Turk;
Mr. Speaker, we live in unprecedented times, and face many challenges such as the effects of climate change, including natural disasters, emerging and reemerging diseases, and pandemics.
As such Mr. Speaker, it is imperative that we work together across all sectors to create innovative solutions across a streamlined set of priorities, which will effectively balance short-term needs, with a long-term vision.
Mr. Speaker, creating a sustainable system requires a cross-sector effort to build healthier, resilient and more prosperous communities.
To this end, Mr. Speaker, I wish to remind us all of the definition of health, which is, “the state of complete physical mental and social wellbeing and not merely the absence of disease or infirmity,” therefore, reducing inequalities and maintaining people’s mental health, physical and social wellbeing, remains at the heart of my Ministry’s focus and should be considered across government departments. It is vital that we work with partners across the public sector so we may collectively rise to the challenges faced.
Mr. Speaker, as Mahatma Gandhi once said “it is health that is real wealth and not pieces of gold and silver.” Health care providers should remain resolute in their continued commitment to doing the very best they can to deliver high-quality, timely, and safe care to the people of these beautiful by Nature Turks and Caicos Islands.
Mr. Speaker in closing, I would like to quote a scripture verse from 1 Corinthians 1:10, “I appeal to you, brothers and sisters, in the name of our Lord Jesus Christ, that all of you agree with one another in what you say and that there be no divisions among you, but that you be perfectly united in mind and thought”.
Thank you and may God continue to bless our beautiful by nature Turk and Caicos Islands!