Budget Debate 20133051 02 Apr, 2013
Ms. Ferguson: Mr. Speaker, I rise to present my analysis of the Budget speech, Current and Capital Revenue and Expenditure for financial year 2013, under the theme, “Overcoming Challenges together, Accelerating Gains for Guyana,” presented by the Minister of Finance, Hon. Member Dr. Ashni Singh. My presentation will focus primarily on the health sector which falls under Sectoral Developments and the Agenda for 2013.
Mr. Speaker, Guyana, over the years, since gaining independence status some 46 years ago, still encounters major challenges in all spheres. As it relates to health, our people, more so the underprivileged, elderly and vulnerable groups, continue to experience challenges. Article 24 of Guyana’s Constitution clearly states:
“Every citizen has the right to free medical attention and also to social care in case of old age and disability.”
Mr. Speaker, I know there are those who would agree with me and those who would not. Guyana continues to struggle among CARICOM countries to rise from just above Haiti. Our country does not have the accountability framework to make all our achievements sustainable. When it has not been the legitimacy to enforce regulations, it has been the majoritarian arrogance in not recognising that accountability relies on impartial and unbiased enforcement of all rules and regulations.
On Monday, 25th March, 2013, we all sat in this honourable House to hear the Hon. Minister, in his usual rhetorical manner, outline what the economy is likely to achieve within the fiscal year. There is not one single determinant in these Estimates of Expenditure, under the health sector, which can convince me that in the year 2013, Guyanese who are reliant on the public health care systems will have access to the quality of professional health care that their tax dollars should afford them. I am disappointed in the manner in which the Budget speech was crafted. For me, it lacks specificity and relevance in health needs for all Guyanese.
The National Health Sector Strategy (NHSS) has indicated that there are four goals of sector development:
1. Equity in distribution of health knowledge, opportunities and services;
2. Consumer-oriented services: people focused and user friendly;
3. High quality services and good value for money; and
4. Accountable providers and government.
To achieve these broad sector goals, the NHSS 2008-2012 focused on achieving strong organisations and built-in incentives to drive change. The Sector Strategy is divided into five main components. I will just, for the sake of time, list them. These are:
1. Decentralization of health services providers;
2. Strengthening the skilled workforce and Human Resource systems;
3. Strengthening government capacity for sector leadership and regulations;
4. Strengthening sector financing and performance management systems; and
5. Strengthening strategic information.
I would like the Minister of Health to say to this nation what the successes and shortfalls in achieving those objectives as outlined in the NHSS are.
I have reviewed the 2010, 2011 and 2012 Budget presentations and compared them with the Budget presentation of 2013. What I found most amusing is that there have been no significant changes regarding the contents of those presentations, except to say that there have been significant increases in figures. The Hon. Member, Dr. Singh, alluded that Government remains committed to ensuring our citizens have access to high quality healthcare services and, in 2012, some $17 billion was expended.
What is of concern to me is that the Government continues to boast of improved facilities within the Health Sector. However, the National Health Sector Strategy for 2008-2012 has been exhausted, yet none has been tabled in the National Assembly. This should have been given urgency since it was common knowledge that the life of the document was soon ending. However, we are to take a close examination of the improvements of this sector under discussion. One can see that year come and year pass, there is absolutely nothing significant to boast about since billions are given to infrastructure while our citizens continue to receive unprofessional service and treatment at the hospitals. They are forced to wait long hours before they are seen by a medical practitioner. There are the issues of unavailability or, in some cases, limited supply of pharmaceutical drugs, continuous deaths of potential mothers and, in some cases, their unborn.
Citizens are given expired drugs. As I am on this point, Sir, it was reported to me that on 18th March, 2013, a drug which was manufactured on 13th January, 2011 and expired on 1st January, 2013 was administered to a patient at the West Demerara Regional Hospital (WDRH).
I have my own experience. In December, 2012, I, personally, visited the Georgetown Public Hospital (GPH) when my grandmother took in that Sunday afternoon. I had to wait long hours. We got there at a quarter to three and she was admitted at a quarter to two on the Monday morning. She eventually succumbed. I just used my personal experience to show how our people are suffering whenever they visit the Public Hospital. The big question here is: are Guyanese truly getting value of service at these public health institutions when they contribute tremendously to our tax system? My answer is a simple no.
Examination of Estimates
Mr. Speaker, an examination and assessment of the Current and Capital Revenue and Expenditure for fiscal years 2012 and 2013 was done. It was established that in 2011, $150 million as grants was budgeted for preparatory studies and designs of a 150-bed specialty hospital. It was reported in the Hon. Members’ Budget speech of 2012, that in 2011:
“Furthermore, $29 million was expended towards land preparation works for the construction of a new state-of-the-art specialty hospital.”
Mr. Speaker, I have before me the relevant facts to show that, to date, works have not commenced on that proposed site.
For fiscal year 2012, the sum of $672.540 million was allocated for designs, construction and equipping of the 150-bed specialty hospital. In 2013, the Hon. Member, in his Budget presentation, stated that a total sum of $1 billion was spent to expand, upgrade and maintain the infrastructural facilities of the sector, including funding a mobilisation payment for the state-of-the-art specialty surgical hospital at Liliendaal which will afford Guyanese the opportunity to access specialised health care services; upgrade of the National Psychiatric Hospital and Georgetown School of Nursing; and construction of the Port Mourant Health Centre.
As I said before, $1 billion was spent to expand works at the National Psychiatric Hospital. When we look out of the windows from this National Assembly, we would see mentally-challenged women and men roaming our streets. Our citizens have been attacked by these people and yet this Government keeps reporting that upgrade works were done at the National Psychiatric Hospital, and, to date, many of our mentally challenged people are left to roam the streets. What exactly is this Government saying to the people in this country? In which other area has the money gone?
I made reference to the specialty hospital. This is what the Hon. Minister of Health reported after an article was carried in the Stabroek News newspaper, dated 8th January, 2013, under the caption, “Hive of activity at specialty hospital site”. This is what the Minister said:
“Government is responsible for preparing the site before the building of the US$18,180,000 ($3,689,616,400) specialty hospital. Contracts worth $98 million were awarded to G Bovell Construction Company back in January of last year to begin preparatory work. The duration given for the completion of the site preparation works was slated as three months.”
This is what the Hon. Minister of Health reported after the article was made public:
“Pre-construction work begins on the state-of-the-art specialty hospital.”
This was carried in Stabroek News newspaper dated 14th July.
“The land preparation process for construction of the multimillion specialty hospital at Liliendaal, East Coast Demerara has begun…”
These are the words which came out of the Hon. Minister’s mouth.
“…and works are moving apace, despite negative talks by some sections of society.”
But let me remind the Hon. Member that in his Budget speech last year when my Hon. Colleague, Mr. Moses Nagamootoo, presented evidence to this House about the proposed site being more or less infested with grass. This is what the Minister of Health said:
“As of 15th March, it was reported that even before those pictures were taken, the Hon. Member, Mr. Nagamootoo, was bantering about some 10 per cent of the preparation of the site had been done. This preparation included the construction of fences, the digging and construction of drains, internal and external sturdy bridges, and so on and so forth.”
I would like to inform, through you, Mr. Speaker, that it is not becoming to impart misinformation on the nation, using this forum without knowing or unwillingly make oneself knowledge of the facts that, of course, those pictures are misrepresentations of.
I have news for you, Hon. Member, because, as of the week of 25th March, 2013, this is what the proposed site looks like.
[Ms. Ferguson displayed pictures of proposed site.]
There is a set of sand; there is a dragline. They talk about sturdy bridges being built. There is no evidence of bridges being built. They talk about drains being dug. There is nothing of that sort.
Mr. Speaker, this is taxpayers’ money, people’s hard earned moneys, deducted from their salaries, that are being used and this Minister would have made it public…[Mr. G. Persaud: Hon. Minister.] ...Hon. Minister. Thank you for correcting me.
Mr. Speaker, in the very article in 14th January newspaper, this is what the Hon. Minister of Health said:
“A $97 million contract has been awarded to G. Bovell Construction Company Limited to drain, grade, and fill the land, construct a fence, bridges, gates, culverts and access roads and install utilities.”
Some $97 million of taxpayers’ money was utilised, according to the Minister.
This question must be answered: what was the $97 million used for when, according to the Minister, these works were done based on the moneys awarded to G. Bovell Construction Company?
Mr. Speaker, I am eager to see what the responses would be like since these moneys are debited from the citizens’ salaries and credited to the tax system. Anticipating that answers will be given, permit me to remind and inform Members of this National Assembly of the following. Well, I already showed the pictures of what the site looks like.
I am weary of how the people’s money is being utilised. Therefore, I am calling on the Minister responsible to explain to this National Assembly why works have not commenced and what has become of the sums allocated in the last fiscal year’s Budget.
Mr. Speaker, the President, in his Address to this National Assembly on the 10th February, 2012, said:
“Already we are investing in a new and modern hospital in Guyana. This will give us the ability to deliver certain services at a fraction of what it will cost elsewhere in the region and further afield. We hope to have this modern facility within the next five years. With these few words said in a positive tone, we can only hope that this is realised.”
From all angles, in my own judgment, another election will come and this project may still be an embryo.
What is even more surprising is that in the Auditor General’s Report for the fiscal year ending 31st December, 2011, no mention was made of the works to which I alluded earlier. As a legislative body, the onus is on us to ensure that systems, as per law, are enforced.
Regarding works at the Georgetown School of Nursing, it has been reported that works commenced sometime in the latter quarter of 2012 on the building. Hon. Members, I have news for you. What was brought to my attention… The existing building in East Street, Georgetown is a structure that is being added. This started sometime in the latter part of 2012 when we approved allocation to the tune of $25 million. The work commenced in the latter part of the quarter in last year.
Mr. Speaker, what is interesting to note is that in the Estimates of Expenditure for the fiscal year 2012, the sum of $25 million was budgeted and approved by this National Assembly for the following: payment of retention and rehabilitation of Georgetown School of Nursing to be done as per project reference 197. In contrast, for the current fiscal year, it has been recognised that the sum of $25 million has been budgeted for allocation in order to effect the following. Remember, last year it was to pay retention fees, do rehabilitation works at the Georgetown School of Nursing.
In this year’s Budget, there is another $25 million to pay retention fees, extend the Nursing School at East Street, and rehabilitate the annexe at Kingston.
Therefore, the sum of $25 million is being sought in fiscal year 2013 to defray expenditure in these three areas, while, on the other hand, the same amount was sought and approved, as alluded to earlier, in 2012. To reinforce my argument, this sum was for retention fee and rehabilitation work at the Georgetown School of Nursing.
In reviewing Capital Expenditure for fiscal year 2011, the sum of $900 million was budgeted to procure generators for the Georgetown School of Nursing School, New Amsterdam and Linden. My investigations have revealed that this item - I can only account for the Georgetown School of Nursing - was never procured and installed at the Georgetown School of Nursing. The National Assembly should call on the relevant Ministers to state why the generator has not been installed as approved. Were generators purchased for the other areas? If not, what has become of the funds?
The Hon. Minister of Finance has reported that Government proposes to invest $369 million for human resources development. This has been a projection of 4.6 per cent in reduction for training, as compared to the amount budgeted in 2012 which was $387 million. Emphasis must be placed on training and development of our people within the health sector since Guyanese’ expectations are that…
Thank you very much, Mr. Speaker. My other colleague, Dr. Norton, is going to cover what I missed.
In a letter carried in the 21st March edition of the Kaieteur News captioned “Wakenaam residents are receiving primitive treatment”, this is what the writer had to say:
“The Hospital has no proper equipment to provide health services. Many times patients are referred to West Demerara Regional Hospital, which has proven to be very costly, risky and fatiguing, notwithstanding the fact that no electricity is also a reason for such referrals.”
As I said earlier, the budget presented under the Health sector is more or less a budget that deals with infrastructure works. I do not know how the Government sits and puts the budget together. Apparently, they do not take into account the other needs. Apart from buildings people want to ensure that whenever they turn up at public health institutions they must be treated properly.
In another article, Three-year old heart patient - ‘a survivor’, this is what is mom had to say, it was carried in Kaieteur news dated 21st March:
“Nonetheless Farada’s family was devastated, his surgery could not be facilitated here in Guyana, he needed to go to India. This is where the Three Rivers Kids Foundation, a Canadian based kids’ charity foundation, came into play”.
From what I gather here apparently, and I can be corrected, this Government did not contribute or stand the necessary expense to help three-year old Farada Ali.
In concluding, the only way Guyana can overcome challenges and have its gains accelerated is that political players should put aside partisan politics and work together towards the development of Guyana in order to improve the lives of its citizens. Government must embark on ensuring that goals set out in the Millennium Development Strategy are achieved by 2015. However within the health sector emphasis should be placed on goals 4 to 6 since the health sector continues to face challenges. In my opinion infrastructure should not negate the need for adequate human resources to achieve given objectives. Therefore I am challenging the Government to ensure that focus should not only be placed on training but retention of suitably qualified staff. And that is a big thing in the health sector. The nurses are calling for better remuneration and incentives.
For Guyanese to enjoy a good life the APNU had outlined a number of measures towards the enhancement of the health sector. However, we continue to place on record that there is urgency to strengthen the delivery of primary health care services in general, more particularly to meet the needs of remote communities including environmental surveillance. The APNU would welcome the following: strengthening the procurement practices utilising objective scientific tools; increased oversight on the sufficiency and quality of the consumables; encourage the use of private medical insurance by providing tax rebates for medical care. I, therefore, challenge the Government to consider these measures since they will work in the interest of Guyanese especially those contributing to the tax system.
I rest my case. Thank you. [Applause]
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