NOW WE SEE, NOW WE DON’T!

Sep 16, 2015 Features / Columnists, Peeping Tom

I was not the only one who saw it. A friend also saw it and gave me a call. “Can you believe it?” he said, “Fifty thousand grand for an MRI at a private hospital. How can poor people afford that?”
I said I do not know. He was not finished.
“The government should buy one of those machines and set it up at the Public Hospital so that the poor man does not have to pay all that money for an MRI. Why do public hospitals not have MRIs?”
I had to ask him which country he was living in all these years. There are many like him who believes that it is inexcusable that the public hospitals in Guyana do not have MRIs.
But consider what would happen if there was an MRI scanner. Persons would go to the public hospital for the MRI and then go to a private doctor for treatment. Some private doctors would unscrupulously see their private patients at the public hospital so that these expensive tests can be done free while they draw down on their consultation fees at their private clinics.
This is believed to be already happening and is one of the reasons why for a long time this column has been saying that if a doctor works in the public health system, that doctor should not be having a private clinic. Some people feel that there is no conflict of interest in a doctor in the public health system moonlighting in private hospitals. They are looking in the wrong direction. They are only looking at what they think is happening. They are not looking at what can happen.
Right now a doctor earning a decent salary at a public health clinic can do part-time work at a private hospital. That doctor does not need any permission to do so. But an ordinary public servant barely earning enough to pay for transportation and lunch, has to seek permission from his superiors to do a part-time job as a waiter or waitress in the evenings. This is how public service rules apply. The small man has to get permission while the rich doctor can freely moonlight.
Ministers of the former government were known to be involved in businesses. Yet a small Office Assistant cannot even dare take a few tamarind balls to her workplace to sell. That person has to get permission. They are some persons who are selling phone credit at their workplace and they have to do so secretly because the bosses are also selling the same phone credit.
A Regional Executive Officer was recently appointed and indicated that he will still be running his private clinic. Regardless of whether the position is technocratic/ bureaucratic or quasi political, how can someone in such a senior position be allowed to have a private clinic?
The justification may be that the clinic is unrelated to the job. But how do we know that someone wishing to enjoy the favour of a senior official, will not want to go and befriend that senior official as a client in order to get into that person’s good books. It is not what is happening, but what can happen. This is why there should be strict rules about these matters.
If you have a fulltime public service job, then you should not be working anywhere else. This should be the rule, period, especially if you are a senior official or a doctor.
Let us suppose that you are a Minister and your Ministry awards contracts. If at the same time you own a restaurant or a banquet hall. Someone wants to be in your good books. That someone has a child who is marrying. They come to you and they offer to rent out the restaurant or the banquet hall. You have entered into a contractual arrangement with that person.
That same person has a bid in front of you when you are performing the duties of a Minister. You may or may not favor that bid. But in any court of law, the mere likelihood of you having to make a decision while in public office about a private client of yours constitutes a conflict of interest.
We can see that but yet we cannot see why persons working in the public health care system should not be working for private hospitals. We cannot also see that REOs should not be allowed to have part time employment. Now that is something that should be in the Code of Conduct for public officials.
We cannot see these things and therefore we will never understand why it makes no sense in the present context for the government to have its own MRIs.

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