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Healthcare in Trinidad & Tobago

Trinidad & Tobago operates under a two-tier healthcare system. That is, there is the existence of both private healthcare facilities and public healthcare facilities.

The government's allocation for health was TT$1,263 billion in 2003, which is a per capita amount of approximately TT$10,000. In recent years, a considerable proportion of the allocation has remained unspent. The source of the government health expenditure is general taxation revenues. A health surcharge is deducted from the monthly salaries of all wage earners; however, it is not directed to a fund for healthcare but goes to the Government Consolidated Fund.

In Trinidad & Tobago the share of the health budget has declined over the period from 12 % of the budget in the early 1970s to about 7 % in 2003. The average Total Health Expenditure (THE) per capita (THE pc) for the period 1997-2001 was $239. As a percentage of GDP, the THE was 4.3 %. In terms of the public-private mix, private and government health expenditures as a percentage of THE were 55 % and 45 % respectively. The government has recognised the potential of social health insurance as a means of providing additional funding. As a result of PAHO/WHO technical assistance, a master plan and a task force is being established to guide this process.

A National Health Accounts system has not yet been implemented and it is difficult to find accurate data on expenditure by type of service. In 2002, The Cabinet appointed a National Health Accounts Committee which has now been revitalised.

The foundation of the health sector in Trinidad & Tobago is the public health system, which includes several hospitals (8), a large network of primary healthcare and community clinics (107), and other services. A significant private healthcare sector exists. The private sector is composed of a number of hospitals, nursing homes, clinics, numerous pharmacies, bio-medical laboratories and radiological- image diagnostic services.

A 100-bed secondary care hospital is being constructed in Scarborough, Tobago. Plans are also in place to improve selected facilities at existing hospitals. The government has decided to renovate the Eric Williams Medical Sciences Complex (EWMSC) and rationalise services to fully utilise its capacity including integrating the Mt. Hope Maternity Hospital and housing the National Oncology Centre into the renovated facilities at the EWMSC.

Facilities and biomedical equipment maintenance continue to be an area of weakness. Equipment enhancement projects are underway in various stages. According to an evaluation performed in 2001, the National Public Health Laboratories and Blood Transfusion Service are in poor condition. Physical facilities, equipment, policies and procedures, in addition to management and organisation of the services, were considered to be of poor quality.

The public health sector is financed through general taxation and user fees. The Ministry of Health level of expenditure increased by about 20 % during the 1990s, from $83.6 million in 1991 to $105.6 million in 1997. In 1997, primary care expenditure accounted for 10.9% of total health expenditure.

Recently, the government has launched Chronic Disease Assistance Programme (CDAP). The CDAP provides citizens with free prescription drugs and other pharmaceutical items to combat certain health conditions, such as diabetes, asthma, cardiac diseases, arthritis, mental depression, etc. There are over 250 pharmacies throughout the country that provide medications through CDAP. All citizens of Trinidad & Tobago are eligible. There are no age restrictions or exceptions.





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