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The Rs 17.2 billion allocated to the Ministry of Health for the financial year 2024-25 will not be enough to resolve all the problems of public health services. In addition to infrastructure, human resources are also necessary, highlight stakeholders in the sector.

Of this Rs 17.2 billion, Rs 1.7 billion will be devoted to modernizing the service, including the construction and renovation of various infrastructures such as hospitals, medical clinics, Area Health Centers and Community Health Centers ( see box). While this allocation is welcome to equip the public health department with more modern and spacious infrastructure, stakeholders hope that the Ministry of Health will also consider recruitment of staff.

“We are facing an acute shortage of staff,” say Dr. Meetheelesh Abeeluck, president of the Government Medical and Dental Officers Association (GMDOA), Ram Nowzadick, president of the Nursing Association (NA), and the Dr Vinesh Sewsurn, President of the Medical and Health Officers Association (MHOA). An opinion shared by the paramedics and the Records Officers, although they did not wish to be quoted.

“It is good to build medical clinics and community health centers for the well-being of the population. On the other hand, we do not see measures for the recruitment of general practitioners, nurses, attendants, Health Care Assistants and ambulance drivers,” points out Dr Abeeluck. For him, improving infrastructure to provide better treatment and expand the range of services requires staff. “How can these health centers operate without human resources? » he asks himself.

Quality service

The president of the GMDOA notes that many projects are mentioned each budget year, but that staff recruitment does not follow. He deplores that current employees have to work overtime or “bank sessions” to compensate for the shortage of staff, often to the detriment of their health. With delays in overtime payment, frustration is growing among staff. Attributing these delays to the delay in submitting returns is a “bogus” argument, according to Dr. Abeeluck. “We cannot bury our heads in the sand by asking employees to work without paying them afterwards. This kind of argument is unacceptable,” he said.

Dr Sewsurn also deplores this situation and thinks that more attention should have been given to this aspect to strengthen the workforce. “We are building centers but we are not recruiting enough staff. We must recruit and train officers, whether they are nurses, doctors or paramedics,” he adds. For him, arrangements should have been made to retain public service health professionals. “With the increase in the number of private clinics, we are facing an exodus. New graduates are not interested in the Ministry of Health. We should have proposed measures to motivate them to join or stay in the public service,” he emphasizes.

Ram Nowzadick shares this opinion and pleads for a nurse/patient ratio in order to be able to use the equipment correctly and prevent it from being underused due to lack of staff.

“There is an acute shortage of nurses, which prevents us from respecting the nurse/patient ratio and providing quality service to the population,” he says. With all the new infrastructures and services that are gradually being put in place, having a sufficient number of trained and qualified staff is essential to achieve the set objectives.

It is as important to modernize the health service and infrastructure with modern equipment as it is to have the adequate staff to work in these establishments, he makes it clear. And training should not be neglected. “All staff must be trained and have the necessary expertise to provide the required service effectively and efficiently. This will only be possible if the health service has sufficient numbers of staff,” he maintains.

The recruitment of personnel is also desired by ambulance drivers and Records Officers. According to a paramedic, massive recruitment is necessary to prevent the system from collapsing. He points out that the service operates 24/7, whatever the weather conditions.

Rs 1.7 billion for various infrastructures

The 2024-25 Budget provides:

• Rs 800 million for the operationalization of the New Flacq Hospital;
• Rs 311 million for finishing work on the new kidney transplant unit in Rose-Belle;
• Rs 310 million to complete the work on the new ophthalmological hospital in Moka;
• Rs 127 million to complete the work of the Area Health Centers in Bambous, Bramsthan, Cap-Malheureux and Curepipe;
• Rs 81 million for improvement work in various regional hospitals;
• Rs 55 million for medical clinics in Grand-Bois and Chemin-Grenier;
• Rs 38 million for renovation work on 10 medical clinics, 17 Area Health Centers and 18 health offices across the island;
• Rs 11 million for the construction of the Community Health Center in Écroignard and Roche-Bois.

Decentralization

The Ministry of Health is working hard for decentralization in order to offer a local service outside hospitals through medical clinics, Area Health Centers, Community Health Centers and others. However, it seems that many people still go to regional hospitals for minor health problems, notes the paramedic. For him, regional hospitals should be reserved for urgent cases or cases referred by the various health centers installed in different localities of the country.

Salary relativity

In addition to the delay in overtime payment, the silence surrounding salary adjustments is criticized by public health service staff. The frustration is palpable, according to Ram Nowzadick, president of the Nursing Association. “There is a distortion of wages with the minimum wage. A person just starting out can receive almost the equivalent of the salary of someone with many years of service,” he says. The reduction in the salary gap in employee grades is also a source of discontent, add the president of the NA and a paramedic who did not wish to be quoted. The relativity of salaries between various positions must be respected, they emphasize. “It is unacceptable that those who have diplomas have almost the same salary as those who have just joined the service,” criticizes Ram Nowzadick.

The paramedic adds that all the staff were left hungry. “We all expected a salary readjustment, but that was not the case. While the minimum wage has risen to reach Rs 20,000, those who have many years of service see their ceiling stagnate,” he laments.

It highlights that health personnel work body and soul to satisfy the population. However, their efforts were not rewarded. “We feel abandoned. The Minister of Labor could plead in our favor. With rising prices and spiraling inflation, we are struggling to make ends meet. The civil servants are starting to feel the effects,” continues the paramedic.

“We hope that the ministry will take into consideration the work we do and reward us. With unpaid overtime, it's time to pay us. We will see if the ministry will give us what is due to us,” he adds.

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