By Dana Malcolm
Staff Writer
#TurksandCaicos, June 30, 2022 – An Intensive Care Unit is under active consideration for the Turks and Caicos however it will be a long and expensive process with an at least $10 million dollar price tag attached; the good news is the space is available and the Health Minister wants to cut the cheque.
“In our 2021-2024 strategic plan and with the group that we have through our contract management unit and our collaborations with NHIP; these are some of the services that we are looking at over the next three years to build a business case based on our data and their data to present to government with a proposal. Now we recognize that we have to take our time in presenting all of these proposals to Government because they are the ones funding it.”
Dr. Denise Braithwaite Tennant, CEO of InterHealth Canada explained the extreme complexity of planning and building an ICU in this British overseas territory.
“There are different levels to the ICU, there are ICUs that focus on medical, trauma, and high complexities such as open-heart surgeries and ecmo. So we recognize we have to have a starting point and we are building the business case for that and it’s the most complex one we’ve ever had to build… our aim is to start with a medical ICU so that we can reduce the number of persons going abroad for surgeries that we do here.”
The medical ICU is especially important because what has happened in the past and continues today is that residents with certain comorbidities are sent overseas for surgeries offered on the island. While the surgery expertise exists in-country, post-surgery ICU care is not.
“Because of their patient complexity we’ve decided that it’s not safe to do it in the absence of an ICU,” Braithwaite-Tennant explained
Building a business case for an ICU is intricate and demands that planners identify the requisite staff, consider the infrastructural needs and introduce the proper operations program and many other factors. These boxes must be
checked even before the Government then weighs in on the proposal which they must agree to fund from the public purse.
Jamell Robinson, the TCI Minister of Health in that Tuesday press conference offered a simple, “Long time” when asked if he would be willing to support putting the money behind the development of an ICU and other areas itemized as priorities by the hospitals CEO.
Dr. Braithwaite-Tennant says there are two other high volume procedures putting a strain on taxpayers and Turks and Caicos should begin immediate work on addressing the deficiency in these clinical services.
“As a unit they may not be very expensive but because of the critical volumes that they generate they still end up causing NHIP a lot of money.”
These high volume services were named as surgical and medical Ophthalmology or eye care, which she describes as a “key driver in terms of volume” and vascular which is climbing in demand as the number of dialysis patients in the TCI is on the rise.
Despite the difficulties in crafting these plans, TCI Hospitals’ executives are assertively pushing for the in country services in ophthalmology, vascular and an ICU and have confirmed that by year end, the businesses cases will be handed over to Government for review.
“Thereafter it’s going to be a back and forth communication about it, group meetings explaining so they can fully understand and then comes the part of funding it.”
One good thing is that the physical building space already exists as the government had built the hospitals with expansion capacity.
“The ICU buildup is complex — thankfully the government of the Turks and Caicos Islands had the foresight to build expansion spaces. All it is now is a shell and we currently use it for storage but it has the fixtures in the walls to come forward.” she said.
Dr. Braithwaite-Tenant explained they were moving on these medical services proposals aggressively because they recognized that the current system is not sustainable.
“The project agreement did not necessarily envision it being used with an ICU component– but COVID forced that because there were times in the very beginning that no one wanted patients who had Covid-19. No one.”
Which meant TCI islanders who tested positive for the virus prior to being medially evacuated, were denied medical care. It placed Islanders in life threatening situations.
The idea that in five months, Turks and Caicos Islands Government could be holding the plan to build an Intensive Care Unit and to add specialists in eye and vascular care is heartening. Residents have long been calling for the extension and the country is in a fantastic place, fiscally, to action and approve these significant upgrades.
The 40,000 residents and two million visitors will be able to rest easier with the assurance that specialized care is only minutes away; giving patients more precious life saving time which could mean the difference between life and death.