Health reform refers to changes in health administration, health planning and health research that place significant emphasis on local health challenges aimed at improving health administration, health planning health and medical care. They will be combined to produce an efficient health service delivery model capable of increasing the physical, medical and psychological safety of the patient. Health reform must be driven by empirical data, best practices, and evidence-based practices. A variety of health statistics; such as mortality, labor needs, technology performance, and patient satisfaction; they must be analyzed and used in strengthening health systems.

In Trinidad and Tobago, the current health system is highly centralized. The Ministry of Health maintains operational supervision of five regional health authorities. These are the Northwest Regional, North Central Regional, East Regional, Southwest Regional, and Tobago Regional. South West, North West, and North Central are the largest regions; each serving the health needs of more than three hundred thousand people.

A significant reform should be the specialization of the Ministry of Health in fewer functions aimed at improving the efficiency of medical care. For example, you can focus on data collection and analysis. It should have expert health researchers charged with analyzing changes in epidemiology and trends in morbidity and mortality. In addition, the Ministry of Health should have the power to instruct regional authorities to make systemic and resource changes based on the statistics collected and analyzed. Regional bodies should be mandated to provide health statistics to the Ministry of Health on a quarterly basis. The Ministry of Health must maintain the general supervision of the regional authorities. It must produce annual reports based on self-monitoring and evaluation of the systems, performances, and challenges in each region. The financial statements and audits must be submitted annually to the Ministry of Health and the factors that account for the variation must be justified. Recommendations should be made to improve and prosecute incidences of white collar crime.

An important reform that must be implemented is to grant absolute autonomy to the regional health authorities for the provision of health services. They should be able to generate their own funds by charging fees for their services. This would eliminate dependence on the state or the Ministry of Finance for funding. Each regional health authority should be able to invest in the stock market or undertake other income-generating measures that it considers feasible. Your funds must be spent in accordance with the health needs of the population you serve. Regional authorities should be responsible for primary, secondary and tertiary healthcare. In addition, they must be supervised by private hospitals and health facilities in their geographic regions. Private facilities must be subject to price controls to avoid exorbitant charges and must be required to pay at least ten percent of their annual profits to the regional authority.

In addition, regional authorities should have the power to ensure that all health institutions and providers adhere to national accreditation standards. The Ministry of Health should be responsible for developing national accreditation standards in all aspects of the operations of health institutions. These should include hospitals, pharmacies, private practices. Also conventional and alternative medicines must be subject to accreditation standards. Each and every health institution must be subject to accreditation standards comparable to those of more developed countries such as Canada and the United States.

It is palpable that the boundaries of each regional authority are redefined so that they have an almost equal population size. Right now, South West Regional is responsible for just over half a million people. Therefore, given its limited resources, it cannot be expected to operate as efficiently as possible. Given that the best health facilities are located in urban centers, this would be a challenge that must be met with judgment. To accommodate this reform, regional authorities must induce joint public and private partnerships in the provision of health centers in rural areas and other districts less accessible to major hospitals and health centers.

For the health system to be efficient, a centralized electronic health record system must be developed and implemented. This would ensure that patients could access care in any region. Therefore, it would facilitate access to the medical records of any health center that is owned and operated by any regional authority. The Ministry of Health is expected to take a leadership role in this endeavor. Regional authorities should have access to private hospital patient records, as they may be transferred to a public hospital if the care they need cannot be obtained there. Sometimes, for financial reasons, such as exorbitant cost, patients can be transferred to a public hospital.

Employment policies should allow the free movement of skills and expertise between regions. In some cases, patients from other regions must have highly specialized surgeons and caregivers according to their needs. In other words, one region may pay another for the services of the skilled human or physical resources it demands.

Regional bodies can collaborate in health planning. They can develop their strategic, business and budget plans cooperatively. Later, they can modify their plans to adapt them to the needs of their population. The main benefits of central planning will be greater interoperability, accountability and transparency. Inter-planning can reduce competition between regions and ensure that scarce resources are used efficiently. Indeed, the Ministry of Health can compare operational effectiveness and best practices in all regions and provide opportunities to strengthen operational or institutional efficiency.

The health system must be reformed so that it can provide high-quality care to patients. Patients must be well educated to take advantage of a competent, highly organized and skillfully managed healthcare system. Finally, the reform must involve all interested parties; government, private doctors and citizenship. A convergent bottom-up and top-down model must be adopted so that there is universal acceptance of the health reform capable of contributing to the economic and social development of the country’s human capital.