Putting Some Order in the House 

By Dr Balmick Foogooa 

A couple of months ago, I pointed out how millions of Rupees worth of drugs issued by the Ministry of Health (MoH)

During the Colonial period, instead of the MSS, we had the Poor Law Office (PLO). At least one such office was found in all towns and main villages of the Island. In our village, Long Mountain, the PLO was manned by one Government Officer whose job it was to effect payment of Old Age and Retirement pensions. The Officer would also allocate other types of Social benefits, but only upon the recommendation of the Pension Board whose members were, as far as I can remember, six in number. In most cases, the Board comprised members from different communities and a variety of professionals. Thus, in Long Mountain, at one time the members were Father Sauzier (RC priest), Mr Osman (a relative of the first Mauritian Governor, late Sir Raman Osman), Mr Beeharry Panray (an attorney-at-law) and Mohabeer Foogooa (my late dad, a primary school teacher). I am afraid I cannot remember the names of the other members, but none of them was paid for this job. Obviously, due to the transparency of the system in those days, it was not easy to recommend any Tom, Dick or Harry for Social aid. 

Medical Boards 

After independence in 1968, the PLO was replaced by the MSS. Instead of a Board comprising members from different communities and professions, Government decided that the Board would be made up solely of 3 doctors and, bearing in mind the susceptibility of Mauritians, it was scrupulous about selecting the Board doctors from 3 different communities. The Board’s duty was, and still is, to consider applications for Basic Invalidity pensions following accidents and disease, and many other types of social benefits.  

Here I’ll digress to suggest that, in order to reassure everyone, the PSC and the DFC and any other such body should absolutely consist of members from all the main ethnic groups of the country. I would love to hear of anyone who has no special feelings for his community! But this special feeling should not at any cost be a deterrent to peaceful coexistence.  

Coming back to the medical board of those days, because of the plural nature of its composition, there was hardly ever any request for reassessment of decisions taken. But most unfortunately today, we find some medical boards sitting with a single doctor in attendance —that is, in the absence of his colleagues. Hence, he/she can recommend any person, deserving or not, for pension and other social benefit. In case benefits are given to undeserving persons in the event, it would be a scandalous waste of public money, and even more so a crying injustice to the genuinely eligible people! 

False Economy 

The Government might be saving peanuts on Board staff, but what if it were squandering millions on the other hand by paying social benefits to the undeserving? There are unfortunately doctors who may not be firmly grounded in Integrity. There may be some, for example, who might, for a fee, be prepared to issue Medical Certificates to malingerers and other so-called patients. I am told that this crooked business has been going on for decades and with total impunity! If true, there are people who are not assuming their responsibilities. 

The MoH and the MSS should be particularly watchful about so-called “psychosomatic” cases. Since ancillary scientific investigations are of little use in the field of mental disease, the diagnosis is totally subjective and is based solely on the opinion of the single Board doctor who is deemed to be qualified in the field. This kind of situation makes it easy for improper practices to creep in, with most of the malingerers coming from this group of patients. I have good grounds to be most distrustful of phantom diagnoses! 

Back to Basics 

In order to remedy any malpractice, it is advisable to have dubious cases reassessed by a Board of 3 specialist doctors from 3 different ethnic groups. Furthermore, we must ensure that all 3 Board members (or their deputies) are present at every sitting of the assessment session. In fact, since practising doctors have time constraints due to professional commitments, why not revert to the old system of 6 voluntary members — who can be drawn from a list of retired professionals — with a majority of 4 needed to form a quorum?  

Thus, unless all of them can be influenced en masse by the “patient” in a singular act of coincidence, adopting such a practice would eliminate potential corruption at a stroke; and save a lot of Government money which could in turn be used to bring much needed enhancements to the National Health Service. 

land up in the kitchen bin. In this piece, I am going to dwell on the Ministry of Social Security (MSS) where billions have been perversely squandered during the past decades. And this is due to the blatant malpractices complacently tolerated by the authorities.

* Published in print edition on 30 September 2011