Source document: https://docs-lawep.s3.us-east-2.amazonaws.com/1694834277400.pdf (Guyana)
NATIONAL ASSEMBLY MINUTES OF PROCEEDINGS OF THE 123RD SITTING OF THE NATIONAL ASSEMBLY OF THE FIRST SESSION (2006-2010) OF THE NINTH PARLIAMENT OF GUYANA HELD AT 2.00 P.M. ON THURSDAY, 22ND APRIL, 2010 IN THE PARLIAMENT CHAMBER, PUBLIC BUILDINGS, GEORGETOWN MEMBERS OF THE NATIONAL ASSEMBLY (70) Speaker (1) The Hon.

Hari N. Ramkarran, S.C., M.P., Speaker of the National Assembly MEMBERS OF THE GOVERNMENT (41) People’s Progressive Party/Civic (40) The United Force (1) The Hon.
Samuel A.A. Hinds, M.P., (Region No.

10 – Upper Demerara/Upper Berbice), Prime Minister and Minister of Public Works and Communications (Absent – performing the functions of Office of the President) The Hon.

Clement J. Rohee, M.P., Minister of Home Affairs The Hon.

Shaik K.Z.

Baksh, M.P., Minister of Education The Hon.

Dr. Leslie S. Ramsammy, M.P., (Region No.

6 – East Berbice/Corentyne), Minister of Health The Hon.

Carolyn Rodrigues-Birkett, M.P., (Region No.


9 – Upper Takutu/Upper Essequibo), Minister of Foreign Affairs *The Hon.

Dr. Ashni K. Singh, M.P., Minister of Finance The Hon.

Robert M. Persaud, M.P., (Region No.

6 – East Berbice/Corentyne), Minister of Agriculture *Non-elected Minister /…2 2.

The Hon.

Dr. Jennifer R.A. Westford, M.P., (Region No.

7 – Cuyuni/Mazaruni), Minister of Public Service The Hon.

Kellawan Lall, M.P., Minister of Local Government and Regional Development *The Hon.
Charles R. Ramson, S.C., M.P., Attorney General and Minister of Legal Affairs The Hon.

Dr. Frank C.S.

Anthony, M.P., Minister of Culture, Youth and Sport The Hon.

B. H. Robeson Benn, M.P., Minister of Transport and Hydraulics **The Hon.

Manzoor Nadir, M.P., Minister of Labour The Hon.

Priya D. Manickchand, M.P., (Region No.

5 – Mahaica/Berbice), Minister of Human Services and Social Security The Hon.

Dr. Bheri S. Ramsaran, M.P., Minister in the Ministry of Health The Hon.
Jennifer I. Webster, M.P., Minister in the Ministry of Finance The Hon.

Manniram Prashad, M.P., Minister of Tourism, Industry and Commerce *The Hon.

Pauline Sukhai, M.P., Minister of Amerindian Affairs The Hon.

Mohamed Irfaan Ali, M.P., Minister of Housing and Water Mr. Donald R. Ramotar, M.P.

Ms Gail Teixeira, M.P.

Mrs. Indranie Chandarpal, M.P., Chief Whip Mr. Harripersaud Nokta, M.P.

Ms Bibi S. Shadick, M.P., (Region No.


3 – Essequibo Island/West Demerara) Mr. Albert A. Atkinson, J.P., M.P., (Region No.

8 – Potaro/Siparuni) *Non-Elected Minister **Elected Member from the United Force /…3 3.

Mr. Komal Chand, C.C.H., J.P., M.P., (Region No.

3 – Essequibo Island/West Demerara) Mr. Bernard C. DeSantos, S.C., M.P., (Region No.

4 – Demerara/Mahaica) Mrs. Shirley V. Edwards, J.P., M.P., (Region No.

4 – Demerara/Mahaica) Mr. Mohamed F. Khan, J.P., M.P., (Region No.
2 – Pomeroon/Supernaam) Mr. Moses V. Nagamootoo, J.P., M.P.

Mr. Mohabir A. Nandlall, M.P.

Mr. Odinga N. Lumumba, M.P.

Mr. Neendkumar, J.P., M.P., (Region No.

4 – Demerara/Mahaica) ***Mr. Steve P. Ninvalle, M.P., Parliamentary Secretary in the Ministry of Culture, Youth and Sport Mr. Parmanand P. Persaud, J.P., M.P., (Region No.

2 – Pomeroon/Supernaam) Mrs. Philomena Sahoye-Shury, C.C.H., J.P., M.P., Parliamentary Secretary in the Ministry of Housing and Water (Absent) Mr. Dharamkumar Seeraj, M.P.
Mr. Norman A. Whittaker, M.P., (Region No.

1 – Barima/Waini) Dr. Vishwa Deva Budhram Mahadeo, M.P.

Rev.

Kwame Gilbert, M.P.

Mr. Lloyd J. Pereira, J.P., M.P.

Members of the Opposition (28) (i) Members of People’s National Congress Reform-One Guyana (22) Mr. Robert Corbin, M.P., Leader of the Opposition (Absent) Mr. Winston Murray, C.C.H., M.P.

***Non-elected Parliamentary Secretary /…4 4.


Mrs. Clarissa S. Riehl, M.P., Deputy Speaker of the National Assembly Mr. E. Lance Carberry, M.P., Chief Whip Mrs. Deborah J.

Backer, M.P.

Mr.

Basil Williams, M.P.

Dr. George A. Norton, M.P.

(Absent – on leave) Mrs. Volda A. Lawrence, M.P.

(Absent – on leave) Mr. Keith Scott, M.P.

(Absent – on leave) Ms Amna Ally, M.P.

Ms Cheryl Sampson, M.P.

Mr. Dave Danny, M.P., (Region No.

4 – Demerara/Mahaica) Mr. Aubrey C. Norton, M.P., (Region No.
4 – Demerara/Mahaica) (Absent) Mr. Ernest Barnabas Elliot, M.P., (Region No.

4 – Demerara/Mahaica) Mrs. Judith David-Blair, M.P., (Region No.

7 – Cuyuni/Mazaruni) Mr. Mervyn Williams, M.P., (Region No.

3 – Essequibo Island/West Demerara) Ms Africo Selman, M.P.

Dr. John Austin, M.P., (Region No.

6 – East Berbice/Corentyne) Ms Jennifer Wade, M.P., (Region No.

5 – Mahaica/Berbice) Ms. Vanessa Kissoon, M.P., (Region No.

10 – Upper Demerara/Upper Berbice) Mr. Desmond Fernandes, M.P., (Region No.
1 – Barima/Waini) Ms Dawn Hastings, M.P.

/…5 5.

(ii) Alliance for Change (5) Mr. Raphael G.C.

Trotman, M.P.

Mr. Khemraj Ramjattan, M.P.

(Absent) Mrs. Sheila Holder, M.P.

(Absent – on leave) Mrs. Latchmin Punalall, M.P., (Region No.

4 – Demerara/Mahaica) Mr. David Patterson, M.P.

Guyana Action Party/Rise Organize and Rebuild (1) Mr. Everall N. Franklin, M.P.
OFFICERS (2) Mr. Sherlock E. Isaacs, Clerk of the National Assembly Mrs. Lilawtie Coonjah, Deputy Clerk of the National Assembly COMMENCEMENT OF SITTING The sitting commenced at 2.12 p.m. PRAYERS The Clerk read Prayers.

/…6 6.

REPORTS FROM COMMITTEES- (1) By the Speaker of the National Assembly, (Chairman of the Committee of Selection): Minutes of Proceedings of the 20th Meeting of the Committee of Selection, held on Thursday, 8th April, 2010.
(Circulated) (2) By the Minister of Human Services and Social Security, (Chairperson of the Special Select Committee on the Sexual Offences Bill 2009): Report of the Special Select Committee on the Sexual Offences Bill 2009 – Bill No.

30/2009.

(Circulated) (3) At the request of the Minister of Health, (Chairman of the Special Select Committee on Persons with Disabilities Bill 2009), the following report was deferred: Report of the Special Select Committee on Persons with Disabilities Bill 2009 – Bill No.
44/2009.

(To be Circulated) (4) By the Minister of Finance, (Chairman of the Special Select Committee on the Credit Reporting Bill 2009): Report of the Special Select Committee on the Credit Reporting Bill 2009 – Bill No.

37/2009.

(Circulated) /…7 7.

QUESTIONS ON NOTICE- For Written replies 1.

HEALTH SECTOR POLICY Member Asking: Mrs. Sheila Holder, M.P.

Minister Answering: The Minister of Health Is there a Health Sector Policy?
(i) If so, could the Honourable Minister give the House a status report on the progress being made, measuring where we are as against where the Policy says we should be?

(ii) How many resignations across categories of nurses/doctors and other health workers did the public health sector experienced last year?

(Notice Paper No.

427 (Q306 Opp281) published on 2010-03-05) Answers: (i) Yes, there is a health sector strategy.

It is for the period covering 2008-2012.


The work plan for the strategy is being implemented in accordance with the timeline.

The mid-term review of the plan has shown that the plan is being implemented on a timely basis.

(ii) There are 110 resignations in 2009.

These included 13 doctors and 39 nurses.

/…8 8.

2.

EFFICIENCY AND EFFECTIVENESS MEASUREMENTS IN THE HEALTH SECTOR Member Asking: Mrs. Sheila Holder, M.P.
Minister Answering: The Minister of Health Could the Honourable Minister of Health tell the House what efficiency and effectiveness measurements he applies to the Health sector?

(Notice Paper No.

428 (Q307 Opp282) published on 2010-03-05) Answer: There are various instruments we are using to measure efficiency and effectiveness.

These are all instruments that have only begun utilization in the last few years.

We have developed proficiency in the use of some of these instruments.
The others are at various stages of being implemented.

The following are some instruments: Instrument 1.

Service Agreements What does it Measure?

Seek to ensure proper facility management, adequate reporting and financial management and management of supplies and adherence to clinical guidelines 2.

Quarterly Health Reports Mainly seek to establish surveillance of health problems 3.

Monthly Financial Reports Ensuring effective use of financial resources 4.
Health Facilities Inspection Reports Requirement of the Health Facilities Licensing Act 2007.

Insures facilities and management process meet certain established standards, supporting safety and quality of facilities and services Status Introduced in 2009 for GPHC and Region 6 and on a trial basis for all other Regions.

• GPHC scored 81% • Region 6 scored 83% • All other Regions scored between 66 to 80% New format enforced in 2009 All Regions =70-80% performance levels New format enforced in 2009.
All Regions = 80-85% performance levels Introduced for public sector in 2009.

GPHC and Regional Hospitals performed well and no less than private hospitals.

Generally meet all requirements.

5.

Assessor Reports 6.

Maternity Monthly Reports 7.

Maternal Death Internal Investigation and Assessment Report 8.

National Maternal Death Audit Committee 9.

Child Health Monthly Report 10.

Child Mortality Monthly Report 11.

Child Mortality Internal Investigation and Assessment Report 12.
Morbidity and Mortality Committee Requirement of the Health Facilities Licensing Act 2007.

This ensures that facilities are meeting minimum clinical standards of practice Numbers of deliveries and outcome Each facility must submit within 24 hours a report of any maternal death and within 48 hours a report of an internal investigation of the event.
The causative factors for each maternal death Numbers of newborns and numbers of illnesses in under-5 children Number of neonatal, infant and U5 deaths Each facility must submit reports of any U5 death within 24 hours and submit a report of an internal investigation within 48 hours Identifying unusual events in morbidity and mortality cases in hospitals and identifying possible preventive measures 13.

Medical Advisory Committee Interventions for improvement in hospitals 14.
Clinical Audit – see below for write up on this Assess quality of charts and identify whether appropriate care is being provided 15.

Laboratory Proficiency Program Accuracy Performance of Labs 16.

QA/QC for Labs 17.

Health Qual Ensure continuous measurement of quality in labs Measure clinical quality and outcome of HIV Treatment and To be introduced in 2010.
Will be conducted between June and September Introduced in 2007 Introduced in 2007 Introduced in 2008 Introduced in 2007 Introduced in 2007 Introduced in 2007 Introduced in 2002.

Presently at GPHC and New Amsterdam Hospitals.

To be extended to all Regional Hospitals and to 2 private hospitals this year Introduced in 2002.

Presently functional at GPHC.

Will also be introduced in Linden and Region 6 Introduced on a limited basis in 2003 and being expanded in 2010.
Will conduct clinical audit for quality of charts, maternity and accident and emergency Introduced in 2002.

The GPHC and several public health labs perform at levels about 90% and higher than private labs Introduced in 2002 Introduced in 2007 Maternal and Child Health Guyana has shown relatively good performance 18.

Immunization Periodic Assessment Measure quality of immunization service and data quality Introduced in 2001 and done every 4 years through international peer ew.

19.
19.

Behavior and Biological Surveillance Surveys To assess the effectiveness of health promotion efforts and the sector’s public awareness and education programs 20.

Client Satisfaction Surveys To survey client satisfaction at various public hospitals around the country.

21.
21.

UNGASS Reports A consensus report by all stakeholders on effectiveness of HIV Program Guyana continues to score high Introduced in 2003 Generally demonstrate programs are reaching people and are effective in transforming behavior Introduced in 2009.

Show acceptable patient satisfaction.

Main concern is nursing attitude First Report in 2004.
Demonstrates good outcome and effectiveness of programs Clinical Audit in the Health Sector as a Quality Improvement Tool Clinical Audit is one of the measures being utilized by the Ministry of Health to promote improved quality of health care services in Guyana, particularly in the public health sector.

The introduction of the Health Facilities Act 2008 provides the legal framework for the institutionalization of clinical audit in the health sector, both in the public and private sector.
The 2010 Plan: The 2010 Plan will be implemented with support from PAHO/WHO, UNICEF, UNFPA and CDC (USA).

The Clinical Audit will be coordinated by the Chief Medical Officer (CMO).

The Clinical Audit will include international experts provided by PAHO, UNICEF, UNFPA, CDC and other partners.

In 2010, a wide ranging clinical audit program is to be instituted in the health sector.
The following areas are to be subjected to a clinical audit exercise in 2010: • 2nd Edition of the Comprehensive Clinical Audit with international reviewers for the Maternal and Neonatal Services in the public sector at the GPHC, New Amsterdam Hospital, Linden Hospital, Diamond Diagnostic Center, West Demerara Hospital, Suddie Hospital and Lethem Hospital and in each of the private sector hospitals.

/…11 11.
/…11 11.

• 2nd Edition of the Neonates and Still Births Clinical and Environmental Analysis with international reviewers to be carried out in the hospitals named above.

• Introduction of Clinical Audit for Emergency and Accident Rooms at GPHC, New Amsterdam Hospital, Linden Hospital and Diamond Diagnostic Center and two private hospitals.

• Audit of Charts for quality of records Previous Experience: Clinical Audit as a tool for improved quality was introduced formally in 2005 in the public health sector.
In 2005, clinical audit measures were identified for Maternal and Neonatal Services in the public health sector.

Comprehensive clinical audits at Georgetown Public Hospital and New Amsterdam Hospital were conducted.

Support for this comprehensive clinical audit was obtained from PAHO.

The goal was for a comprehensive clinical audit to be completed with international reviewers every five years.

Thus, the 2nd Edition of the Comprehensive Clinical Audit is to be done in 2010.
Preparation for the 2010 Comprehensive Clinical Audit for Maternal and Neonatal Services is being completed for a May/June exercise.

The 1st Edition of the Comprehensive Clinical Audit for the Maternal and Neonatal Services was completed in 2005.

The intention is that each year a limited clinical audit review with local investigators will be done.

In between the comprehensive clinical audit, a comprehensive review of selected aspects of the maternal and neonatal services is planned.
The 1st detailed analysis took place in 2008 and studied neonatal deaths and still births in five hospitals in the public health sector.

This study will be repeated in 2010.

/…12 12.

3.

VACANCIES IN THE HEALTH SECTOR Member Asking: Mrs. Sheila Holder, M.P.

Minister Answering: The Minister of Health Could the Honourable Minister of Health say how many vacancies, in each category, there are in the health service across regions and how does the Budget provide for these to be filled during this year?
(Notice Paper No.

429 (Q308 Opp283) published on 2010-03-05) Answer: The Health Sector has completed a human resource requirement for the health sector and is presently studying the report.

The plan was necessitated by the inappropriateness of the public service establishment.

However, if we were to use the existing public service establishment, there are over 300 technical vacancies.

The 2010 health sector budget does not cater for the filling of these vacancies.
The Ministry of Finance usually makes provisions for budgetary resources to cater for filling of vacancies in all the sectors.

/…13 4.

FINANCIAL AFFAIRS OF THE GEORGETOWN PUBLIC HOSPITAL 13.

CORPORATION Member Asking: Mrs. Sheila Holder, M.P.

Minister Answering: The Minister of Health Will the Minister of Health ensure that the corporatized Georgetown Public Hospital Corporation conduct its financial affairs according to the law and avoid the annual reprimand by the Auditor General?
Answer: (Notice Paper No.

430 (Q309 Opp284) published on 2010-03-05) The GPHC was established as a semi-autonomous agency in 1999 by the Order #3 of 1999 made under the Public Corporations Act 1988.

In the view of the Auditor General this qualifies the GPHC for a subvention.

The Order establishing the GPHC caters for GPHC to be a budget agency.
The Ministry of Health has been in discussion with the Ministry of Finance to determine the way forward in the context of the Auditor General’s annual remarks relating to this subject.

The Minister of Health assures the House that he will continue to do all he could to ensure the Auditor General finds comfort in the mechanism of financing for GPHC.

5.

SUPPLEMENTARY FINANCIAL PAPERS – PURCHASE OF DRUGS AND MEDICAL SUPPLIES Member Asking: Mrs. Sheila Holder, M.P.
Minister Answering: The Minister of Health Can the Honourable Minister of Health say if the 2010 Budget takes account of the supplementary financial papers approved by this Assembly late last year giving the Ministry of Health money to buy drugs and medical supplies through to the end of April?

(Notice Paper No.

431 (Q310 Opp285) published on 2010-03-05) /…14 14.

Answer: Yes.

The health care services have been growing each year and the supply of medicines and other supplies have increased significantly.
The 2010 budget is only likely to get us through to December, 2010.

We are likely again to request supplementary funds to obtain medicines to meet the demands between January and April, 2010.

INTRODUCTION OF BILLS Presentation and First Reading FISCAL ENACTMENT (AMENDMENT) BILL 2010 – Bill No.

5/2010 The Minister of Finance, on behalf of the Government, presented the following Bill, which was read the first time: A BILL intituled AN ACT to amend the Income Tax Act and the Corporation Tax Act.
PUBLIC BUSINESS - (i) GOVERNMENT BUSINESS BILLS – Second Readings ITEM 1 - POUNDS (AMENDMENT) BILL 2010 – Bill No.

4 /2010 published on 2010-03-26 The Minister of Home Affairs moved the second reading of the following Bill: A BILL intituled AN ACT to amend the Pounds Act.

(Read a first time on 2010-04-08) The following Members spoke to the motion: Mrs. Deborah Backer The Minister of Local Government and Regional Development /…15 15.

Thereafter the Minister of Home Affairs replied.


The Bill was then read a second time.

Assembly resolved itself into Committee to consider the Bill clause by clause.

In Committee Clauses 1 to 2 were passed as printed.

Assembly resumed On a motion by the Minister of Home Affairs, the Pounds (Amendment) Bill 2010 was read a third time and passed as printed.

ITEM 2 - THE SEXUAL OFFENCES BILL 2009 – Bill No.


30/2009 published on 2009-07-08 The Minister of Human Services and Social Security moved the second reading of the following Bill, which was referred to a Special Select Committee for consideration and report: A BILL intituled AN ACT to reform and consolidate the laws relating to sexual offences and to provide for related matters.

(Read a first time and committed to the Special Select Committee on 2009-07-09) The following Members spoke to the motion: Mr.
Basil Williams The Minister of Culture, Youth and Sport /…16 16.

SUSPENSION OF SITTING At 3.55 p.m., the sitting was suspended for refreshments.

RESUMPTION OF SITTING At p.m., the sitting was resumed.

The following Members also spoke to the motion: Mrs. Latchmin Punalall The Minister of the Public Service Mr. Everall Franklin Mr. Mohabir Nandlall Thereafter the Minister of Human Services and Social Security replied.

The Bill was then read a second time.


Assembly resolved itself into Committee to consider the Bill clause by clause.

In Committee Clauses 1 to 18 were passed as amended.

Clause 19 Mrs. Latchmin Punlall moved the following amendment, which was put and carried: Clause 19(1)(g) – In the second line after the word ‘instructor’ insert the words ‘Minister of Religion’ /…17 17.

Clause 19 was then passed as amended.

Clauses 20 to 95 were passed as amended.

The Schedules were passed as amended.


Assembly resumed On a motion by the Minister of Human Services and Social Security, the Sexual Offences Bill 2009 was read a third time and passed as amended.
(iii)COMMITTEES BUSINESS MOTION ITEM 3 - ADOPTION OF THE FOURTH PERIODIC REPORT OF THE PARLIAMENTARY SECTORAL COMMITTEE ON SOCIAL SERVICES Ms Amna Ally, M.P., (Chairperson of the Parliamentary Sectoral Committee on Social Services) moved the following motion: BE IT RESOLVED: That the Fourth Periodic Report of the Parliamentary Sectoral Committee on Social Services be adopted.

(Notice Paper No.
(Notice Paper No.

456 (M131 Opp 35) published on 2010-04-08) The following Members spoke to the motion: Mr. Norman Whittaker Mrs. Latchmin Punalall Thereafter Ms Amna Ally replied.

/…18 18.

The motion was then put and carried.

ADJOURNMENT At 7.10 p.m., on a motion by the Minister of Home Affairs, the sitting was adjourned to a date to be fixed.

……………………………………………….. HON.

HARI N. RAMKARRAN, S.C., M.P., Speaker of the National Assembly PARLIAMENT OFFICE, Public Buildings, Brickdam, Georgetown.
22nd April, 2010.