North Central Regional Health Authority (NCRHA) chairman, Dr Tim Gopeesingh, has highlighted the dismantling of the overtime pool system for nurses as one of the most significant cost-reduction initiatives following an eight-month assessment.
Gopeesingh said the Authority identified and eliminated “irregular practices within the nursing pool overtime system,” describing it as part of a broader effort to curb financial leakage and restore accountability.
He stated, “The Authority identified and dismantled irregular practices within the nursing pool overtime system, resulting in the elimination of an overtime expenditure pattern estimated at approximately $36 million per annum.”
He reported that the move formed part of a wider financial overhaul, which has so far yielded substantial savings and recoveries.
“These have focused on enforcing financial discipline, identifying and addressing irregular payments, restoring merit-based management, strengthening procurement oversight, and improving the delivery of clinical services,” Gopeesingh stated in his report submitted to Prime Minister Kamla Persad-Bissessar.
He added, “As a result, significant sums have been recovered and saved, outstanding debt has been materially reduced, improper arrangements have been identified and addressed, and core healthcare services have been expanded, stabilised and significantly improved.”
According to the report, more than $150 million was identified, prevented, or recovered from what Gopeesingh described as “mismanagement, corruption, nepotism, and payments made without proper contractual arrangements”.
The chairman detailed a series of cost-cutting measures, including approximately $30 million reductions in both security and janitorial expenditure, as well as the rationalisation of a vehicle rental system that previously included 353 vehicles, many of which were not in legitimate use. That number has since been reduced to 23, generating estimated annual savings of $20 million.
The review also uncovered significant irregularities in procurement and contracting.
“The Authority identified over $140 million in payments to contractors without tenders or contracts from 2023 to mid-2025. A forensic audit is currently in progress,” the report stated.
It further noted that a contractor was found to have received approximately $120 million over a two-year period.
At the time of the board’s appointment, Gopeesingh said the NCRHA faced “serious and deeply rooted challenges,” including a debt burden exceeding $350 million, widespread irregular expenditure, and systemic weaknesses.
“These included a substantial debt burden exceeding $350 million, widespread irregular expenditure, procurement practices that bypassed established requirements, and clear evidence of systemic weaknesses that allowed mismanagement and, in some instances, corrupt practices to persist,” he said.
He noted that urgent intervention was required “to arrest financial leakage, restore proper governance, and stabilise the institution”.
Acting management appointments revoked
Within eight months, Gopeesingh reported that outstanding debt was reduced to under $150 million, while more than $160 million in payments was processed, and the number of suppliers was cut from over 500 to approximately 100.
“These actions restored supplier confidence and ensured continuity of essential services,” the report stated.
On the human resource front, the chairman said the NCRHA reversed 25 acting management appointments made shortly before the April 2025 general election, citing concerns over qualifications and experience.
“Twenty-five acting managers, appointed shortly before the 2025 general election, were found to be unqualified and inexperienced. All were reverted to their substantive positions, and management structures were corrected to reflect competence and experience,” he stated.
The Authority also began recruiting additional staff, including 100 nurses and 55 doctors, in an effort to address staffing gaps.
Gopeesingh pointed to measurable improvements in service delivery, including reduced waiting times for surgeries, outpatient appointments, and Accident and Emergency services.
The NCRHA reported approximately 500,000 patient visits annually, with more than 80,000 clinic visits recorded within the eight-month review period.
Diagnostic and treatment capacity has also expanded, with approximately 32,000 CT scans, 3,200 MRI scans, and between 900 and 1,000 angiograms and angioplasties conducted. Laboratory services exceeded three million investigations, while radiology services now operate continuously.
In surgical care, operating theatre capacity has more than doubled, from three to seven functioning theatres, while specialised services such as an Oral and Maxillofacial Surgical Unit have been introduced. The renal transplant programme has also resumed, with five procedures completed.
Infrastructure upgrades were also highlighted, including the installation of a 7.5 MVA electrical transformer system, repairs to standby generators, and the upgrade of elevators, lighting systems, and critical utilities across facilities. Community healthcare access was expanded with the introduction of 24-hour service at the St Joseph Health Facility and extended hours at five health centres.
Gopeesingh said the combined measures have “established a more disciplined and functional organisation, better positioned to provide reliable and timely healthcare services”.
“Work remains ongoing. However, the progress achieved within this period reflects a clear and sustained effort to restore proper management and improve operational performance across the NCRHA,” he stated.
Beckles: Government out of touch
However, Opposition Leader Pennelope Beckles sharply criticised the Government’s stance following the release of the report, pointing to recent protests and ongoing industrial unrest among nurses.
“On Friday, April 10, at the sitting of Parliament, I asked the Minister of Health a simple but urgent question: What is the Government doing as the nursing crisis enters its third week?” Beckles said in a post.
“The minister’s response: ‘There is no crisis.’”
She added, “It is clear that the minister, Dr Lackram Bodoe, the NCRHA chairman, Dr Tim Gopeesingh, and this UNC Government are totally disconnected from the realities of the nation.”
Beckles referenced protests in Port of Spain, where nurses demonstrated over staffing shortages, working conditions, and unresolved pay issues.
“On Friday, hundreds of nurses took to the streets of Port of Spain, protesting in the blazing sun, voicing frustration over staffing shortages, working conditions, and unresolved pay issues following weeks of smaller strikes across various health facilities in the country,” she said.
She further accused the Government of ignoring mounting pressure within the system.
“This Government is out of touch, out of excuses, and rapidly running out of time,” Beckles stated.
“Why hasn’t the Minister of Finance met with nurses? Can Dr Gopeesingh even meet with nurses? And when will nurses see and feel the love from Prime Minister Kamla Persad-Bissessar? Are they not deserving?”
Beckles warned that the consequences of inaction would be borne by both healthcare workers and the public.
“Nobody is winning in this crisis, least of all the nurses and the people of T&T,” she said.
For weeks, nurses have engaged in protests calling on line minister Bodoe to address their concerns over wages, staffing shortages and working conditions.
