Public SLP Services in Trinidad and Tobago or Nah?

Why aren’t there speech-language pathology/therapy services in Trinidad and Tobago's public hospitals, or clinics, or schools?

That is not a question that should be directed to a speech-language pathologist/therapist. The professional association and regulatory bodies have been appealing to the relevant ministries for quite some time. We just have not been met with feedback that can help us forge a new frontier for the field. There have been claims that therapists are charging exorbitant prices for their services. I saw somewhere on social media that our associations do not regulate costs. I do not hear or see the same complaints for doctors or dentists or nail techs or make-up artists. Why, then, are allied health professionals, specifically speech therapists, being targeted in this regard? SLP is a profession on servitude and self-giving. Prices match our qualifications and expertise, not to outdo our potential clients’ pockets.

Did you know that there are public speech pathology and occupational therapy services in Tobago? Why can’t that be the same in Trinidad? Speech-Language Pathologists and Therapists are highly qualified, specially trained clinicians who hold master’s degrees. (FYI: an MBBS is a bachelor’s degree). We all know that public pay would be less than private pay. That is a no-brainer. However, there is no doubt that we want to serve the general public too. Nonetheless, we should be adequately compensated for our time and expertise.

Further, there is ONE (or two?) position available in San Fernando General Hospital (maybe?). Any hospital in any metropolitan city in the US or the UK has AT LEAST five SLPs on staff – be it full-time or part-time. I, personally, do not know of any private hospitals who have an SLP on staff. How is one person supposed to service all the needs of a population of over one million people? SLPs do not only treat children with autism or who stutter. We see your uncle who was a heavy smoker and now can’t speak clearly due to throat or mouth cancer. We see your grandfather whose words no longer make sense since he suffered a stroke. Your childhood friend who was in a bad car accident last week that left her with a severe brain injury – we help her too. People with congenital developmental issues: down syndrome, cerebral palsy, fragile X syndrome. That premature baby who can’t suckle a breast or drink from a bottle because she is so underdeveloped, so much so that she is also non-responsive to her environment even though her little heart is beating and her eyes are open. She can be helped by a speech-language pathologist.

But where can we work publicly?

“How about the schools?” you ask. Which schools? Which office? Which space? To see which students? Would they be screened before they get to us? Do we screen everybody? Which protocols are in place for us to do that? Preschools? Primary schools? Secondary schools? It is already so much of a stretch for school administration and teachers to allow us to see the students on the school compound or in the class as private practitioners. Do any of the schools have the required tools, assessments and resources for us to be there full-time or even part-time? This, of course, is not an admonishment of the schools, teachers and principals but rather an admission of confusion regarding the systems in place that inhibit students’ optimal performance.

The majority of SLPs in the country work in private practice because there are no adequate public positions for us. If the relevant ministries would create per diem positions at different hospitals or schools where a different clinician can be there one day a week or half day a week, that could get the relevant processes started. There are 22 practicing SLPs in the country. If we each shuffle around our private schedules, I am certain that we could each be at one public facility once a week. The responsibility does not fall squarely on us. We are willing. We are ready. Our associations have been advocates along the journey, so it is quite surprising that we have been publicly chastised of recent. Do I think we can do more? Certainly!

Help us to help you. Let’s all push together to get those public positions created! Then, the public wouldn’t have to worry about the costs of services. Let’s choose us. Let’s choose serving our country. Let’s choose each other!

What’s your Choice?

Coming soon: Why do we even need SLPs in Trinidad and Tobago?

Kiara M. Matthews, MS, CCC-SLP

Founder and Speech-Language Pathologist