The health services in Mauritius are in need of improvement. The hygiene level, general cleanliness and preparation of food have been shown to be of very poor standard for a fast developing country. There can be no justification for the slackness and wrongful expenditure highlighted by the National Audit Report. Look at the state of the old Civil Hospital. The decline and neglect is obvious. Our health services are just not working and not good enough. What can we do to ensure that things change and improve? The message from the MOH appears to be that nothing will change and the population has to endure a crumbling national health

service (NHS) not fit for the 21st century. A few eye-catching operations here and there from foreign surgeons are welcome but that will not improve our NHS fundamentally. Our NHS needs urgent surgery and imagination from the MOH. It seems the latter is bankrupt of ideas and, more importantly, unable to serve the people of this country.

Rumour has it that there is intense political jealousy and rivalry between the MOH and MOE. The MOH has encircled itself with a banner saying to the MOE: “Do not touch anything where Health is concerned.” This is deeply worrying and flawed. Well, the MOH must know that health is a multi-agency business and it must very often be a collaborative multi-ministerial effort. The MOH by isolating itself and not wanting to work with other ministerial departments is not putting health first and is deliberately flawed. How can the MOH deliver services on its own when healthcare professionals need new skills, new initiatives, new pedagogy and new practices? The message to the MOH must be loud and clear. Isolating itself means denying to people new progressive services. Health first means working with other ministries and convincing them to join the struggle for better hospitals, better doctors, higher standards of care and better motivation and education for staff. The MOH on its own will not be able to service the needs of our people and, more importantly, it will be floundering in very poor standards. The MOH must grow up and not fester political rivalry but show a mature and greater interest in healthcare development.

<B>BSc Nursing practice</B>

Increasing healthcare demands from an evolving population need highly educated professionals. The MOH has a myopic view of what healthcare is and how it should be delivered. The truth is that the MOH does not understand the changing needs of our people and therefore sees no future for higher education in health. This is a catastrophic view, which will deprive our nation of a better healthcare system. All practice-based professions are developing and educating their professionals to degree and doctorate level. The Police force has entered into higher education. Why should healthcare professionals not? Look at what has happened to the catering trade. We have chefs who have aspired and achieved national and international qualifications and recognition within the higher education system. Consequently, we have better meals, better presentation of food and happy customers. This is the result of education. Let us all shout to the MOH that education transforms practices and services. The conclusive evidence is that higher education for all healthcare professionals will bring better healthcare services. Stopping BSc Nursing studies and punishing those who aspire to higher education is retreating to the dark ages. The MOH must move forward.

If it does not, then the health care professionals, the unions and the population have to take matters in their own hands.

The proper place for higher education is the university. All healthcare education must be in an environment regulated by university criteria and subjected to the Tertiary Education Commission jurisdiction. Anything less is misreading future developments, is a retrograde step and dragging Mauritius back fifty years. The MOH must realise it's high noon and time to wake up and shake off political rivalry. The Institute of Health must be part of the university; the MOE and the MOH must work together to uphold higher education. It is time to put aside personal political aspirations and point-scoring and put the country first. Move all healthcare education to the university. That is what is required and what will serve Mauritius with a better healthcare system and retain all the nurses, who are moving to the UK. Continuous professional development in Mauritius for professionals is abysmal and political strains can only make it worse. It can only get better in a university environment.

It is sad that professionals and their representatives have to threaten strike action for progress to be made in healthcare education. On the other hand, it shows how weak and frightened our MOH is. Is there a feeling that the minister has seen his brother rise to the Presidency and his nephew to Leadership status and therefore wants to make a point? If not, why this intransigence? Why no more higher education for nurses? Why are nurses deprived of the basic professional right to work in the private sector in their own time? Why is the MOH dictating how nurses should spend their free time? Why this flagrant violation of human rights? Why deny nurses the right of enhancing their income in their own time? Why this nanny attitude to running the MOH? This is no way to promote good industrial relations. It is dictatorship. This is no way to motivate nurses to perform and give quality care. The style of the MOH seems more confrontational than collaborative, more entrenched in power relations than social struggle and more autocratic than facilitating. If there has been abuse in the past, tighter contractual obligations, performance monitoring and better supervisors and managers must resolve the problems. Banning people from working in the private sector is a blanket approach, which stifles good, honest nurses who have never abused their rights. Why should the innocent law-abiding nurses suffer because a handful has been found to be untrustworthy. Discipline and dismiss the abusers but do not shackle good workers with autocratic lock and chain.

<B>Conclusion</B>

There is an urgent need for a total review of strategy at the MOH. It needs to be more facilitating than punitive and more creative than maintaining the status quo. The decline in our NHS is due to a dormant posture of the MOH. Health is more precious than anything and the MOH can make a real name for itself by harnessing the support of other ministries to promote healthcare. The policy of isolation is disastrous and sadly the population will continue to suffer. Has the MOH got the vision to lead healthcare in Mauritius? Where is the evidence?