Tue | Apr 25, 2017

Kevin Sangster: Privatise Jamaica’s hospitals

Published:Wednesday | July 15, 2015 | 7:00 AM

As we continue to contend with dwindling public resources and our unattractive and untenable big government realities, the Government should move, as a matter of policy, to privatise our public hospitals.

It should not be strategically and economically desirable for us to continue to operate the more than 24 public hospitals, not when private interests can more cost-effectively run them, and when our public hospitals continue to face serious challenges.

Our public hospitals are not effectively meeting the needs of the citizenry, with the perennial cries of lack of adequate resources and supplies to properly serve the populace, and the unattractive remuneration of our health-care workers who have to work long hours under trying circumstances.

The last Jamaica Labour Party administration, with good intentions, abolished user fees in the public-health system. While such a move has made hospital care more accessible to the average Jamaican, the demand for such care has increased dramatically without significantly more funds being made available to equip the hospitals with better technologies, resources and medical supplies.

we can't afford it

The truth is that we just cannot afford a properly run public hospital system - not at this time or for the foreseeable future, given our precarious economic situation. Nor should we ever desire to operate a fully or largely public health-care system.

In line with the arrangement of the University Hospital, which is affiliated with the University of the West Indies, the University of Technology, which ought to be restructured and renamed Jamaica National University, or the University of Jamaica, could assume the operations of one of the major hospitals, whether through outright sale or long-term lease, and affiliate it with its medical faculty as another teaching hospital that provides medical care.

Hospital firms or private interests would be better able to manage the public hospitals, possibly resulting in fewer, but more efficient and better integrated hospital networks than we currently have. Moreover, such a move would prove helpful to the elderly, poor and taxpayers generally, because there would be improved productivity and a system that treats more patients more cost effectively.

The regional and some of the major hospitals currently could be maintained but improved as first-class general hospitals, while some of the smaller ones could be developed around certain specialities. As such, no one, including our political top brass and moneyed people, should have to leave Jamaica to access quality health services.

The development of our hospital system by private interests could also provide the fillip for our entry into medical tourism, thereby widening the customer base and providing the opportunity for better pay for our medical professionals.

With a better-operating and equipped hospital system, the Government could then focus on providing the citizenry with the insurance necessary to access such services and better developing the primary health-care system, operating those facilities as preventative and primary treatment centres.

referral points

The primary health-care centres would be referral points for those patients under the national health insurance scheme. This would encourage our people, except for those in real emergency situations, to first seek care from the primary health-care centres, whose services would be cheaper than hospital care.

The proceeds from the sale of the hospitals could be channelled into the National Health Fund (NHF) to help fund the national health insurance scheme to assist, at least, the elderly, indigent, and unemployed who cannot afford their own care, and beneficiaries under the Programme of Advancement Through Health and Education (PATH).

Employers should be expected to provide their employees with health benefits, with especially the small employers receiving tax breaks for providing such benefits.

The health proceeds from the Culture, Health, Arts, Sports & Education Fund and PATH would also be directed into the NHF, which would get supplementary annual subventions from the national budget.

While the State has a responsibility for protecting and promoting the health of the country, the Government can meet this obligation by becoming a facilitator and purchaser rather than a provider of hospital services.

- Kevin K.O. Sangster is an attorney-at-law. Email feedback to columns@gleanerjm.com and sangstek@msn.com.