Why hide health audit?
As bits and pieces of the controversial audit of Jamaica's health sector begin to creep into the public domain, one wonders: Why was it not disclosed long ago? What was all this fuss about?
The Access to Information Act sets the framework for the flow of information between the Government and the people. The act is very clear about those sorts of documents that are protected from disclosure. You can read about it on the Ministry of Health's website: http://moh.gov.jm/access-to-information/.
The hospital audit does not fall into any of those categories and is not exempt from disclosure. This is fairly straightforward. The law makes it clear that it should be disclosed. The Ministry of Health demurred, or at least waited, as long as they could under the law. Why?
I heard some unfortunate official statements about wanting to shield people from vilification, or protect their feelings, or some other eye-roller of an excuse. The supposed emotional state of health workers has never trumped the principle of transparency or the law. Nor have I reason to believe that our health-care workers are so emotionally fragile - quite the opposite.
The truth, as anyone who has interacted with our public-health system knows, is that our health workers are enduringly heroic. They have been making the best of a bad situation for generations now, largely in dignified silence. But it is also true that the situation has worsened over the last few political administrations. One doctor, Alfred Dawes, broke the silence; we see what became of him. An audit was ordered to tell us what we already knew; we see what has become of that.
Rather than spending the last few months twisting, turning, making silly speeches, carding people on social media, trumpeting context-free budget numbers, and dodging the obvious, Jamaica could have been having an honest national conversation. We could have laid bare the many faults in our health-care system in the context of our economic situation.
We could have engaged everyone - locally, in the diaspora, in the private sector, in the development community. We could have been solving the problem rather than pretending there was none or scoring political points that the majority of us do not care about.
We still can. It begins with transparency. Not just transparency as a buzzword that gets thrown around, but as a lived philosophy and style of governance. I dare say that it would be a more useful approach for everyone.
'Everyone' includes even those persons who are concerned with scoring political points. Transparency has great political value. Releasing the audit early and getting in front of this affair would have allowed the minister better control of the public narrative. We could be talking about the surprisingly good statistics or the sober science instead of the tragic particulars or the disastrous faux pas.
better technical approach
The approach to transparency being taken now appears similar to what Jamaica saw during the chikungunya epidemic, and it is resulting in the same acrimonious loss of public confidence. It is not an approach that is broadly acceptable to citizens, particularly the young, who expect information flows that are fit for the Information Age.
Transparency is not only what citizens are demanding; it is not only a better technical approach. It is a way for politicians to win the confidence of voters.
Some young politicians are taking that approach, with citizens of either and neither party cheering them on. Some other politicians would do well to echo the approach so that we can all get on with making the country better.