Fri | Sep 22, 2017

Please, Honourable Health Minister (Part 2)

Published:Monday | November 30, 2015 | 11:00 AM

When most of the individuals who guide and advise the health minister are hard-wired to work with 'the system', no matter how bad it is, things are bound to go wrong.

Health ministry workers are often forced to accept chronic substandard circumstances. Many continue to think inside the box and sometimes watch helplessly as young and old alike die because of scarce resources.

Private-sector health-care providers have an unencumbered and uncoloured panoramic view of health care in Jamaica. We see and hear of the trials encountered by many patients who must access the public system. We are marginalised and alienated so nobody seeks our input; we can only watch helplessly as some of these patients, who are in need of life-saving care, die waiting on the system to help and save them. We hear of the successes, kindness and the brilliance of our medical personnel; but we also hear of the shortages, callousness, carelessness and failures.

One recent case involved a 42-year-old fit gentleman who fell off a roof and fractured his thigh bone in two places. It was not a compound or complicated fracture, but neither he nor his family could afford the surgical devices needed to internally fix the fractures. He was given anticoagulants but died from a clot because he was left on protracted traction in the hospital.

Innumerable citizens die waiting on essential investigations, surgery, radiotherapy and/or chemotherapy. We have too many overworked doctors with long and overbooked lists who are working under very substandard circumstances.

Inefficient systems breed frustration, complacence and corruption. Although the public health system boasts that it does not charge user fees, many patients pay touts and hustlers who 'collect' low ticket numbers and sell them to patients who want to escape the interminable, all-day waiting at clinics and pharmacies. Where is the freeness in those everyday instances?

 

Snap inspections

 

Please, Honourable Health Minister, conduct unannounced visits (snap inspections) of hospitals, clinics and pharmacies. When official visits are announced, great effort is made to spruce up the place. Please, Honourable Health Minister, consider looking into setting up a system of direct reporting (to you) of problems from anyone working in the government system and from private individual doctors and organisations.

Please, Honourable Health Minister, consider lowering the threshold for reporting infections, morbidities and mortalities and set up a special rapid response division, answerable only to you, to look into and ameliorate or fix urgent or emerging problems and situations.

And as for the regional health authorities, please, Honourable Health Minister, review their relevance.

If the circumstances under which health-care workers operate are below the acceptable standard for good medical practice and, therefore, pose a danger to patients, they should refuse to work there until the problems are remedied and report them directly to you. Working under unsafe conditions of crumbling ceilings, hot operating rooms, poor lighting and ajar theatre doors is unethical and litigable.

The National Health Fund (NHF) has been minimising the lag time for supplying essential medications. But, there remains significant and serious dislocation in some critical care departments. Although the NHF has robust supplies of powerful drugs, try as it might, some doctors are unable to get them for their critically ill patients because people in charge of ordering them (not necessarily the pharmacists) are not sufficiently motivated or do not care enough and are not held accountable for the suffering and deaths that ensue.

Please, Honourable Health Minister, consider allowing doctors to submit requests for drugs and equipment directly to a responsible central body.

And finally, Honourable Health Minister, please consider fundraising from outside of the usual government system. Seek more contributions from companies and offer rewards (like tax breaks) for donations.

Additionally, I know friends who tried donating medical equipment from the USA but the duties, multitude of fees and cumbersome system stopped them cold. Once this is addressed, many in the diaspora will donate.

These suggestions are by no means expansive or exhaustive. The morbidity and mortality caused by our health system is unacceptable. Please, Honourable Health Minister, don't follow along the beaten path.

- Garth A. Rattray is a medical doctor with a family practice. Email feedback to columns@gleanerjm.com and garthrattray@gmail.com.