Glen Archer’s death and public health care
The passing of Glen Archer, super Spelling Bee coach, at 61, has left many deep regrets behind -and some important questions.
Glen was deeply committed to his vocation, his mission, and his ministry. So much so that he was prepared to skip offered medical care that would take him away from his duties. As part of a defensive move against allegations that the Government did not sufficiently assist Archer, afflicted with kidney disease, a senior official of the Ministry of Health (MOH), who asked not to be named because of the delicate nature of the issue, told the Sunday Observer that the MOH had made several offers for dialysis treatment at the Kingston Public Hospital.
"I know for sure that the ministry offered to allow Rev Archer to do dialysis at the KPH and we selected the days that he could come in for treatment," the official stated. "But he refused to come in on certain days that we set, saying he had to teach his spellers on those days." Minister Fenton Ferguson has promised a "comprehensive response soon".
Glen's family has issued a release expressing pain at the public controversy over who did not do enough for him in his illness and expressing a desire for closure on the matter so they can mourn in private. He was, they said, extremely private in his personal affairs. But Glen Archer led a very public life and, unfortunately, died a very public death.
I, too, am distressed by having to publicly discuss Archer's sickness and death against the wishes of his family, some of whom I have known for years without discovering the connection until his passing. But some important things need to be publicly said from the passing of this public man, this deeply regretful event serving as a prominent peg upon which to hang the story.
The stories are seeping out of the family compound. The never-married teacher, pastor and super-coach was apparently quite nonchalant about his personal and domestic affairs as he devoted himself to his calling and public life. Not unusual. We have seen this with artistes and sports persons and even politicians falling upon hard times post-career and end of life. Joining them are multiple thousands of ordinary Jamaicans out of the public limelight. If the comments by the senior MOH official are anything to go by, Glen may not have given sufficient attention to his health and welfare as he devoted himself to selflessly serving others. The rest of us should take heed.
But it is the expectation of special services for a celebrated Jamaican and the condition of public health care that is the centre of my concerns today. Glen is gone. The MOH official on record said that to make the offer of 'special care' that the Government did for Glen Archer, "you are talking about 'cutting the line' to allow Rev Archer in to do dialysis, as there are more than 700 patients on our list for dialysis treatment at the KPH." The 700 are those fortunate to be registered and in the line. And, of course, Rev Archer would never condone or allow cutting the canteen line at Ardenne!
Users have been bitterly complaining about the availability and quality of service in public health care. A situation exacerbated by the removal of user fees by the last JLP Government as a political three-card manoeuvre. After years of stiff upper-lip silence, workers in the health services are more and more adding their voices. As they should.
UNABLE TO COPE WITH THE DEMANDS
This is Budget season, and health is to get a substantial increase (at the expense of other things, for sure!). As the Gleaner editorial of February 21 puts it, "Set against the context of acute shortages of materials, medicine and manpower, a health budget of $50 billion may not be enough to put the country's health services in a position to deliver quality service to most of its patients. Even though this allocation, announced in the 2015-2016 Estimates of Expenditure, represents an increase of $7.7 billion over last year, it may not result in substantial improvement to what is now being described as a dire service unable to cope with the daily demands of the population.
"So," the editorial continued, "the big questions are: Will patients who turn up at health-care facilities continue to wait for long hours before they are able to get medical attention? Will there be an ease in the shortage of materials and medicine in health-care facilities? Is protection for the most vulnerable factored into the health-care budget?"
"We are not convinced," the paper inveighed, "that the budget allocated to health will result in better protection of the most vulnerable in society. We are also not convinced that the priority areas have been addressed."
The permanent secretary at the MOH recently reminded us ahead of Budget that some 80 per cent of the ministry's Budget goes to salaries. And salaries are slated to budge upwards this year after several years of a wage freeze in the public sector. Permanent Secretary Kevin Harvey is admitting that there are shortages of drugs, including items on the vital, essential and necessary list. There is a shortage of everything else, including working dialysis machines for kidney patients like Glen Archer.
Part of the reason the country is so heavily indebted is the expenditure on public services like health and education beyond what tax revenues can pay for, hence the need to borrow continuously and then borrow some more simply to pay back on what was borrowed already.
The Gleaner editorial notwithstanding, the country cannot afford the health system it has created much more to substantially improve it without further unaffordable debt. More people will have to help themselves. And the Government should long ago have enforced a system of mandatory health insurance.
Glen Archer, as a state schoolteacher, would have had health insurance as a 'benefit'. I don't know if he had life insurance, which is available for critical illness. Only around 15 per cent of the population has any kind of health insurance. And the Government, much to the satisfaction and profit of the insurance companies, doesn't even have an organised system for insurance payment for state health services delivered to the insured.
In the midst of scarcity and crisis, how and to whom are state resources for health to be allocated? Glen Archer's halo has blinded many members of the public into simply accepting that he deserved special treatment. To be honest, at crunch time, I wouldn't mind if the same were thought of me. But the MOH official has made it quite clear that those offerings meant 'cutting the line'. So who gets shuffled back, and on what grounds? Who else gets a celebrity bly unknown to the public unless a controversy arises and it (bruk out)? And who else gets shuffled back?
Glen Archer has left us confronting the big questions of access, equity, transparency and operating procedures to ensure these in the delivery of public health care.
What Glen most needed was a kidney transplant. Typically, as a gift from someone with a close genetic match, that is, close family. He was the country's top spelling bee coach, a competition run by this newspaper. He has had 26 champions and has coached others, many of them now established professionals. He has laboured devotedly at Ardenne High School for most of his working life with hundreds of past students whose lives he touched in classes. As a devoted Christian and clergyman he has a church family. These are the first responders in his hour of need.
I am not into who did or didn't do what for Glen Archer. I only want to ask, when we expect, and the State thinks it its duty, to cut the line and give priority medical care to an iconic champion spelling bee coach, what happens, in the scheme of things, to the regular citizen who can't spell so 'gud' but who is the sole breadwinner in the family with four children, one at UWI, one at UTech, one at Campion, and one a spelling bee at Ardenne?