Orville Taylor: Health, stealth and a defensive ministry
I am going to remind my friend, Comrade Dr Fenton Ferguson, that despite the propaganda of the yes-men who call me often to say what a perfect job he is doing, the first word in the name of his party is people.
Having finally got the anti-smoking legislation passed, there can be no screen created except from the still unfurling Riverton City fire fiasco, foible and any other alliterative word for coughing up.
Our double-F physician took office on the back foot, because his administration followed the old maxim about another
F-word making many, and kept the fee-free regimen implemented by a desperate Jamaica Labour Party (JLP) that eventually smelled defeat before being booted in 2011.
In many ways, the removal of user fees for clients in our health services was a sort of coup. An erstwhile socialist party seemed to have lost its working class-orientation, and the Labourites, recognising this, opened the health pork barrel and flew open the floodgates.
poor economics and governance
Yet, while it was a good political move, it was poor economics and governance. This current People's National Party (PNP) administration has kept it because, though unsustainable, it makes good politics.
Despite the defence from principals in the health ministry, the conditions surrounding workers in the health sector are far from ideal. It is a simple formula and doesn't require a degree for anyone to understand. Workers, as they were in the 1970s, are the axis upon which performance in any sector revolves.
Workers employed to the South East Regional Health Authority (SEHRA) have been put in the embarrassing situation of not having their deductions remitted to their creditors. Hopefully, their statutory withdrawals have been forwarded to the National Housing Trust, the National Insurance Scheme and, of course, Tax Administration Jamaica.
There is something very uncomfortable about the
dialogue between the Jamaica Medical Doctors Association (JMDA), Medical Association of Jamaica (MAJ) and the Government. Somebody is not being straight.
Both the MAJ and the JMDA have pointed to unsavoury working conditions, and there have been allegations that some doctors were pilfering supplies. Recently, on TVJ's 'All Angles', SERHA attempted to downplay the absence of
amenities and the revelation that the popular black plastic bag has now developed a new twist to the moniker, 'scandal', by which it is commonly known.
But this is the same health ministry that said the chikungunya epidemic was not a crisis, and when the JLP, as politicians do, made political mileage out of it, they were accused of being dishonest. Well, even now, the persons in a constant state of 'bruckins' and 'della move' are still wondering if mosquitoes could have been so effective in transmitting the virus, and the numbers have not finally been tabulated.
The JMDA has a right to be suspicious. Few will recall that it was in the wake of an International Monetary Fund (IMF) agreement that had quantitative guidelines when the issue of doctors being properly remunerated for their excessively long hours came to the fore.
Jamaica had failed a 1977 IMF test and we were under great pressure to devalue the currency by 10 per cent under the new three-year extended fund facility. But the IMF always liked tightening of screws on workers. In 1978, the Labour Relations and Industrial Disputes Act (LRIDA) was amended to give more control to Government over the process of collective bargaining. For the next 15 years, it did precisely that.
For the next decade and a half, Jamaican workers, but especially government employees, were locked into a set of wage ceilings, whereby they saw inflation outdistancing their earnings.
The present set of health workers, although they are now experiencing the lowest level of inflation in their adult lives, have been in a wage freeze or restricted wage environment for the better part of the 2000s.
Interestingly, as Government reportedly established a task force for the implementation of a new system of working hours, without proper consultation, it causes a flashback to the end of the 1970s and beginning of the 1980s when the Junior Doctors Association, the first incarnation of the JMDA, went to court to demand payment for overtime. As it turned out, the courts sided with the government and ruled that overtime pay was not a legal entitlement, unless one is working at the national minimum wage.
Although sound in law, the judgment was socially unjust, because it set the tone for unrewarded work beyond eight hours, for medical personnel, who were already pressed and stressed. If my recollection is accurate, Dr Winston Dawes, father of the JMDA's immediate past president, Alfred, would have had intimate knowledge of this case as well.
Like so many other public-sector workers in this country over the past 30-plus years, health-sector employees have laboured under adverse conditions, and with what now looks like a diminishing pool of resources. In the past few years, expenditure on health has moved from above six per cent of gross domestic product (GDP) in the 1990s, to somewhere around five per cent in 2012. The number of hospital beds per 1,000 persons fell from 2.2 in year 2000 to around 1.7 in 2012, and the list can go on.
Yet, the health workers ought to be given semi-hero status. The health indicators of Jamaicans are close to First World standards. Over the period, life expectancy has grown by close to five years. Now the average citizen lives to around 74 years. Infant mortality is at a decent, though improvable, 13.69 deaths per 1,000 live births. In simple language, we are getting far more from the health-sector workers than the government has been putting in over the past three decades.
However, there is an adage about bucket and well, and the minister must not push his luck.
- Dr Orville Taylor, senior lecturer in sociology at the UWI and a radio talk-show host, was the 2013-14 winner of the Morris Cargill Award for Opinion Journalism. His just-published book, 'Broken Promises, Hearts and Pockets', is now available at the UWI Bookshop. Email feedback to firstname.lastname@example.org and email@example.com.