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No user fees, no problem - Future JLP gov't would implement creative measures to ensure that public health care remains free

Published:Sunday | January 24, 2016 | 12:00 AMErica Virtue

A Jamaica Labour Party (JLP) government will not reverse the no-user-fee policy introduced while it led the country between 2007 and 2011, despite claims by several persons in the sector that it is unsustainable.

JLP leader Andrew Holness last week declared that the free health care was non-negotiable if his party is given the nod to form the next government.

But accepting that the public-health system is in need of a cash infusion, Holness said a government led by him would speedily introduce the long-proposed national health insurance scheme.

"We will reinforce the free access to health-care policy as it was in 2008. We will start the process of setting up the national health insurance scheme, where everyone can contribute towards public health," Holness told a Gleaner/Mona School of Business and Management Leadership Round-table Forum last Wednesday.

"We are not saying that there aren't challenges in the health sector. It was never a policy of the JLP to say free access to health care and not match that with a consistent budgetary increase yearly," added Holness.

The no user fee in public-health facilities was a campaign promise of the JLP in the lead-up to the 2007 general election and, in the aftermath of a close victory, the Bruce Golding-led administration was quick to carry out its promise.

The People's National Party (PNP) continued the policy after its election victory in 2011 despite clear signs that the public-health system was struggling to cope with the increased number of persons seeking treatment without a similar increase in resources.




A Caribbean Policy Research Institute (CaPRI) survey done in 2013 revealed that health-care professionals and patients believed the no-user-fee policy was negatively impacting the quality of the service provision in hospitals.

The CaPRI survey confirmed that more than 65 per cent of both patients and hospital staff (doctors and nurses) were of the view that the no-user-fee policy should at least be revised to include ensuring that those who can afford to pay should pay.

Addressing members of The Gleaner's editorial team and selected sector representatives last week, Holness accepted that the sector needs adequate financing to ensure that it functions properly with the no-user-fee policy.

According to Holness, during the three years of the free access to health care under the Golding government, the budget allocated to the sector was increased consistently, despite one of the worst global recessions in modern history.

Holness declared that a new JLP government would continue to increase the allocation to the public-health sector with additional funding from the fees collected from casino gambling, a proposal put on the table by the JLP from 2009.

"So we give a commitment to maintain the free access and to maintain a consistent increase in the health budget. Every single Jamaican should take comfort in that commitment," said Holness.

The Opposition Leader added that a government led by him would continue to urge Jamaicans to take responsibility for their proper health and would invest heavily in public health education.

In the meantime, Holness said a JLP government would review the operations of the regional health authorities which have come in for criticisms from some major players in the sector.

While not committing to do away with the system, Holness said the role of regional boards would be closely scrutinised as his administration would focus on greater effectiveness for better outcomes and functions.

"There are services that are being done that are not efficient. For example, one region is procuring the same drug at a price of 80 per cent more than another region. One region has gauze and the other has none. So we are all for revising how they operate. It may well be serious revision," said Holness.