Give Jamaica an 'EPOC' for health
The health of a population has a key role to play in the mission to generate economic growth and create jobs. It is against this background that Fourth Floor participants stressed that it is time that this be taken seriously.
"We have not recognised the role that health plays as a pillar of development ... . I have never seen a health target in any IMF (International Monetary Fund) programme, and I think it is a huge mistake by both the policymakers and the international partners," said Christopher Zacca, chairman of the National Health Fund (NHF).
Zacca joined a panel to discuss ways of funding health, and one by one they expressed strong feelings about how health care should be funded and managed, and shared strategies for reducing the burden of illness on the public sector.
Citing the measly spend on health, Zacca said: "Between Government and the private sector, only about 5.8 per cent of GDP is spent on health, compared to our neighbours in the Caribbean - Barbados and the Bahamas at 7.5 per cent each and Cuba at 11 per cent."
Wayne Chen, chairman of the Southern Regional Health Authority, in the meanwhile quipped: "We see it [health care] as welfare, we don't see it as an investment."
Chen called for the public-health system to be properly managed and monitored by an EPOC-type committee, which was established to oversee Jamaica's financial arrangements with the IMF.
"Public-health management should present a programme of development to be approved by Cabinet and it should be monitored by such a committee, and it cannot be funded only through the National Health Fund. There has to be a reprioritisation away from some of the non-essential areas of Government into essential areas such as health," he submitted.
Fourth Floor participants acknowledged that improving management accountability at all levels of the system would create better leverage of scarce resources and bolster efforts to meet patients' needs and deliver quality care. This was followed by a call for good governance principles and astute management to ensure the effective use of limited resources.
"The management of resources has to be sharp and evidence-based," suggested Chen.
Zacca described a scenario at the NHF where he found some 66 approved projects in the pipeline when he took over the chair. The projects, which span the entire range of the public-health sector, totalled $2.6 billion. He said two-thirds of the projects were overdue and most of them had overshot their budget.
After making representation to the Ministry of Health, a committee headed by Peter Jervis, project manager and engineer, has been assigned the task to review the outstanding projects and consider new submissions "to ensure that there is some coordination of project implementation".
He added: "If we can do that, we could save hundreds of millions of dollars annually."