Sun | Mar 18, 2018

Free health care a farce?

Published:Wednesday | December 7, 2016 | 12:00 AM
Annotto Bay Health Centre and Hospital.
Dr Christopher Tufton

Acute shortages in the public health-care system are hurting the very people that Government's no-user-fee policy is meant to protect because the resources are just not enough to guarantee efficient and timely medical attention.

Shortages identified in a 2015 audit of the public-health system included manpower, equipment, medications, wheelchairs, stretchers, gloves, beds, and other essential supplies.

A cursory examination of the Jamaican situation will reveal that a two-tier system of health care exists, in which those with money can access high-quality services in the private sector, while those who depend on the public system have to wait for even basic services.

So is free health care a farce? Not so, said Health Minister Dr Christopher Tufton, as he sat down to talk with The Gleaner about the challenges in health. He continued, "One has to accept that health care is not free. Somebody has to pay for it."

If that someone is the Government, then 3.3 per cent of the national Budget has proven to be woefully inadequate to provide the levels of service required for free health care. The World Health Organization (WHO) suggests that the budgetary allocation should be at least six per cent.

"You can't administer 'no user fee' or 'free health care' and expect all to be well on a 3.3 per cent budget. You are going to have shortages," reasoned Tufton.

Take the shortage of beds as an example. The minister said a study done a few years ago suggested that there ought to be about 7,000 hospital beds to serve the population. However, there are about 3,500 beds in the public health-care sector.




This reality is compounded by the fact that no new public hospital has been built in Jamaica in 25 years. The other factor is that some patients remain in hospital long after they have been discharged because they have no homes. The minister says he is talking to Food For The Poor to add capacity to some of the infirmaries so that those who can be moved will have a place to go to.

Tufton shared his plan to deal with the migration of health-care professionals, 70 per cent of whom blame poor compensation for their decision to accept overseas jobs.

The minister has been talking to Cuba, China, Canada, and the United Kingdom about some kind of collaboration in the training of these professionals. "I am now trying to refine an approach that says we will train them in the theory and you take them for the practical side for the exposure in the hospitals and we develop some sort of exchange programme."

In that programme, the minister believes both sides will benefit for he can train more personnel, their earning potential would improve, but at the end of the day, Jamaica would retain the staff.

On the matter of recruitment, Tufton suggested that the WHO Charter was being breached by some recruiting states. The Charter, although not enforceable by law, says a state cannot recruit to the detriment of another state. Tufton raised the issue at a recent WHO meeting in Washington by demonstrating how Jamaica was being deprived of its trained professionals. He believes that there is firm ground on which to find some workable solutions with the recruiting countries.

While acknowledging that the paucity of resources poses many challenges, Tufton was neverthe-less effusive in his praise of the dedicated professionals in that sector. For despite these shortages, in 2015, the roughly 320 clinics across the island dealt with more than 1.4 million visits, while 1.3 million visits were recorded at the 24 hospitals in the public sector.

"UHWI (University Hospital of the West Indies) has done some exceptional procedures in areas like neurology, [and] KPH (Kingston Public Hospital) has an accident and emergency response system for trauma that is second to none in the region," he said, pointing to some centres of excellence in the system.

The Government remains firmly committed to the no-user-fee policy, and the likelihood of a larger slice of the budgetary pie going to health appears slim.

So in the meantime, the minister says he will ensure that Jamaicans get better value for the money spent in the health sector. He will try to build alliances with the private sector and bilateral partners.