Dennie Quill, Contributor

THE NATIONAL Health Fund (NHF), which gets the bulk of its money from excise tax charged on tobacco products, is on a mission. The mission is to reduce the burden on health care in Jamaica. This explains why, from time to time, we see smiling photographs of the NHF head handing out cheques to deserving organisations, most recently to the Jamaica Heart Foundation - $30 million for a new headquarters and to expand its services. If one visits the NHF website as I have done, one gets a better appreciation of some of the projects that have already been funded by the NHF or have received commitment from the fund.

Here are a few examples: repairs to the roofs (sic) of the Cornwall Regional Hospital and staff quarters valued at $34.8 million; a $1 million scholarship for the training of a health economist; $12m to study the relationship between diet and the incidence of prostate cancer in Jamaica; $10.1m for the Red Hills Road multi-purpose complex to promote healthy lifestyles; $1.7m to build 53 pit latrines in St. Elizabeth and $8.2m for Road Safety Public Education. I cited these to demon-strate the variety of projects that have been funded by the NHF.

The question that I would ask of the authorities is what mechanisms of accountability have been put in place to ensure that the NHF resources are being well spent?

Urgent national concern

Simply by examining some of the projects approved by the NHF, one could conclude that the lines between the responsibilities of the Ministry of Health and the NHF appear blurred. One expects that the Ministry of Health should fulfil its mandate to fully undertake all essential public health functions. The NHF should, therefore, be cast in a supporting role. But the demand for health care and how to finance it is always a difficult issue. However, all the players seem to agree that there has to be alink between the financing of the system and the actual performance.

I decided to focus my attention on the NHF this week because of an urgent national concern; that is, the regular press appeals by needy Jamaicans who are seeking assistance to acquire life-saving medical treatment mainly for children. Most often this treatment is only available overseas. Two weeks ago there were two appeals on television relating to children with disorders of the spine. To see a distressed parent (usually the mother) holding up her sick child before the cameras while she pleads for help is not a happy picture. I believe it is a problem that we need to confront as a nation. The affected children fall into the category of the most vulnerable in society and they ought not to be left to fend for themselves and be thrown at the mercy of a kind soul.

The needs of children

I have no access to statistics on the subject, but I would hazard a guess that less than 500 children are affected by these non-communicable diseases. I base this on a PAHO report of 1999 which says congenital defects accounted for 9.1 per cent of 941 certified deaths in Jamaica. This needs to be reflected in the organisation of health services and should be given priority in the allocation of resources.

In order to safeguard this group of children with life-threatening diseases and to expedite their treatment and eventual cure, I am suggesting that the NHF develop a programme to address their needs. Surely their cause would be much more valid than that of training a health economist.

It is not the public - overburdened and overtaxed - that should be called upon to stretch the hand of benevolence in these cases. Mothers would apply directly to the NHF, which has enormous resources, such applications to be supported by recommendations of an attending physician.

If we are committed to a Jamaica that is healthier and more equitable with regard to access to health care then it cannot be beyond us to find a solution.