Dwight Bellanfante, Gleaner Writer
Jamaicans have been urged to quit overloading hospitals with minor health issues and instead attend community clinics islandwide.
"Many health centres are well equipped to handle much of the demand on public hospitals and the ministry is committed to gradually improving them," noted Dr Jean Dixon, permanent secretary in the Ministry of Health, at a recent Gleaner Editors' Forum.
Since the advent of the user-fee waiver, patronage of the public health-care system has increased by between 16 and 23 per cent, mainly at public hospitals.
A comparison of patient utilisation of hospital services provided by the health ministry shows significant increases in demand in various areas:
Visits to Accident and Emergency (A&E) services are up from 725,199 cases in 2006/07 to 824,254 cases in 2009/10.
Pharmacy items dispensed at hospitals have risen from 1,282,507 in 2006/07 to 2,063,617 in 2009/10.
Pharmacy items dispensed at health centres have moved from 382,391 in 2006/07 to 563,995 in 2009/10.
However, despite the existence of health centres islandwide, many prefer to go to public hospitals. Complaints abound about the lack of medical personnel and essential medical supplies at these centres, notwithstanding the fact that more pharmacy items have been distributed there since free health care came on stream, a major plank of the Jamaica Labour Party's election platform.
But Dixon and change-management consultant at the health ministry, Sandra Graham, are confident that, over time, these problems will be resolved as increased confidence permeates the system.
Reducing hospital visits
They pointed to a number of ongoing and planned efficiencies in the allocation of the ministry's human and material resources, as well as behaviour-change public education initiatives to reduce hospital visits and admissions. These include healthy lifestyle campaigns to get people to reduce their dependence on health facilities such as safe-sex, childhood-obesity and road-safety campaigns which were having a positive impact on areas such as HIV/AIDS transmission and A&E admissions.
"A lot of these admissions are due to lifestyle and behaviour related issues and so if we can continue to reduce these effects, we can significantly impact this problem," Dixon said, adding that the primary health-care system could then address more cases.
Meanwhile, Graham noted "there are recommendations to recentralise certain services based upon a number of studies and we are in the process of streamlining those recommendations".