EDITORIAL - Health policy suffers from ADS
WE ARE FAST concluding that Fenton Ferguson, the health minister, is chronically afflicted by a condition that appears to haunt the Simpson Miller government: attention deficiency syndrome (ADS).
This administration can't seem to concentrate on anything for too long. It flits from one thing to anything else that catches its fancy, no matter how improbable the idea. The upshot: declarations are conflated with outcomes and little that is substantive gets done.
This takes us back to Dr Ferguson and the danger he is likely to face.
Dr Ferguson is in charge of a portfolio that is short of resources and upon which there is great demand. In such circumstances, policymakers/managers are likely to achieve the best results by establishing priorities - it makes sense to identify programmes that provide a reasonably decent service to the most people - clearly articulate what these are and then work assiduously towards achieving them.
BIG, SHINY STUFF
This approach does appear to appeal to the health minister. He seems to like big, shiny stuff, buffed by big declarations.
So last week Dr Ferguson was in Montego Bay addressing a symposium of Caribbean health experts on neurosciences. There he announced his intention to proceed "at a fast pace to establish a centre of excellence for the treatment" of non-communicable diseases (ncd), including cancers.
Such diseases, the health minister said, are responsible for 56 per cent of deaths in Jamaica annually, 20 per cent of which are cancers. They cost the state about J$2 billion a year to treat, or over six per cent of the entire health budget.
By any measure, the impact of these non-communicable diseases is significant. Dr Ferguson has good reasons to be concerned.
The issue now is how the health minister responds.
The fact is that NCDs are primarily the symptoms of our lifestyle choices: primarily bad diets and too little exercise. Of course, we have to treat these chronic illnesses and it would be good to have a centre of excellence in which to do so. Indeed, we would wish if Jamaica could transpose to Kingston, say, the Mayo Clinic, with all its resources, for the treatment of our cancer patients. That, however, is not realistic.
Something to aim at
What our minister should aim at is to use the resources available to him as wisely as possible. That, to this newspaper, translates to focusing on where he can achieve the largest return of the investment. That is primary health care.
Dr Ferguson thinks fixing the problem of most NCDs is mostly about education on lifestyle choices, supported mostly by services delivered at clinics. Or, looked at another way, it demands primary health-care interventions. Which, of course, is not to say that we wouldn't want Cancer Treatment Centers of America-type facilities, if we could afford them.
So, here is the bottom line.
Rather than concentrating, at this time, on building a new paediatric hospital for children in Montego Bay, Dr Ferguson should invest what he can reasonably muster into making the Bustamante Hospital for Children as good as possible. And instead of flitting to this new NCD thing, get down to the hard, grubby job of delivering excellent primary health care. Get this done before chasing the next flash of light glimpsed from the corner of the eye.
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