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- Providers fear further freeing up of service
published: Sunday | December 9, 2007
Gareth Manning and Edmond Campbell, Sunday Gleaner Reporters
Undue pressure on public hospitals from the previous People's National Party (PNP) administration's policy of free health care for children is making health-care providers fearful that any further move to free up health care in public-health facilities could be disastrous.
They say before any imposition of the sort can be made, Government must move with urgency to upgrade public hospitals and improve staff complements and equipment in the sector.
Government promised that its free health regime, which was a promise of its campaign leading up to the September 3 general election, would be instituted by April 2008.
Since the imposition of free health care for children by the Portia Simpson Miller-led administration in May, hospitals have been bending over backwards to meet the added demand on its accident and emergency (A&E) units.
The Bustamante Hospital for Children, for example, has been seeing up to three times the number of patients since the freeing up of health care for children, The Sunday Gleaner understands. Those seeking care in A&E increased from just about 100 patients to 300 last month.
The Kingston Public and Cornwall Regional hospitals have also been seeing more children in non-emergency cases in the A&E departments, increasing delays in those hospitals. The operating list in both hospitals has been getting longer. As a result, some operations considered electives, have had to be postponed.
Even the University Hospital of the West Indies (UHWI), a regional facility, which was exempt from the policy, was initially affected by the policy, though in a different way, sources have told us. The UWHI lost several patients, limiting its teaching and research capacity. The hospital also recorded a loss in revenue. However, patient numbers have now normalised.
Medical Association of Jamaica (MAJ) president, Dr. Rosemarie Wright-Pascoe, says a drove of people has been drifting from the private and primary health-care facilities to public hospitals, and the increasing numbers have been resulting in a serious strain on the hospitals.
"No provisions were made for the expansion of the physical plant to accommodate the increased number of patients, parents and caregivers. No provisions were made to increase the professional staff," she says.
She says while the number of doctors has been increased in A&E in some hospitals, more are needed, but the infrastructure cannot accommodate another increase.
"This is causing inordinately long delays in accident emergencies and casualties," she argues.
"There are not enough doctors, not enough surgeons, not enough anaesthetists to put patients to sleep, not enough operating time, not enough recovery room, the clinics are, therefore, overwhelmed ... and this is, therefore, not the kind of quality health care we would like to give our people," she continued.
More staff needed
While opining that the free health- care system for children is a positive move that is being utilised by people, Nurses' Association president Edith Allwood-Anderson agrees that staff needs to be increased for free health care to work efficiently.
"Whether it is a good concept or not, the fact is that the impact on the system is there for all to see, and if there is further extension [of free health care] then you understand the implication," she says.
The MAJ says abolition of user fees is utopian. Dr. Wright-Pascoe says while those who need health care most find it difficult to access it, the funds are needed to help with functionary aspects of the health facilities, though they contribute less than five per cent to the annual budget. Eighty per cent of the annual budget is paid out in salaries, the remaining 20 per cent is used to address operational costs.
"We think the Government should learn from what happened with the abolishment of user fees for children. We think the Government should recognise that the strains that we are seeing now will be expanded quite dramatically," she says.
In its manifesto, the JLP promised to upgrade the Mandeville and St. Ann's Bay hospitals to Type A level facilities, as well as upgrade all public hospitals to Type B, and upgrade the range of specialist services to the Bustamante Children's Hospital.
The JLP also promised to establish diagnostic and treatment centres and to provide radiology, ultrasound and radiotherapy and dialysis services at the major hospitals.
"The Government is committed to offering free health care to all. Clearly, the Government must have a plan to upgrade the public-health system and upgrade the primary health-care system and must thus address the drift from private health care to public health care," Dr. Wright-Pascoe says.
Health Minister Rudyard Spencer could not be reached up to news time for comment on how the Government would pursue the free health-care regime.
published: Sunday | December 9, 2007
Gareth Manning and Edmond Campbell, Sunday Gleaner Reporters
Undue pressure on public hospitals from the previous People's National Party (PNP) administration's policy of free health care for children is making health-care providers fearful that any further move to free up health care in public-health facilities could be disastrous.
They say before any imposition of the sort can be made, Government must move with urgency to upgrade public hospitals and improve staff complements and equipment in the sector.
Government promised that its free health regime, which was a promise of its campaign leading up to the September 3 general election, would be instituted by April 2008.
Since the imposition of free health care for children by the Portia Simpson Miller-led administration in May, hospitals have been bending over backwards to meet the added demand on its accident and emergency (A&E) units.
The Bustamante Hospital for Children, for example, has been seeing up to three times the number of patients since the freeing up of health care for children, The Sunday Gleaner understands. Those seeking care in A&E increased from just about 100 patients to 300 last month.
The Kingston Public and Cornwall Regional hospitals have also been seeing more children in non-emergency cases in the A&E departments, increasing delays in those hospitals. The operating list in both hospitals has been getting longer. As a result, some operations considered electives, have had to be postponed.
Even the University Hospital of the West Indies (UHWI), a regional facility, which was exempt from the policy, was initially affected by the policy, though in a different way, sources have told us. The UWHI lost several patients, limiting its teaching and research capacity. The hospital also recorded a loss in revenue. However, patient numbers have now normalised.
Medical Association of Jamaica (MAJ) president, Dr. Rosemarie Wright-Pascoe, says a drove of people has been drifting from the private and primary health-care facilities to public hospitals, and the increasing numbers have been resulting in a serious strain on the hospitals.
"No provisions were made for the expansion of the physical plant to accommodate the increased number of patients, parents and caregivers. No provisions were made to increase the professional staff," she says.
She says while the number of doctors has been increased in A&E in some hospitals, more are needed, but the infrastructure cannot accommodate another increase.
"This is causing inordinately long delays in accident emergencies and casualties," she argues.
"There are not enough doctors, not enough surgeons, not enough anaesthetists to put patients to sleep, not enough operating time, not enough recovery room, the clinics are, therefore, overwhelmed ... and this is, therefore, not the kind of quality health care we would like to give our people," she continued.
More staff needed
While opining that the free health- care system for children is a positive move that is being utilised by people, Nurses' Association president Edith Allwood-Anderson agrees that staff needs to be increased for free health care to work efficiently.
"Whether it is a good concept or not, the fact is that the impact on the system is there for all to see, and if there is further extension [of free health care] then you understand the implication," she says.
The MAJ says abolition of user fees is utopian. Dr. Wright-Pascoe says while those who need health care most find it difficult to access it, the funds are needed to help with functionary aspects of the health facilities, though they contribute less than five per cent to the annual budget. Eighty per cent of the annual budget is paid out in salaries, the remaining 20 per cent is used to address operational costs.
"We think the Government should learn from what happened with the abolishment of user fees for children. We think the Government should recognise that the strains that we are seeing now will be expanded quite dramatically," she says.
In its manifesto, the JLP promised to upgrade the Mandeville and St. Ann's Bay hospitals to Type A level facilities, as well as upgrade all public hospitals to Type B, and upgrade the range of specialist services to the Bustamante Children's Hospital.
The JLP also promised to establish diagnostic and treatment centres and to provide radiology, ultrasound and radiotherapy and dialysis services at the major hospitals.
"The Government is committed to offering free health care to all. Clearly, the Government must have a plan to upgrade the public-health system and upgrade the primary health-care system and must thus address the drift from private health care to public health care," Dr. Wright-Pascoe says.
Health Minister Rudyard Spencer could not be reached up to news time for comment on how the Government would pursue the free health-care regime.
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