Economist suggests privatization as a means of bringing down state’s expenditure
In the face of mounting concerns about the Government’s fiscal position, economist Ryan Straughn has issued a fresh call for certain aspects of the island’s health care services to be privatized, as a means of bringing down the state’s expenditure.
Among the areas he suggests the Government can realize a cut in spending is laboratory services. He is also proposing closer collaboration with countries of the Organization of Eastern Caribbean States (OECS) in terms of pharmaceutical procurement services.
“Whether you go the IMF [International Monetary Fund], the UAE [United Arab Emirates] or whoever, fundamentally you still have to fix this Government’s problem in terms of how you deliver public services and where you spend the money,” warned Straughn.
“If you are going to prioritize, health certainly has to be one of the areas in which you prioritize your spending, and it is about choices. There are things that you would like to do and there are things that you have to do and do properly,” he continued, adding “for the long term we are going to need to have a serious discussion about how the operations are managed, how the actual facilities are managed. It has to be very comprehensive, but as I said the first place to start could be joining the Pharmaceutical Programme of the OECS to ensure that you have supplies to do the job at the QEH and polyclinics”.
Straughn further advanced his argument for Barbados to join the OECS Pharmaceutical Procurement Services, saying it was “probably the only viable long-term option on the table” to be able to better deliver health care at the level that was required across the island.
“The part of the budget you have for supplies and pharmaceuticals it could go further so that patient care would not be compromised [and] you wouldn’t have a situation where doctors are saying that they are only treating emergency cases because that is not the way to run a health institution,” he added.
Stressing that privatization was not a bad word, Straughn said there could be private/public sector partnerships to help Government rein in its health spend.
He also suggested that by handing over some services to the private sector there could be an improvement in health care delivery.
“Laboratory services and the other supporting services can be privatized without compromising any of the services. At the end of the day you want to ensure that your equipment is always running. The private sector is going to ensure that they are, and clearly that is how you are going to make the money,” he said.
“So we will have to move out of the mode of public sector delivery to engage more in public/private sector partnerships. That has to be part of the narrative certainly for the hospital[QEH] if we want to see improvements of patient care there, because it is the only full service hospital we have”.
Arguing strongly that Government should share the financial burden of health care, Straughn acknowledged that systems or mechanisms could be put in place for the most vulnerable who would not be able to afford the services.
“We cannot allow the budgetary [constraints] of Government to compromise health care. So if there are to be user fees, let us have a public discussion. If you need to get national health insurance, let’s discuss that and put the mechanisms in place.
“So there are a lot of different things that would need to take place so that the QEH and the health system work better because you will see cost savings in some areas.”
The economist noted that while the University of the West Indies and other organizations were instrumental in carrying out various health studies, more research could be done and systems put in place to better target health care spend on areas that needed it most.