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Duguid’s QEH lottery plan is thoughtworthy

Whether we care to acknowledge that the practice is already widespread, or choose to raise strong opposition on either moral or religious grounds,
the reality is that Barbados can very much be considered a gambling nation.

The phenomenal success of the Barbados Lottery over the past two decades stands as a clear testimony to this. Thousands of Barbadians across the social spectrum are sold on the idea of paying for a chance to earn a few thousand or million dollars and living happily after for some time.

On any given day, especially when hefty jackpots are up for grabs, patrons flock in their numbers to the various lottery outlets across the island to make sure they have at least a ticket to be in with a chance. Some patrons, looking to significantly up their chances, are known on such occasions to spend heavily on the purchase of tickets.

It is against this backdrop that a proposal put forward by former Barbados Labour Party (BLP) parliamentarian and dental practitioner Dr William Duguid for the establishment of a lottery, to finance the operations of the state-run Queen Elizabeth Hospital, seems to make much sense from the standpoint of practicality and viability.

Dr Duguid, a former chairman of the privately run Bayview Hospital, put forward the proposal at the final town hall meeting sponsored by the Ministry of Health to canvass the ideas of the Barbadian public as Government seeks to come up with a new financing model for public health care on the island.

Government has raised the idea of introducing user fees for services at the QEH where generations of Barbadians have received quality care at no direct cost over the years. Public financing challenges, however, have forced Government to rethink this long-standing policy as the costs of health care keep rising, as well as the public demand. After education, health care traditionally has received the largest chunk of Government’s annual budget.

In a previous Editorial, we suggested that consideration be given to the introduction of national health insurance based on the Canadian model, with specific reference to the Province of Ontario’s Health Insurance Plan or OHIP. Under this system, every working resident of the province pays a monthly OHIP contribution which is deducted at source.

In the event of admission to a hospital or a visit to a doctor, OHIP foots the bill directly. It guarantees a basic level of quality care. However, if the patient wishes to go beyond, then it becomes necessary to take out a private health insurance plan to cover the difference. Persons who are not working and children are also covered. No one is excluded.

Drawing on an existing practice in a number of countries, Dr Duguid’s proposal adds an interesting dimension to the debate. He is firmly of the view that patient care delivered through the QEH should remain free and has presented a strong case centred on a special lottery as the financing solution. The proposal further builds on the existing concept here where some of the proceeds from the Barbados Lottery goes to support worthwhile causes, namely the development of sports, youth and culture.

The beautiful thing about public consultation is that it allows policymakers to be exposed to wide range of perspectives from the persons who will be directly affected by any policy changes. The Ministry of Health ought to be commended, therefore, for adopting this approach to support its search for a viable solution to the health financing issue.

Based on the success of the Barbados Lottery, the odds appear favourable that a hospital lottery too would be a success once it offers attractive prizes. Barbadians are civic-minded and, though playing to win, will also appreciate that in doing so, they are supporting a worthwhile cause, as they will actually be making a contribution to helping themselves or their relatives.

We hope that the Ministry of Health will give due consideration to Dr Duguid’s proposal which essentially offers a win-win solution for Government and the Barbadian taxpayer. We also hope that the ministry will report back to the people when it has arrived at a firm decision on the way forward so that Barbadians can also have an opportunity to participate in any
fine-tuning of the plan.

The Ministry of Health has our best wishes as it moves towards a successful resolution of an important issue that, hopefully, will be informed by the just ended consultations so that it can attract wide public buy-in.

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