At odds

by Shawn Cumberbatch

Barbados’ push to become a global leader in medical tourism is causing tension between public and private health care providers.

And Canadian medical researchers investigating the island’s intensified focus on this area are warning Government it risks potentially crippling domestic health worker migration unless there is “greater transparency and stakeholder inclusion”.

That’s the conclusion of a new study on the topic Understanding The Impacts Of Medical Tourism On Health Human Resources In Barbados: A Prospective, Qualitative Study Of Stakeholder Perceptions.

Conducted by a team from Canadian public research institution, Simon Fraser University, led by Assistant Professor in the Faculty of Health Sciences, Dr. Jeremy Snyder, the study found that various “stakeholders” were at odds over the merits of medical tourism, and the impact of facilities including American World Clinics, which will be constructed on the site of the former St. Joseph Hospital in St. Peter.

“Stakeholders interviewed who were connected to medical tourism expansion or the tourism sector took a generally positive view of the likely impacts of medical tourism on health human resources in Barbados,” researchers found.

“However, stakeholders associated with the public health system and health equity expressed concern that medical tourism may spread inequities in this country. The study went on to indicate that it was unclear how the negative health equity impacts observed in other countries would be avoided in Barbados.”

The research team, which conducted interviews here in April 2011, and via telephone prior to and after their visit to the island, said the area of concern that was potentially problematic was employment.

A major fear of some in Barbados, they found, was that there would be a worker migration from the local public health care sector to private facilities, at a time when the supply of nurses and other key personnel was a concern.

Referring to the possible influence of the AWC effort, Snyder and company said it was “possible that this impact will be positive, with new health workers being trained, more physicians and nurses choosing to pursue careers in Barbados, and better employment opportunities created throughout the health system”.

“However, it is possible to envision a much different and far more problematic outcome. If inadequately managed and regulated, benefits of medical tourism might be restricted to the private health system, with new health care resources not being shared with the public sector,” they stated.

“An even more worrisome scenario would involve public resources flowing without compensation to the private system.

“There is reason for concern, as some stakeholders stressed, that medical tourism expansion in Barbados could have future negative impacts on health equity and even absolute levels of access to care and health worker levels in the public system.

“This concern is illustrated by a tension found both in the sentiments of the private sector and government stakeholders interviewed and in media coverage of medical tourism in the country,” the research team added.

Based on their interviews here, the Canadians also saw a need for more transparency.

“Limited transparency and reported non-inclusion of public system voices in the early stages of the AWC development does not mean that the planned steps to protect against public to private health worker migration will be insufficient,” they said.

“Skepticism about these plans is warranted, however, and greater transparency and stakeholder inclusion is needed to ensure that crucial voices in long- term health human resources planning in Barbados’ medical tourism sector are heard.”

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