Our good health at what price?

The cynical might be moved to observe that the Queen Elizabeth Hospital’s chief executive officer Dr Dexter James is stuck in replay mode on the challenges to the institution’s ability to continue offering full and free health services to the nation’s sick. The unsettling truth is, the Government, which bankrolls the operation of our premier health facility, has cut the national health budget in recent times, and there is no indication of any return to previous levels of financing. If anything, the signs are the budget could be trimmed even more.

The more empathetic among us will therefore understand and commiserate with Dr James’ anxiety over a shrinking Government budget –– not to mention dwindling donor aid as well –– which the hospital has been constrained to live with. And the troubled QEH boss will have little comfort when he must juxtapose this unsettling state against the hospital’s recurring and skyrocketing expenditure. If we call a spade a spade –– or a scalpel a scalpel –– the CEO’s previous discomforting prognostications are no less so now, and will hardly be better any time soon.

Dr James, addressing the Second Queen Elizabeth Hospital Health Care Financing Conference today at the Lloyd Erskine Sandiford Centre spoke to the limit of $190 million which the QEH had to sustain its “minimum package of services”, and which did not cover “planned replacement of capital items”.

Indeed, staring us in the face is the unflattering picture of not being able to boast much longer of full free national health care for all, given the recently reported new development of older patients needing much more intensive care, and QEH machines becoming obsolete and in need of replacement. Barbadians paying for some of their major health care at the Queen Elizabeth Hospital is becoming more and more a reality.

Unless some prudent and practical approach to financing of our health care is taken, we run the risk of eroding all the gains made in the past, to which a populace would insist upon clinging. Being forced thus to scale down services –– to those of “urgency” and “emergency” –– putting the “regular” unwell, especially those among our senior population, in peril, would be, Dr James says himself, “a catastrophic situation”.

As has already been suggested, the services offered by the QEH are not so much luxurious and exotic as they are profoundly essential.

In a brusque statement at this very QEH conference this morning, the outspoken Acting Minister of Health Donville Inniss knocked what he saw as the average Bajan’s mindset of being taken care of by the state “from conception to resurrection”. Oh, indeed, that those of us who expired when our national health care service failed us might reach Mr Inniss’ declared latter stage! But we will be real and take the minister’s expression for what it is –– hyperbolical articulation to make the salient point of challenging costs.

We do truly need a reformation in thinking about our national health care. We are fortunate to live in a nation where the health care is considered paramount, next to education, but we cannot continue to take its sustainability for granted. And dwelling on what was, and that it must continue to be, is tantamount to fleeing reality.

It takes millions a month to pay for our modern hospital care –– including just over $1 million alone to keep 225 kidney patients alive; to sustain sophisticated equipment; to properly equip our polyclincs; to adequately remunerate our skilled and dedicated physicians and nurses; and purchase appropriate and effective medications. To tax citizens more to keep previous levels of financial upkeep of our national health care programme is hardly likely to succeed, given that neither the Government nor average citizenry has any bottomless pockets of money.

But Barbados Association of Medical Practitioners (BAMP) president Dr Carlos Chase’s suggestion at today’s conference of a $100 deduction from the 100,000 employed Barbadians there are might be worth examining. Dr Carlos calculates that this could raise $10 million a month, which we envision would be a supplement to Government’s own present commitment.

It would ideally be commendable and invaluable if each and everyone of us could contribute to the larger good –– particularly those of us who really can, for ourselves and for those less fortunate. As we have asked before, why couldn’t a willing and able public whom the hospital currently serves help. If we cannot have the giant benefactors donating funds for the purchases of essential pieces of equipment, like incubators in the Neonatal Intensive Care Unit, and ensuring the elevators work, then why not instead have more community groups, societal groups, fund-raising foundations and the like showing and delivering greater charity for the common good –– and for future emergencies?

It might even give Dr Chase’s idea a further boost.   

Maybe, the greatest contribution all of us could make is leading and living a more healthy lifestyle ourselves. It is no secret that much of our health care dollars is spent on patients with chronic conditions, which might have been prevented –– these ailments that needed not have sprouted into crises and unnecessary costs to the hospital itself. It certainly is neither rational nor considerate to eat and drink whatsoever, without thought of benefit or not to body, but with the satisfaction the QEH is there to put whatever is wrong right –– free of cost.

In a very weird twist such conduct is a contributor to wastage: an expense that could have been done without. For the sustainable good health of our citizenry we really must put our hands to the plough –– and keep away as much as we can from the medicine cabinet.

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