Facing up to our health care challenge

We have some big problems to solve . . . . The hospital is like a revolving door. There are people who come into the hospital –– some may require in-hospital care, but, for the most part, most of them require just stabilizing their condition and then they are discharged. And we wonder why the QEH is always short of funds.

–– Queen Elizabeth Hospital chief executive officer Dr Dexter James, as he delivered the 22nd Annual Louis Lynch Memorial Lecture on Universal Health Care And Sustainability last week.

As the “sun” appeared to set over one of our traditional media houses this past weekend, we couldn’t help but be reminded of the now inevitable situation facing our free public health care system, which continues to implode from within, with death now knocking with a great degree of certainty on its door.

Indeed, the chief executive officer of the state-run Queen Elizabeth Hospital has said as much.

While sounding the unofficial death knell of “free” health care here last week, Dr James sought to address quite frontally the whole question of the hospital’s finances.

He went to great lengths to detail the QEH’s current level of expenditure, explaining that it currently costs about $15.8 million monthly to effectively manage and run the hospital.

Of that total, wages and salaries account for $9.5 million, which is nearly two thirds of the hospital’s monthly budget. The remainder is split almost evenly between medical supplies, drugs, utilities, maintenance and operating expenses, which means that at the end of the day, “we really need about $190 million to run the package [annually]”, the hospital CEO said.

If you ask us, that situation sounds very unsustainable, especially considering that in this year’s Estimates, the total vote for the QEH is actually $150 million.

What this means is that the already haemorrhaging hospital, is entering fiscal year 2015/2016 with a recognizable shortfall, which can only spell trouble for a health care institution that is already heavily indebted to its suppliers, and whose doctors, nurses and patients are already shouting the dreaded “C” word –– crisis!!!

As difficult a pill as this may be to swallow, Dr James is right in saying that in such circumstances, “something is going to give”.

Which begs the question: what? Or worse yet, who?

We note that from the very onset of this national health care funding debate, which has intensified somewhat since last August, Prime Minister Freundel Stuart has asserted that the QEH “must not ever lose its human face”.

In fact, he has promised to put a mechanism in place to ensure that those who can afford to are made to pay for the hospital’s services, while the Government looks after the basic requirements of all others.

Still, the question needs to be asked, where does the Government really begin to implement cuts in services?

“Do you stop dialysis for the 241 kidney patients for example? Do you stop treating those on life support? Do you close down the Neonatal Intensive Care Unit?

We certainly hope not!

As Dr James rightly acknowledges, the QEH is not a supermarket in which “you could look at slow-moving items and then pull them off the shelves”. Definitely, not when lives are at stake.

And not in the context of our population that has come to regard free health care as something of a right and a sort of Holy Grail –– all of which makes the current conversation a very difficult one to have.

While we agree in principle that those who can afford to pay should be made to do so, we believe the current debate needs to move very quickly from the hypothetical.

Instead of asking at this stage, as the hospital CEO did last week: “Has the shelf life of the taxation model outlived its usefulness? Is it time for us to now embrace a new model of health financing?”, Government should be putting some very firm financing options on the table urgently, as the opportunity for effecting the same is fast elapsing.

And given the strong likelihood that the changes foreseen will be implemented before the end of this current fiscal year –– the Estimates for which are currently being debated –– we believe now is as good a time as any to get moving.

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