QEH in financing quandary

There is a gaping hole in the financing of health care in Barbados, and the Queen Elizabeth Hospital (QEH) is leading the way with an annual deficit of about $35 million that has no immediate end in sight.

The hospital’s chief executive officer Dr Dexter James last night gave details of the gulf between what the medical institution receives annually, against what is needed, and the future prospects of higher operating costs as a result of increased patient demands and sky-rocketing equipment and supplies prices.

Noting that almost all the QEH’s operating cost is paid for by the Treasury through taxation, he said the taxation model could only afford $155 million while the package of services which the population needs runs close to $190 million.

“So, therein lies a financing gap and the concerns around how are we going to sustain the packages of services that we currently provide to the Barbadian population,” James said in opening remarks at the QEH’s fourth Annual Healthcare Financing Symposium, in the Henry Fraser Lecture Theatre at the University of the West Indies, Cave Hill Campus, held under the theme, Universal Health Coverage: A Privilege or a Right.

Further breaking down the institution’s expenditure he said: “Today, our run rate [monthly operating cost] at the Queen Elizabeth Hospital is estimated about $16 million, of which payroll is about $9.6 million. Over the last 10 years, we were receiving just about $155 million appropriated by the Parliament of the country.”

James said high public expectation is another driver of cost, noting that Barbadians demand the best technological treatment, even in the current economic crisis.

According to James, the QEH is also under pressure in circumstances where the non-communicable diseases (NCDs) of diabetes, hypertension, heart disease, and prostate cancer are among the leading causes of death within the population.

“Today, 25 per cent of our population has at least one NCD and that is expected to go to 33 per cent by the year 2025,” he pointed out.

The hospital CEO said chronic diseases have “gone to a stage of almost epidemic proportions”, pointing to Barbados National Registry data for 2013 that showed there were 14 heart attacks per month and 53 strokes per month, all related to NCDs.

Detailing other costs at the country’s main public health care institution, James said that every day a patient stays in the Intensive Care Unit (ICU) costs the hospital between $1,500 to $2,500, based on the medication and drugs to treat those patients.

Additionally, he said: “QEH today manages 310 patients on haemodialysis. It costs $18 million per year to take care of these 310 patients, or about 12 per cent of the Queen Elizabeth Hospital budget. The growth rate is four to five new patients per month.”

“We have 35 to 40 patients currently on [breast cancer treatment] and they consume about $2.8 million per year. Injuries and accidents are a new and emerging phenomena that consume tremendous resources of the Queen Elizabeth Hospital,” James added.

Against the backdrop of that high demand, he said the QEH faces factors beyond its control but which are vital to its operations, such as the cost of drugs and other supplies, along with medical equipment and their upgrades.

“Whatever the market says are the costs, we have to bear it. Therefore, those costs which are outside of our control consume about 17 per cent of our cost structure,” he explained.

James said that in the circumstances, “the policy questions around sustainability must be built around an acknowledgement firstly that increasing health care costs are a serious threat to health and health care sustainability”.

12 Responses to QEH in financing quandary

  1. Ali Baba
    Ali Baba August 26, 2017 at 12:23 am

    de 142 million dollars that went to liat, surely de 42 mill would have lift the qeh….but we know how it is wid the teeths

    Reply
  2. jrsmith August 26, 2017 at 5:14 am

    Stop stepping over the various governing and managing problems with public areas of barbados………………….The major problem in Barbados ,, we dont have the management expertise to deploying the cleverest people , who is capable of effectively managing and overseeing areas as like the major hospital, our main medical unit………………………
    As like our transport , as like our roads , as like our law enforcement, as like our water , as like our light and power, as like collection of taxes , we are not capable of managing (Barbados LTD) we must look oversees if we want to survive , we have too much education………

    Reply
  3. Petra August 26, 2017 at 6:40 am

    Some of us have to pay for care at the hospital can’t be business as usual

    Reply
  4. Ann Harding August 26, 2017 at 7:35 am

    Agree with jrsmith on all points but one. Expecting someone from overseas to fix everything is a symptom of the problem: lack of belief in our own abilities. Management skills can be taught/learned, “best practice” isn’t a mystery. But without a “can do” attitude that facilitates teamwork, we just continue to blame others, do nothing, back stabbing, raise taxes.

    Solution: teach healthy living in schools: nutrition, recycling, gardening, money management, causes of NCDs & STDs, respect for all things. Basic life skills, along with the 3 R’s. Not: lashings. Our past demands this cure.

    Barbadians CAN.

    Reply
  5. Lee August 26, 2017 at 7:39 am

    “GO FUND ME” , Dr. James. Give locals a chance to contribute easily if Government is unable to close the recurring gaps through taxation. Barbadians can be persuaded that regular voluntary contribution to the maintenance of QEH is our best and cheapest insurance policy. We will all need medical attention someday. Have your office explore GO FUND ME or some such instrument and you will even have foreigners contributing. It might not solve the deficit entirely but it will help give citizens a chance to share your concern tangibly based on means.

    Reply
  6. Shelly Ross
    Shelly Ross August 26, 2017 at 8:25 am

    What is wrong with introducing a fee of BD$20 for all persons going to A&E and a mandatory fee of BD$100 for all related violent injuries.

    Automobile accident victims must pay and this is through their insurance. Car owners must pay insurance fees and so the insurance companies should be responsible or such cost at the QEH.

    Reply
  7. Lynn Haynes
    Lynn Haynes August 26, 2017 at 8:40 am

    When you talk to doctors at QEH – wow a horror story. Tax payer dollars. It’s mind boggling.

    Reply
  8. Heather Williams
    Heather Williams August 26, 2017 at 8:42 am

    Not surprise. No one cares about maintaining life.

    Reply
  9. Ali Baba
    Ali Baba August 26, 2017 at 9:26 am

    THESE STEELING HOUSE SLAVE BASTARDS GET BOUT HERE AND FEED DEMSELVES WELL, AND THE FEW ELITE WHITES, COWS, BIZZYS, MALONY, DASILVA, TEMPRO, BJARKHAM, WITHE THE TAXPAYERS MONIES….SO NOW THE MASSES MUST PAY FOR EVERYTHING HUMMMMMMMMMMMMMMMMMMMMMMM

    Reply
  10. Milli Watt August 26, 2017 at 9:57 am

    Dr Dexter James stop the lot a long talk and go public with the file that has the proposed charges to some services at the QEH. The go from there as usual you have become your worse enemy taking up valuable time talking around the topic sstuuppsseee

    Reply
  11. Petra August 26, 2017 at 3:58 pm

    Agree with Shellie. we have to pay something

    Reply
  12. DeMarlehole August 28, 2017 at 6:46 am

    Thanks for the article George Alleyne added on August 25, 2017.
    Saved under Local News

    Reply

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