WE WRITE CONCERNING an article that appeared in another section of the media published online last Wednesday. Written by Mr David Comissiong, attorney at law and president of the Clement Payne Movement, it was captioned: Backward Idea – Privatising The QEH.
It is with great surprise and disappointment that we read what appeared to be a vehement attack on the president and council of the Barbados Association of Medical Practitioners (BAMP) and an attempt to confuse the public with respect to the position of BAMP regarding health care financing.
Let us firstly reflect upon how the issue of a new model for health care financing arose. In 2013 Barbados faced a setback when, in the midst of an increase in demand for services, there was a reduction by $35 million of the subventions to the Queen Elizabeth Hospital (QEH) and we made our opposition to this known.
Thereafter, we consistently pointed out instances of shortages of basic supplies affecting the QEH out of a moral duty to protect the public, to allow informed decisions to be made and to bring urgent attention to the issue of sustainable health care financing.
The executive council of BAMP has spent many hours researching health care finance models used in various countries of the world and also canvassed our members for their opinions. This information was collated and a comprehensive BAMP proposal for sustainable health care financing was presented to the Minister of Health and officials of the Ministry of Health and the QEH on September 26, 2014.
The BAMP proposal states up front that we believe that no citizen should be disenfranchised and denied health care based on their social standing and their ability to pay for services. Privatisation of health services to allow for their more efficient management, does not mean that the hospital and other health care institutions will be privately owned and operated as a for-profit business in which the poor will have no access.
We have therefore set out here the main tenets of our proposal so that the public may judge the content:
1) Health care financing must be a part of the national vision.
2) The public must understand that the current method of health financing is unsustainable and buy-in must be sought from all of the major sectors of society.
3) Sustainable health care solutions must be found for all and the most vulnerable must always be protected with no fee-for-service extended to them.
4) A health care fund, managed in a similar manner to the National Insurance Scheme in which employed persons contribute to the health of the nation according to their means.
5) More attention should be paid to the primary care services already on offer at the polyclinics and that the relationship between the QEH and the polyclinics be formalised in such a way that these institutions compliment and contribute to services provided by each other.
6) The elderly should be protected from abandonment at the QEH and enhanced support, through nursing and welfare services, must be provided to encourage families to look after the elderly at home.
7) Encouragement must be given to those more affluent members of society to look after themselves. This may be achieved through incentives for taking up health insurance and by other means.
8) Reduction of private doctors’ fees can be achieved through reducing the cost of business. We suggest capping of malpractice insurance claims and allowing duty-free concessions to medical practices to reduce costs passed on to the public.
9) The QEH should run on a public-private model where the Government is the main shareholder of a health care corporation that employs contractors to ensure the efficient 24-hour functioning of the institution. The management and profitability of the institution as well as the performance and efficiency of staff would be answerable to shareholders.
10) Tax and other incentives should be given to those companies and individuals who benevolently fund the hospital through donations.
We invite Mr Comissiong, even at this late stage, to put forth real and innovative ideas for consideration. We would delight in seeing him at the town hall meeting to be held at the Lloyd Erskine Sandiford Centre on February 29 at 7 p.m., where we will once again present our proposal. We hope that on this occasion he may fully grasp the nature of our comprehensive proposal and that after this, he and the public would be in a better position to pose informed and pertinent questions based on facts.
– DR CARLOS CHASE, BAMP president, Dr Lynda Williams, PRO.
