Since the Democratic Labour Party came to power in 2008, we have heard from at least two Ministers of Health that Barbadians may be required to pay some portion of the cost for services at the Queen Elizabeth Hospital (QEH).
On Sunday, based on the statements of Prime Minister Freundel Stuart, it became clear that this introduction of fees at the QEH is now more a matter of when, rather than if.
No doubt this will upset some Barbadians, as has been the case with the introduction of tuition fees for Barbadians studying at all campuses of the University of the West Indies (UWI), the controversial municipal solid waste tax, the rise in value added tax from 15 per cent to 17.5 per cent, and so on.
Some people seeking to defend the Government’s actions have pointed out that times have changed, the demands on the state are significantly greater today than they were 25 years ago – and in the case of the UWI fees, no less a person than the Prime Minister has noted that it was never the intention of the Government to provide free university education for all ad infinitum.
The fact of the matter, however, is that Government has never provided Barbadians with any services for free. Our citizens have always paid comparatively higher taxes than their counterparts in every other Caribbean country and for it they have received, in most instances, a higher quality of services in a wider range of areas.
An additional truth is that generally Barbadians have never really complained about the high taxes because they were satisfied that essentially they got their money’s worth – and that those who would not have been able to pay, if they were required to at the point of delivery, also got the same level of service. Barbados benefited.
We accept that times have changed and Government cannot manage its finances the way we did a quarter-century ago.
It would appear that many Barbadians are starting to accept that the future can’t be based on the poor and the not-so-poor being subjected to the same payment methods for public service as has been our approach since Independence.
What the Freundel Stuart Government is doing is radically changing the whole approach to the delivery of public services and how the country pays for these services, and it cannot do so with the piecemeal approach it has adopted. And it certainly ought not
to do so without dialogue with the population.
If we were starting from scratch, that might be an acceptable approach, but we already have a situation where people are paying higher taxes than others across the region for the same services.
So if, for instance, Government believes it is necessary to introduce user fees at the hospital, it can’t just be a matter of applying them to the middle-income earner or above, while leaving it “free” for the man at the bottom.
The inequity will be that the man on whom the fees are being imposed is already paying high taxes and most likely will object.
Government needs to spell out its overall policy for public services and seek buy-in, instead of the appearance of a new imposition each month, depending on how strained its budget becomes.
It may discover that Barbadians are more understanding than anticipated if they are treated with respect.
