#BTEditorial – A malady in need of a remedy – and compromise

Just as delaying surgery to give a patient a better chance of survival or wellness is foolhardy, so too are the stalled negotiations on introducing 24-hour polyclinic services.

Our nation has a health care system ranked among the best in the Caribbean. But we are all too aware of the challenges facing our public health care infrastructure, which is under pressure to keep up with growing demand and dwindling resources.

Round-the-clock health care, to be introduced at two clinics, the Winston Scott Polyclinic at Jemmotts Lane, St Michael and the David Thompson Health and Social Services Complex, Glebe Land, St John, is a bold and necessary move.

It is a singular point upon which the disputing parties – nurses and the Ministry of Health and Wellness – are all agreed.

The initiative is intended to reduce wait times for patients at the Accident and Emergency Department at the Queen Elizabeth Hospital by offering them round-the-clock service elsewhere.

The two polyclinics will offer urgent care for illnesses and injuries that require immediate attention but are not life-threatening, as well as routine care, which may include follow-up care for chronic conditions and health checks.

Hardly can anyone who has visited the hospital’s A&E any day or night, forced to wait hours waiting in line for medical attention, can argue against the move towards the 24-hour clinics.

But as always the devil is in the details.

The National Union of Public Workers insists that it does not want to stop round-the-clock care but its members say that to adapt for urgent care would detract from their community work.  The nurses also contend neither of the clinics has the required space.

For its part, the Barbados Association of Registered Nurses says it will only support the proposal with the following demands: that the manpower be supplied in full in order to cover rostering; that the amenities needed to support the 24-hour service be provided in the form of security, transportation, rest facilities, material resources and equipment that is adequate for functioning. It has also made a case for remuneration outside, over and above certain hours.

In the eyes of Minister of Health Lieutenant Colonel Jeffrey Bostic, the nurses’ concerns are legitimate but he means to see progress in the interest of Barbadians who cannot afford to access private health care.

At the last round of talks last Friday, all three sides walked away from the table standing their ground with no new date set for further talks.

Many moons ago, the Rolling Stones put it in song – “You cant always get what you want but if you try sometimes, you might find you get what you need.”

Negotiations are always tough but they don’t have to mindless battles. True, we are conditioned to think of negotiations as a contest of wills where one side emerges victorious while the other is shamed.

But as advised by the Rolling Stones, shouldn’t it be more about what we all need than about what some want?

Nurses are admittedly taken for granted, underpaid and certainly deserving greater respect as they care for us all. Their concerns about issues of security, adequate remuneration and supplies are no doubt valid to get this 24-hour clinic right.

But hardline positions will not yield what they need. Perhaps, the bodies representing the nurses should willingly return to the table with a compromise that can at least help nurses to get what they need.

What is so wrong with meeting the Ministry of Health halfway and perhaps agreeing to start with one of the proposed polyclinics on a test basis?

And what would be so terrible if the Ministry were to take two steps forward and clearly demonstrate to nurses that it means business by setting realistic timelines and putting in motion concrete actions to remedy the nurses’ chronic complaints?

A return to the bargaining table is needed on this potentially life-saving plan.

The patient – our nation’s healthcare system – needs a remedy.