A study to help Government determine how to cut costs in the health care sector and continue to finance health services is currently under review by Cabinet.
That disclosure came today from Minister of Health Lt Col Jeffrey Bostic in response to questions from Opposition Leader Bishop Joseph Atherley who suggested that the current model of financing public healthcare is unsustainable.
Although saying he could not disclose too many details about the study which was carried out by the Health Economics Unit of the University of the West Indies, St Augustine, Bostic said that it had offered insight into how some services could be streamlined.
“When we were able to compare the cost of the provision of services, for example at the Queen Elizabeth Hospital (QEH), with comparable services in the private sector, we were able to see even within the polyclinics where we could make some changes that are necessary,” he said.
“Where there are polyclinics that offer certain services in a greater catchment area and are doing more in that regard than other polyclinics, we can rationalize services,” Bostic said.
His comments came after Bishop Atherley expressed concern about how the government intended to finance health services in Barbados going forward.
“The current model is not sustainable; the current model will not take us where we need to go; the current model is not properly addressing the immediate problems in the health sector and it is not likely to be viable in the face of new challenges that will come,” the Opposition Leader insisted.
“This government right now is constructing a survivalist platform rather than a growth platform. In the absence of a growth platform, and constrained as we are in terms of generating, using the historical models, revenues to support these services, this government…should be in a position to tell us how it plans to finance these things.”
He reiterated his view that the healthcare sector in Barbados is facing “the perfect storm”.
Bishop Atherley identified the elements contributing to that state of affairs as the government’s inability to “fully and properly” subsidize healthcare services, an aging population, the incidence of NCDs, a lag in equipment deficiency, aging healthcare plants and infrastructure, nursing shortages, the rising cost of living, the increasing cost of providing private healthcare and the high level of demand for health services by non-residents.
“How does Barbados finance healthcare in that context?” he questioned.
“How do we counter the cost of what is called out-of-pocket care that people must seek even in the context of public service provision of care? You go to the hospital and service is free but then there are other aspects of your treatment and care – medication – that have to be paid for, that comes out of pocket and it is rising. If you have to make a resort to private care services that cost is becoming astronomical in some cases.
“How are we going to derive efficiencies in a system which often still is the subject of political influence and the subject of less than ethical behaviour? And do we contemplate the introduction of some sort of national health insurance to treat to this and, if we do, what would be the basis for that?”
In response, the health minister made reference to the costing study, saying that was the first step in developing a health finance strategy. But Bishop Atherley pressed for more information.
However,Bostic said while preliminary discussions had been held at the level of the Cabinet, a review of the study was still underway and he could not say more.
He said the hope was to have that completed in the coming financial year.
“Regrettably, we slowed down and I apologize for that because we would have been focused on COVID, but this is one thing that we will pick back up. Obviously, the Ministry of Finance and Economic Affairs will also have a say in this but we will be moving swiftly to healthcare financing in the new financial year,” Minister Bostic said.
However, he stressed that even before the study had started, his ministry had embarked on projects to reduce the need for and cost of curative interventions in the health sector, including the introduction of 24-hour services at the Winston Scott Polyclinic.
He added that the QEH had also introduced initiatives to significantly reduce the cost of treating NCDs over time, and an alternative care of the elderly programme, which reduces the cost of in-hospital care, would also result in savings.
The hospital’s executive chairman Juliette Bynoe-Sutherland agreed with the Opposition Leader that the costs of services across the entire system were in need of significant rationalization, and indicated that the QEH had already started to tackle those areas. (DP)
