Financing healthcare delivery vital

Whatever new healthcare model is adopted in Barbados will not be effective until those in the sector find new ways of financing and delivering services.

This from healthcare finance commissioner in the Ministry of Heath and Wellness, Danny Gill, who suggested that one of the major changes needed was in the attitudes of some of the healthcare providers who deliver service as if “they are doing you a favour”.

Gill was on a panel that included insurance executive Roderick Nurse during a virtual seminar titled: The Impact of Private Insurance and Public Healthcare Financing in Barbados, hosted by the Barbados Association of Insurance and Financial Advisors on Tuesday night.

Speaking on a number of healthcare matters in Barbados, Gill said that through a survey conducted in 2016 his ministry learnt that 42 per cent of health expenditure was paid out-of-pocket. This number was up by three per cent from a similar survey carried out in 2012/2013. The World Health Organisation (WHO) suggests that out-of-pocket expenditure should be below 20 per cent, so according to Gill, the present numbers were of concern.

He contended that Barbadians used out-of-pocket expenditure not as any last resort but as a direct result of the service meted out at public primary care facilities. That is why he believed if Government is going to seriously contemplate revamping a system, service must be the first area it considers.

“When you have people waiting too long to access care then that is a barrier. We have to do something about the way these institutions operate. Whatever mechanisms you bring, QEH must become more efficient, the polyclinics have to be more efficient, where you know as a member of the population that when you turn up there is a defined time for you to access care.

“If persons have to go to the polyclinic [now] they know they are going to go down there for a while and they opt then to pay the doctor at his office to shorten the visit.

“For those who can afford it, this is why you would have the Bellevues, the FMHs. This is why you would have Sandy Crest, because people are going to find someplace where they know, it may be a cost, but they can access care in a timely manner. So one of the challenges we have in the Ministry of Health is how do we shake ourselves out of that ‘what we now do’ and really start to function in a delivery mode that satisfies the population,” Gill maintained.

Another area of concern also highlighted, was the lack of value given to maintenance. In fact, Gill noted that a cost index undertaken by his ministry found that maintenance of property was the most valuable asset at the hospital; followed by emergency services and surgeries. However, it was inevitably the first section impacted by cuts in expenses.

Gill added: “That impacts equipment, the ambience you are in, what you are delivering to the public and so on. And I think that [because of that] index, we may have to have a conversation with the Ministry of Finance in terms of … a relook at that because if it is the most valuable asset of the hospital, then we have to put particular care to it.” (KC)