Who will take charge of the muddled health system?

Healthcare has become as much a political issue as the safety and security of citizens and even the economy.

While we are not prepared to say that an election in Barbados will be won or lost on the basis of the performance of a minister of health, it has become a serious social and economic matter that is a pain point.

Important too, is the fact that the provision of healthcare cannot only be assessed through the lens of government as the provider of the social service, but also as the overall national policy setter. Included also must be the exploding private healthcare providers and the role of health insurance companies.

It is not hyperbole to contend that healthcare in Barbados has been allowed to meander along with a growing class divide emerging, and a deteriorating public health system, while the statistics by which the world judges the health of Barbadians show an alarmingly large portion of the population living unhealthy lives.

We are prepared to call for significant reform in the health system, from top to bottom, to reshape it into one that serves Barbadians and is not a source of anxiety and distress.

This is not the time for Barbadians to romanticise the days when people from the Eastern Caribbean travelled to the island to be treated at the Queen Elizabeth Hospital (QEH) when they required intensive, or high-quality care.

Yes, the island’s National Drug Formulary was a revolutionary introduction providing free medications to public health patients and residents under the age of 16 and the elderly who attend private clinics for a number of ailments and chronic diseases. But even that service is under distress as the administration seeks to control spiralling costs, while confidence in the drugs provided has waned, whether warranted or not.

Among the other runaway problems is the QEH’s Accident and Emergency Department, where patients could spend two or three days awaiting treatment.

This is an untenable situation that has become the bane of the existence of successive ministers of health and administrators of the country’s primary care hospital. 

Undoubtedly, there exists a solid framework on which the delivery of public health is provided, in the form of an expansive polyclinic system, a National Drug Formulary, a certified teaching hospital where the best medical graduates of the University of the West Indies compete for internships, a nursing school where students study virtually for free, a high level of taxation to support the public health system that has gobbled up billions in public funds in just one decade. Yet, average Barbadians cannot enjoy a level of healthcare that they are satisfied with or can afford.

While all this is occurring, private healthcare providers are mushrooming as a result of increased demand. The long waits at public facilities have become a drag on productivity. People cannot afford the time, distress and loss of work that can occur in the public system.

A mother of two school-aged children simply cannot afford to spend half of her workday or more sitting on a polyclinic bench waiting for the name of a sick child to be called. The service may be received, and it may be adequate, but the inconvenience is too much. As a result, a parent will spend $80 to $100 for his or her child to be attended to in a private doctor’s office rather than endure the alternative at a public facility.

However, the cost of private healthcare, even to simply see the doctor, is rising at a rate that is making it inaccessible to low-income Barbadians. This does not include the cost of seeing a specialist such as a paediatrician, cardiologist, gynaecologist, or orthopaedic specialist where the minimum fee hovers around $200 to $250. 

Add to that, the expense of various screenings and blood tests. Even for those with major medical health coverage, the high deductibles and low maximum coverage for doctor’s visits often leave those with insurance still footing much of the medical costs.

Compounding this unpleasant picture is the lack of personal responsibility by too many of our citizens who play loose and fancy with their health. Too many Barbadians are living sedentary lives with very little physical activity, leading to obesity and a high level of non-communicable diseases.

We are, therefore, not exaggerating when we characterise Barbados’ healthcare system as requiring a massive overhaul.