Sick health system

Shortages, inefficiencies and lack of equipment across island

BY ALPHEA SAUNDERS Senior staff reporters saundersa@jamaicaobserver.com

Wednesday, September 02, 2015

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THE Ministry of Health yesterday released the main findings of its audit of conditions in the public health care system across the island, but revealed nothing which has not been repeatedly ventilated and brought to public attention in the press, particularly over the past several months.


The audit carried out in the four Regional health authorities (RHAs) focused mainly on maternity wards, operating theatre, neonatal units, intensive care, and accident and emergency, and specifically examined resources, infection control, infrastructure, equipment, and supplies.


At a press conference held at the Jamaica Pegasus Hotel in Kingston, ministry officials insisted that it would not be prudent to issue the full audit report, because it would prejudice the facilities. "We would not want to specifically give you the names of the hospitals. We don't want to tell you which particular hospital has which shortage. It's really not the best thing to do; I don't think this is good to put those out in the public space at this time," Permanent Secretary Dr Kevin Harvey explained.


The findings were made public days after Opposition spokeswoman for health, Senator Marlene Malahoo-Forte, called for Health Minister Dr Fenton Ferguson to reveal the results of the audit, which he ordered in May, amidst repeated reports of a broken down system fraught with problems of lack of equipment, and basic but critical items used in patient care; unsanitary and unhygienic conditions; overworked personnel; and decrepit infrastructure.


The audit teams concluded that there were inadequately maintained systems and infrastructure for infection prevention and control in some facilities; inconsistent supply of pharmaceuticals and sundries in some institutions; inadequate supply or management of linen; inadequate numbers and function of some small medical equipment; and stock management challenges.


In his presentation, Dr Ferguson said there was "inconsistent documentation of critical needs with limited follow-up at the local level, inadequate supplies of personal protective equipment, and challenges with the infrastructure of some hospitals".


He said that, although the gaps are significant, "in many areas they existed over time and we had already started to take the necessary actions to improve the services".


"We have not woken up this morning and decided that we are going to put these interventions in place. It is quite deliberate that we are so far advanced despite being so early in the fiscal year," added Permanent Secretary Harvey.


Meanwhile, the health minister was at pains to point out that the Government was not unaware of the problems and had already been taking steps to fix them, having spent $1.5 billion on the upgrading of infrastructure alone over the past three years. He noted that the budget for this fiscal year had been bumped up by 18 per cent, moving to over $50 billion.


"The piecemeal approach of the past has not served us well. We have acknowledged that the health system is in need of some reform to meet the changing health care needs of the population," he remarked.


Dr Ferguson said the overhaul of pharmacy services were being fast-tracked, with more than 250 pharmacists and pharmacy technicians employed in an effort to improve service delivery. "We have started to implement a pharmacy management information system which will help us to track items, their availability, expiration and order levels," he explained.


He highlighted also that the shortage of pharmaceutical and medical sundries should ease soon, as just last week contracts were signed to increase supplies by $3.8 billion. "This is an initial procurement as we expect to spend close to $6 billion on pharmaceuticals and sundries, and $2 billion on reagents in this financial year alone," he said. "In addition, since April 2015 we have provided the regional health authorities with an additional $130 million per month from $50 million previously," he added.


The minister said that in a move to strengthen infection prevention and control procedures and practices, the Government has now engaged a medical microbiologist, whose duties include visiting and working with the regions to ensure that these standards are "reinstituted or brought up to a standard that is acceptable".


As it has to do with obsolete items, he said the ministry is working with the RHAs to ensure that these are "speedily removed" from the facilities where they are identified. Already, he said, procurement has started for some $14-million spare parts for critical biomedical equipment such as X-ray, CT scan and MRI machines.


There was also a promise that the shortage of ambulances, which health care workers said have been hampering their work, was being addressed. The minister said 18 new ambulances are being bought through various agreements involving Toyota Jamaica, the programme for the reduction of maternal and child mortality (PROMAC), and the National Health Fund.


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