A step forward for the Black River Health Centre

BY GARFIELD MYERS
Editor-at-Large
South/Central Bureau
myersg@jamaicaobserver.com

Thursday, May 09, 2019

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BLACK RIVER, St Elizabeth –— Eleven years after the Bruce Golding-led Jamaica Labour Party (JLP) Government of the day removed user fees in the public health sector, current Health Minister Christopher Tufton is still applauding the initiative.

However, he also conceded that there were negative, unintended consequences of no user fees.

The policy change allowed far more people to access health care and saved lives, which made it a necessary move, he said.

But it also led to a shortfall of resources and a diluting of quality health care, Tufton told his audience at a recent ribbon-cutting ceremony to mark the renovation and expansion of the Black River Health Centre.

The paradox forced the leadership of the health sector to find solutions through improvement of primary care at health centres especially, with the facility at Black River being a prime example, he said.

“... With every adjustment in policy, you have a reaction and a number of other challenges which present themselves for solution, because the consequences of unlimited access (to public health care) created for us a situation of questionable quality of access,” Tufton said.

“In other words, more people were coming in but were not getting what they wanted to get in terms of medical services. They were waiting many hours, and were not seeing the doctor they would like to see because of (inadequate specialist expertise), not getting the diagnostic treatment that they would like to get because of limited equipment [and] sitting in an environment that was uncomfortable.

“What that created was a situation where while we could guarantee access, we had a chequered reputation as a country because of what that access meant for the average Jamaican,” the health minister said.

The obvious need to ensure quality service in a timely manner, even while ensuring unlimited access, “occupied” his mind when he was appointed health minister in the new Andrew Holness-led Government in 2016, Tufton said.

A major hurdle was that many people were bypassing primary care at health centres “because they felt they could go to the hospital and get one-stop all the services that they needed and what that did unwittingly was to create a burden on the secondary health care infrastructure...”

To illustrate, Tufton told his listeners to consider that the Black River Health Centre was located right across the road from the Black River Hospital.

“I bet you that for the average person who don't feel well, they are likely to turn through that (hospital) gate on the other side rather than turn through this (health centre) gate on this side,” he said.

The minister said that “up to 40 per cent, 4 out of 10 persons” who go to accident and emergency areas at hospital seeking care, really should be accessing primary health care at health centres.

Tufton and other speakers at the Black River ceremony said the challenge was to so improve the conditions and environment at health centres to make people see the wisdom of visiting those facilities first.

They said the expansion and renovation of the Black River Health Centre, as well as several other such facilities across the country served that goal.

The Black River Health Centre project was funded by the Tourism Enhancement Fund at a cost of $13 million.

According to the Jamaica Information Service, the facility will now include services relating to maternal and child health, as well as curative, dental, dressing, women's health, nutrition, environmental health, mental health and child guidance.

Dr Tonia Dawkins-Beharie, medical officer for the St Elizabeth Health Department, identified for the Jamaica Observer additional waiting areas with comfortable seating, additional space for specialised staff and additional enclosed areas to treat with patients, among the improvements.

Central to the project at Black River is extended opening hours. That also applies to the Santa Cruz Health Centre as well as other leading primary care facilities across the country.

Since April 1, at the Black River Health Centre, patient care has now been extended beyond daylight hours. It is now available from 8:30 am to 8:30 at night, three days per week — Mondays, Tuesdays and Thursdays.

Tufton said the extended day for health centres signalled the willingness to respond to the lifestyle needs of people.

“It's only common sense... that if we want more people to use the primary health care, the health centre; if people work from 9 to 5 then we must provide them with some additional hours after work so they can leave work and come...,” he said.

“If you go home (from work) and your child not feeling well, relax (because) you can take the child to the health centre (which) is open 'till 8:30,” he said.

Tufton said modern technology is also allowing primary care facilities to digitally share relevant information with hospitals, thereby eliminating frustrating delays for registration and treatment, etc, when patients are transferred from one to the other.

Tufton argued that the drive to improve health facilities and services was aligned to the push for consistent compassionate care and a more people-friendly atmosphere.

He said the improvements and new arrangements at the Black River Health Centre would be a “prototype” and a new “standard” for Jamaica's primary health care facilities, going forward.


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