MINISTER of Health and Environment Ruddy Spencer says the removal of user fees at public health facilities today will only cost the government an additional $1.7 billion this year, because only 15 per cent of fees were actually being collected.

"The abolition of the fees mean that the public health sector would forego fees in the amount of $1.7 billion for the first year of implementation." Spencer told reporters ast Friday.

He said, however, that the government had budgeted a total of $3.85 billion in additional expenditure to cover the fees, plus an expected 30 per cent increase in patient load.
"The truth is that even in the best of times, Jamaicans find it difficult to pay the fees and even those who pay, do so at great sacrifice," the minister said.

He said that, in addition, the collection of the fees at the health facilities has been a major source of conflict and tension between health workers and patients which the service could well do without.

However, Spencer admitted that the abolition of the fees would add to the workload of health workers.

He said that the sector has about 4,402 workers in critical positions, including doctors, public health inspectors, all categories of nurses, physiotherapists and pharmacists. But, it needs another 1,562 mainly doctors, nurses and community health aides.

"We cannot fill this gap in the short term. It is necessary to examine a mix of strategies to ensure that the quality of patient care will not be compromised," he said.
Consequently, Regional Health Authorities (RHAs) will be recruiting suitably trained persons on a temporary or sessional basis. In addition, staff members will be paid for overtime for working outside normal hours, as well as for working outside their base.

The RHAs have also been authorised to negotiate partnership agreements with private providers for medical, diagnostic and other health care services which are normally provided, but are currently unavailable at public health facilities.

Another important development, according to the minister, was the extended opening hours for at least 16 health clinics.
These are located in: Mandeville, May Pen, Black River, Highgate, Gayle, Oracabessa, Mount Salem, Alexandria, Morant Bay, Linstead, St Ann's Bay, Mandeville, May Pen, St Jago Park, Greater Portmore, Stony Hill and the Glen Vincent and Duhaney Park clinics in the Corporate Area. Some of these clinics will also be opened on Saturdays.
Spencer said that the situation will be reviewed periodically and necessary adjustments made.

The minister warned that, unlike criticisms that the effort could become a "Tom Fool's Day trick," he was confident that all will be in place today.

"We are not promising perfection as of April 1. We have met with our workers representatives and will continue to meet with them as we work shoulder to shoulder to provide quality health care to the Jamaican people," he said.

"We are not unmindful of the challenges we face. But now is not the time to shrink back. The abolition of user fees is the start of something great," he added.

He said that abolition of the user fees will signal the start of a comprehensive policy on health in Jamaica, which he will address in the sectoral debate in May.

As of today the government will abolish user fees at its health facilities for registration, doctor's examination, hospital admission, surgeries, medications, diagnostic services, services for mothers and children including antenatal delivery and immunisation, haematology, ambulance service, physiotherapy, blood transfusions and lab tests.

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