Non-na­tion­als debt ‘pil­ing up’

NON-NA­TION­ALS OWE the Queen El­iz­a­beth Hospi­tal (QEH) lots of money – about 70 to 75 per cent of all that is due to the hospi­tal for ser­vices ren­dered.

Daily Nation (Barbados) - - Health -

be­tween $7.5 to $8 mil­lion.

Dur­ing the sym­po­sium, a seven-mem­ber fo­cus group led by Trudy Grif­fith, a phar­ma­cist at the hospi­tal, dis­cussed a sce­nario of a non-na­tional liv­ing and work­ing in Bar­ba­dos for ten years with no le­gal im­mi­grant sta­tus. The per­son be­came se­ri­ously ill and was treated at the QEH, but was not told dur­ing his care that he had to pay. Upon his dis­charge, he re­fused to pay, stat­ing he was a CARICOM na­tional; and the QEH, hav­ing started his course of treat­ment, had to con­tinue with his af­ter-care.

Grif­fith said based on the sce­nario, it should be made clear to all that while the QEH of­fered free care to Bar­ba­dian na­tion­als, res­i­dents with­out cit­i­zen­ship or per­ma­nent res­i­dency were not el­i­gi­ble for that. The ex­cep­tion was where the Min­istry of Health, in col­lab­o­ra­tion with re­gional gov­ern­ments, had pro­vi­sions for gen­eral emer­gency cases, pre-na­tal care, im­mu­ni­sa­tions and mat­ters of pub­lic health sig­nif­i­cance, and peo­ple with HIV/AIDS.

Se­nior ra­dio­g­ra­pher Venice Gill said if the pa­tient was un­con­scious, then the hospi­tal had an eth­i­cal and moral re­spon­si­bil­ity to pro­vide care. How­ever, when the in­di­v­d­ual was sta­bilised, the per­son would be told that fur­ther care would re­quire pay­ment.

How­ever, le­gal coun­sel for the QEH, Ivan Wal­ters, said the per­son must be pre­sented with a bill be­fore be­ing dis­charged since if the in­di­vid­ual left the ju­ris­dic­tion, then pay­ment could be prob­lem­atic. (LK)

Ac­cord­ing to World Health Or­ga­ni­za­tion the no­tion of health is not sim­ply the ab­sence of disease, but a state of phys­i­cal, so­cial and emo­tional well-be­ing. Pal­lia­tive care em­braces this con­cept of health, valu­ing the phys­i­cal, so­cial and emo­tional, while also in­clud­ing the spir­i­tual di­men­sion of a per­son’s life – what­ever form it may take.

2. Tim­ing – when does pal­lia­tive care start?

Pal­lia­tive care ad­dresses the needs of in­di­vid­u­als from the time of their di­ag­no­sis, in­clud­ing while per­sons are un­der­go­ing cu­ra­tive treat­ments such as surgery, ra­dio­ther­apy and chemo­ther­apy. Dur­ing this time, it may be ben­e­fi­cial by in­creas­ing the abil­ity of per­sons to cope and man­age symp­toms they may ex­pe­ri­ence. Pal­lia­tive care is also ben­e­fi­cial when a cure may no longer be pos­si­ble. At this point, much time is spent with the pa­tient and their fam­ily to achieve the best pos­si­ble out­comes.

Some­times the goals of care may be cen­tred on man­ag­ing phys­i­cal symp­toms such as dif­fi­culty breath­ing, loss of ap­petite or pain. Pain man­age­ment tra­di­tion­ally has been one of the cor­ner­stones of treat­ment of the ter­mi­nally ill and fre­quently in­cludes the use of opi­oids and nar­cotic anal­gesics such as mor­phine and co­di­ene. How­ever, pal­lia­tive care also as­sists rel­a­tives and pa­tients by pro­vid­ing care co­or­di­na­tion, in­clud­ing pro­vi­sion of items that help with ac­tiv­i­ties of daily liv­ing such as wheel­chairs and hospi­tal beds. 3. What’s avail­able in Bar­ba­dos? On the is­land, pal­lia­tive care ser­vices are pri­mar­ily com­mu­nity based – with per­sons re­ceiv­ing care in their pri­vate homes, nurs­ing homes and in gen­eral prac­tice and physi­cian of­fices around the is­land. Ed­u­ca­tional ini­tia­tives aimed at rapidly in­creas­ing the num­ber of ap­pro­pri­ately trained health­care providers are also fa­cil­i­tated through the Bar­ba­dos As­so­ci­a­tion of Pal­lia­tive Care, the Univer­sity of the South­ern Caribbean and other non-gov­ern­men­tal or­gan­i­sa­tions (NGOS).

In ad­di­tion, coun­selling and sur­vivor­ship ser­vices are well es­tab­lished through the work of the Can­cer Sup­port Ser­vices and the Bar­ba­dos Can­cer So­ci­ety.

4. Hospice/pal­lia­tive Care As­so­ci­a­tions and re­lated NGOS

In­di­vid­u­als and fam­i­lies who re­quire more in­for­ma­tion can con­tact the fol­low­ing agen­cies:

• Bar­ba­dos As­so­ci­a­tion of Pal­lia­tive Care – www. bar­ba­dospal­lia­tive.org/

• Bar­ba­dos Can­cer So­ci­ety – www. bar­ba­doscancer­so­ci­ety.com/ • Can­cer Sup­port Ser­vices – css.org.bb/ • Univer­sity of the South­ern Caribbean – In Bar­ba­dos, Ge­orge Greaves at greavesg@usc.edu.tt.

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