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.
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 firstname.lastname@example.org.