De­ci­sions, de­ci­sions for He­len’s Health­care

The Star (St. Lucia) - - LOCAL - Claudia Elei­box

“It is no se­cret that the gov­ern­ment has been hold­ing dis­cus­sions with Cay­man Health City,” Prime Min­is­ter Chas­tanet said this week. “Cay­man Health City is the only en­tity that has pro­posed to do a joint ven­ture with the gov­ern­ment.”

But even if the gov­ern­ment de­cides to run with the Cay­man Health, there will still be more re­lated de­ci­sions to be made.

“Is OK-EU go­ing to be a sec­ondary level hospi­tal,” he went on, “mean­ing that all the ser­vices as­so­ci­ated with Victoria Hospi­tal, how we run Victoria, will lit­er­ally be trans­ferred to OK-EU? The pro­posal is to look at OK-EU specif­i­cally as a ter­tiary level health­care sys­tem pro­vid­ing ser­vices that cur­rently don’t ex­ist in Saint Lu­cia.”

To transfer sec­ondary level health ser­vices to OK-EU would mean re­lo­cat­ing staff and pa­tients from VH’s 170-bed fa­cil­ity to the new hospi­tal, which has 50 less beds. The prime min­is­ter said: “Peo­ple are an­tic­i­pat­ing more sec­ondary beds af­ter Victoria has been closed down,” and the cost of main­tain­ing a bed at OK-EU would be four to five times what’s charged at Victoria Hospi­tal.”

And what if the gov­ern­ment chooses the ter­tiary level health­care sys­tem as sug­gested in Cay­man Health City’s pro­posal?

The prime min­is­ter said: “The re­al­ity is that Saint Lu­cia’s pop­u­la­tion by it­self can­not sus­tain a ter­tiary level hospi­tal. The only al­ter­na­tive to have a ter­tiary level hospi­tal is through med­i­cal tourism.”

To do that OK-EU would need to pro­vide high enough ter­tiary level ser­vices at a glob­ally com­pet­i­tive price so peo­ple would come to Saint Lu­cia in­stead of go­ing to other Caribbean is­lands or Mi­ami for med­i­cal treat­ment.

“If the an­swer is we don’t be­lieve that’s the case then we have to find a way to cover the ad­di­tional costs of mov­ing Victoria into OKEU, an ex­tremely ex­pen­sive propo­si­tion, con­sid­er­ing there are no other rev­enue streams to make up for the ad­di­tional costs.”

At the nam­ing cer­e­mony of OK-EU, in Fe­bru­ary 2016, then EU am­bas­sador to Bar­ba­dos and the East­ern Caribbean, Mikael Bar­ford, ref­er­enc­ing the op­er­a­tional costs, said: “In my view, what­ever op­tions gov­ern­ment chooses should not add a bur­den or re­strict ac­cess to sec­ondary health ser­vices to those in most need.”

He added: “Pub­lic-pri­vate part­ner­ships, PPP, and ser­vice level agree­ments have proven suc­cess­ful in other coun­tries to open up the health­care mar­ket and make it at­trac­tive also for in­surance com­pa­nies and for tourists.”

Then he em­pha­sized, “How­ever, the qual­ity of the fa­cil­ity, equip­ment and staff of the Owen King EU hospi­tal holds enor­mous po­ten­tial for the hospi­tal to earn con­sid­er­able in­come and to be self-sus­tain­ing . . . This hospi­tal has a sus­tain­able fu­ture.”

But while the gov­ern­ment tries to de­ci­pher how to incorporate OK-EU into Saint Lu­cian health­care, the prime min­is­ter in­sists, “At Victoria we have sev­eral op­tions.” Those in­clude the pos­si­bil­ity of up­grad­ing the Na­tional Men­tal Well­ness Cen­tre to the “new Victoria” by putting in at least 100 new beds.

An­other idea is to down­grade Victoria Hospi­tal to a poly­clinic and shut down the health cen­tre on Chausee Road in Cas­tries.

The prime min­is­ter of­fered even an­other: “Why not fix up the health­care cen­tre on the Chausee and add a po­lice sub­sta­tion next to it be­cause you’ve got the space to be able to do that? The fact is that peo­ple like that lo­ca­tion.”

What­ever the de­ci­sion, Chas­tanet said, “The num­bers will help tell a lot of the story. I think that if you were to take a vote of the staff, no­body wants to stay at Victoria . . . It’s never been as­so­ci­ated with ex­cel­lence . . . The plan was al­ways to close down Victoria.”

As for St Jude Hospi­tal, no up­dates have been pro­vided since works ceased on roof­ing at the Ge­orge Od­lum Sta­dium.

On Monday the prime min­is­ter said that with the ad­di­tion of the new mini hospi­tal in Soufriere and the poly­clinic in Den­nery, “I will be an­nounc­ing very soon the plans for St Jude’s where we’re propos­ing to do min­i­mum 70-100 beds . . . [it all] needs to add up to more beds than what we have at Victoria.”

Said the prime min­is­ter about the gov­ern­ment’s time­line for a health sec­tor over­haul: “It’s a very tight dead­line. The goal is that we’re go­ing to have a White Pa­per out by late Septem­ber, Oc­to­ber.

“We want to be able to have a fi­nal agree­ment on the struc­ture of health care by the end of this year. And we want to have the new reg­u­la­tions drafted and ap­proved in par­lia­ment be­fore May/June. And then we want to be able to im­ple­ment the new health in­surance and the new pro­cesses within health­care by the end of 2019.”

Prime Min­is­ter Allen Chas­tanet said on Monday, “The plan was al­ways to close down Victoria.”

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