Noth­ing new for the pub­lic health sec­tor

Weekend Mirror - - CHILDREN’S CORNER -


na­tional bud­get, as pre­sented by Min­is­ter of Fi­nance, Mr. Win­ston Jor­dan, on Novem­ber 27th, does not bring much com­fort of re­lief to the masses through its gen­eral thrust and pro­vi­sions, but more par­tic­u­larly also fails to do so in the vi­tal area of Pub­lic Health. No ma­jor new in­vest­ments in Pub­lic Health In­fra­struc­ture has been an­nounced.

The main high­lights in the rel­e­vant Pub­lic Health seg­ment of the APNU+AFC 2018 bud­get pre­sen­ta­tion sim­ply re­gur­gi­tates the lofty achieve­ments of the PPP/C and pla­gia­rizes other PPP/C-era well struc­tured trans­for­ma­tional in­fras­truc­tural and hu­man re­source devel­op­ment ini­tia­tives which were on the cusp of be­ing rolled out. For in­stance, the con­tin­ued de­ploy­ment to the re­cently con­structed Re­gional Hospi­tals and Re­gional Health Cen­ters of more and more grad­u­ate med­i­cal doc­tors and med­i­cal spe­cial­ists, prod­ucts of the Jagdeo/Cas­tro Health Agree­ment of Fe­bru­ary 2006. The Coali­tion barefacedly at­tempts to lay claim to these as its new ini­tia­tives for 2018.

Re­move 14% VAT on Health Ser­vices

Min­is­ter Win­ston Jor­don boasts that some 7% more will be spent in 2018 on the Sec­tor than in 2017. That is to say, G$33.3 Bil­lion or 12.5 % of the to­tal 2018 Bud­get. He failed to re­mind the na­tion that the PPP/C for years al­ways main­tained a sim­i­lar per­cent­age of spend­ing on the Health Sec­tor.

He fur­ther failed to in­di­cate the size of the slice of this “7%” which will go to­wards sup­port­ing the 14% VAT on Health Ser­vices. This will nib­ble away at the “7 per cent more” boast. Re­call that the Pub­lic Health Sec­tor, too, must in­cor­po­rate this cost into its pro­cure­ment costs for Medicines and Med­i­cal Ser­vices and Di­etary Sup­plies. How big in­deed is the “real per­cent­age in­crease” in Health Sec­tor pro­jected ex­pen­di­ture for 2018?

Min­is­ter Jor­dan an­nounced the with­drawal of the 14% VAT on Ed­u­ca­tion Ser­vices. This is a di­rect vic­tory of or­ga­nized and sus­tained peace­ful protests.

Per­haps it’s time for Min­is­ter Win­ston Jor­dan to with­draw the 14% VAT on Health Ser­vices, too. This would then make his Bud­get Speech “7% in­crease” in the pro­jected 2018 Pub­lic Health Sec­tor ex­pen­di­ture less de­cep­tive.

Among the big­gest boasts of sig­nif­i­cant ex­pen­di­ture on health sec­tor in­fra­struc­ture Mr. Jor­dan spends much time and ef­fort on the pro­cure­ment of a mam­mog­ra­phy ma­chine for the Ge­orge­town Pub­lic Hos­pi­tal. This is a vi­tal piece of equip­ment. But what Jor­don failed to tell the Na­tion is that this ma­chine -- and other sim­i­lar pieces of vi­tal equip­ment - would have al­ready been in the Pub­lic Health Sec­tor at the vi­sion­ary PPP/C In­dia Gov­ern­ment funded Spe­cialty Hos­pi­tal at Lil­ian­daal.

So that — to quote Mr. Jor­dan from the same second para­graph : “Screen­ing for breast can­cer no longer needs to be out­sourced at great cost to the pa­tients.” Would have al­ready been a rou­tine re­al­ity.

APNU-AFC Pla­gia­riz­ing PPP/C Projects

Min­is­ter Jor­don lays claim to an­other sig­nal achieve­ment of the Jagdeo era. Min­is­ter Jor­don said: “In 2017, we added an ad­di­tional 9 med­i­cal Spe­cial­ists to Re­gion No 1 and No 2.” He, of course, is herein re­fer­ring to the “Jagdeo Schol­ars” trained in Cuba un­der the Jagdeo/Cas­tro ini­tia­tive of Fe­bru­ary I men­tioned ear­lier.

What Min­is­ter Jor­don also failed to to tell the Na­tion and which we must re­call is that these Jagdeo Schol­ars he “added” to Re­gions 1 & 2 are in the main func­tion­ing at two mod­ern Re­gional Hospi­tals “built, equipped and staffed” by the Jagdeo Ad­min­is­tra­tion with funds pro­vided by the CDB. These are the Lethem Re­gional Hos­pi­tal and the Mabaruma Re­gional Hos­pi­tal. They, so to speak, are “twins”.

The pro­ject to “build, equip and staff” the hospi­tals at Lethem and Mabaruma was a de­lib­er­ate ef­fort by the PPP/C to bring mod­ern Health Ser­vices to these two im­por­tant Hin­ter­land com­mu­ni­ties. This CDB-as­sisted Pro­ject co­in­cided with the sim­i­lar ef­fort to con­struct, equip and staff the now well rec­og­nized four Di­ag­nos­tic and Treat­ment Cen­ters at Di­a­mond, Leonora, Sud­die and Ma­haicony; along with the pres­ti­gious Na­tional Oph­thal­mo­log­i­cal Hos­pi­tal at Port Mourant. These were funded to­tally by GOG money.

New Hospi­tals Built By The PPP/C Ro Mod­ern­ize Health Sec­tor

These new, mod­ern hospi­tals were in­tended to up­grade and mod­ern­ize the Guyana Health Sec­tor which had not seen sig­nif­i­cant in­fra­struc­ture up­grade for decades. They were also seen as the “first phase” of such mod­ern­iza­tion with a “second phase” al­ready on the draw­ing board to raise the bar even higher with the in­tro­duc­tion of spe­cial­ist fa­cil­i­ties. This “first phase” was also de­signed to sup­port the need for these mod­ern ser­vices in emerg­ing new growth-poles such as the Di­a­mond New Hous­ing Scheme and other nearby new hous­ing schemes on the EBD and the other con­se­quences of the mas­sive ex­pan­sion of the EBD High­way it­self, for which fund­ing and pro­ject de­sign had al­ready been se­cured by the PPP/C Ad­min­is­tra­tion.

Di­a­mond (Hos­pi­tal) is a gem. It has jus­ti­fied the in­vest­ment and vi­sion. Like the other four Di­ag­nos­tic and Treat­ment Cen­ters and the CDB twins.

The cur­rent and abid­ing fail­ure of the APNU+AFC Coali­tion to build on this base and to re­al­ize the full po­ten­tial of the PPP/C vi­sion for the Pub­lic Health Sec­tor is patent. This fail­ure is ev­i­dent in the re­peat­ing fail­ures in Min­is­ter Jor­dan’s sev­eral Bud­gets to date to cap­ture sus­tained Health Sec­tor in­fra­struc­ture devel­op­ment for “im­pact and re­turn on the dol­lar”. The Min­is­ter’s lamen­ta­tion in his bud­get speech that the sec­tor con­fronts “...... con­tin­ued stress on the Na­tional Re­fer­ral Hos­pi­tal; health in­fra­struc­ture deficits ....... are but a few of them” can eas­ily be reme­died. How­ever, nowhere in his Bud­get is this key ap­proach seen to be sup­ported by the req­ui­site find­ing. Only tin­ker­ing. And at­tempts to “own” PPP/C-era projects and achieve­ments. “Stress on the Na­tional Re­fer­ral Hos­pi­tal” - by this is meant the Ge­orge­town Pub­lic Hos­pi­tal Cor­po­ra­tion - was ex­pected to be to­tally ad­dressed by the PPP/C vi­sion of a 100 bed In-Pa­tient Ward added to the ex­ist­ing “Phase One” Di­a­mond Hos­pi­tal.

The de­sign specif­i­cally re­served a large piece of va­cant land in the com­pound for the “build­ing, equip­ping and staffing” of this com­ple­men­tary fa­cil­ity. It would have catered for fe­male, male and pae­di­atric pa­tients in sep­a­rate wards. It was specif­i­cally en­vi­sioned that it would also re­move the “stress on the Na­tional Re­fer­ral Hos­pi­tal”.

Change the Bud­get. Needed Ur­gently - In-Pa­tient Wards at Di­a­mond

This is a fail­ure of Health Sec­tor lead­er­ship com­pounded by lack of a larger vi­sion in the Cabi­net. It also re­flects an­other fail­ure — a poor gov­er­nance pos­ture. Re­call that all of these projects — in­clud­ing the Di­a­mond Hos­pi­tal - were very high pro­file, very pub­lic projects. I re­peat­edly and ex­ten­sively in­formed the na­tion on them through Par­lia­ment, other of­fi­cial pub­lic fora and the media — es­pe­cially TV. But more im­por­tantly — prac­ti­cally ALL the se­nior tech­ni­cal and ad­min­is­tra­tive staff which was en­gaged and in­volved in the Di­a­mond pro­ject are ei­ther at fra­ter­nal Min­istries or mostly still at the Min­istry of Health. The only change has been cos­metic — now the “Min­istry of Pub­lic Health”.

The need for a large multi ward in-pa­tient build­ing at the Di­a­mond Hos­pi­tal is ur­gent. The two cur­rent and the one recent Min­is­ters of Pub­lic Health need to get their act to­gether. Enough of cos­metic name changes. Min­is­ter of Fi­nance, Win­ston Jor­dan, needs to take a page out of the note­book his teacher, Dr. Bhar­rat Jagdeo, left him at the Min­istry of Fi­nance. Mr. Jor­dan needs to ur­gently get back to the draw­ing-board. Change the Bud­get. Make it peo­ple-friendly. He needs to al­lo­cate ad­e­quate funds to “build, equip and staff 100 bed in-Pa­tient fa­cil­ity at the East Bank Re­gional Hos­pi­tal at Di­a­mond?

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