Health Minister, John Junor at The Gleaner's Editor's Forum on the state of the nation's health, held recently at the Jamaica Pegasus Hotel in New Kingston. - Carlington Wilmot/Freelance Photographer
IF WE look at the status of health in Jamaica today, we are encouraged, because there are signs about which we should be encouraged, but there are significant challenges as well. In looking at some of the positives, one would mention the health outcomes that we enjoy in Jamaica as a population (such as) our life expectancy, maternal mortality and yes, even up to this year, our immunisation rates.
We recognise that we do have some problems with immunisation from the turn-out last year, which resulted from a number of factors, some of which relate to the fact that as a society, we have not had any of these immunisation preventable diseases for a long time.
CHALLENGES AND MEASURES
We face some financial constraints in the ministry, and that has its own effects in terms of staffing, being able to do the kind of sessions that would put people out there on weekends? To go in the highway and byways to seek out those who are not immunised. We (also) had Hurricane Ivan. The facts are that even with those setbacks, Jamaica still enjoys a health status that approaches middle income countries.
We face a very tight financial situation. You have to pay debt because that is a reality. With the balance left, you have to also ensure that the government does not pre-empt resources that will be necessary for the recovery of the economy. That means that we have to operate with a minimum of deficit, if indeed not in surplus, for us to have an economy that will eventually grow. All sectors therefore face a financing problem.
One of the measures that we have undertaken (to improve the situation) is the establishment of a National Health Fund. It is a platform which we hope will eventually launch into a national health insurance scheme. In addition to the National Health Fund, we have launched the NI Gold programme that has within it as well the potential for expansion for total coverage;that is universal coverage to our population for hospitalisation, pharmaceuticals and diagnostic tests, which is the eventual aim of the national health insurance.
In looking at some of the other challenges outside of financing, we look at the question of the training of our health personnel. We have achieved a level of training in one aspect. In terms of training doctors, we are pretty much there in terms of meeting our needs, although we have not managed to devise the programmes that encourage our young professionals in medicine to remain in our primary health care system. It is a challenge. With respect to the other areas (such as) health professionals, in nursing there is a severe shortage, in some areas, and in others, a moderate shortage. Overall, the system is at about 58 per cent in terms of the cadre.
HEALTH SECTOR REVIEW
That cadre is somewhat outdated and that will be updated in a study now being undertaken by Drs. (Trevor) McCartney and (Denise Duncan) Goffe, to look at how we redesign the health sector, in not just personnel, but the delivery of care.
The other major challenge outside of financing and human resources that we face is what I would want to term the right sizing of the health sector. It's been faced by successive administrations, and it is a difficult political issue to face. Many of our hospitals were established years ago in response largely to where sugar factories were located. They were established at a time when communications in the country was very difficult, both by road and telephone. In today's Jamaica, is that a relevant model that we should still continue with? Should we consolidate and have the opportunity to better offer services from fewer facilities? Those are issues that will be determined during the course of the year as Dr. McCart-ney and his group complete their assessments and face us with some of the decisions that we have to take.
John Junor, minister of health
