Tyrone Reid, Enterprise Reporter

The Cornwall Regional Hospital in Montego Bay, St. James where 75-year-old Vilma McLaughlin died after she was reportedly refused a drug until it was paid for. Her family has instructed their lawyer to begin legal proceedings against the institution. - Claudine Housen/Staff Photographer

A government-commissioned report on the performance of the health sector has revealed that several financially-strapped hospitals and clinics were breaking the law by overcharging their patients.

The comprehensive document, which was gleaned through the Access to Information Act, was captioned "Consultancy to evaluate the implementation of the Health Sector Improvement Programmes in Jamaica" and cost the government more than US$205,000 (approximately $12.5 million at the time the report was submitted).

Consultants from the Wall Street, New York-based DAH Consulting, Inc., who conducted the assessment, said in their report, which was submitted in January 2004, that the illegal act was done to improve the financial standing of the cash-strapped institutions.

"Some hospitals and clinics build their coffers by charging more than the gazetted amount for services rendered," the report said.

Illegal act

When contacted, the Ministry of Health admitted that some of its hospitals and clinics were overcharging patients. But despite acknowledging that this was an illegal act, the ministry said it was done "in the name of quality health care".

"A few institutions charged more than the gazetted amount in order to meet their obligations to provide quality health care for the Jamaican people," the ministry said in response to Gleaner queries.

Indications are that up to yesterday some institutions were still overcharging patients. An undercover visit to the Kingston Public Hospital (KPH) by a Gleaner reporter confirmed that the higher than gazetted user fees were still being charged. It was shortly after 2:30 p.m. While at the cashier's window in the Out-Patient section of the hospital a disgruntled customer was overheard quizzing the cashier about the increase in the price of his drugs. The cashier responded: "Étoo bad everyday drugs raise." The man then asked: "so a so much go pon it one time?"

Then it was The Gleaner reporter's time to ask what was the registration fee. The cashier said she was told by her supervisor to charge $350. She explained that $50 was a contribution towards "hospital improvement".

"We will say $350, if them itch we say alright give me $300 then," she said.

This $350 was in contravention of the stipulated $300, which was stated in a brochure provided by the Ministry of Health.

A man who had just paid $500 for some tablets told The Gleaner that he normally pays $200 to fill the same prescription at a health centre.

Additionally, a woman said that she paid $500 for the contraceptive injection, Depo-Provera. She pointed out that she paid less than $200 for the same dosage at a health centre.

Checks with the KPH's administrative offices revealed that at no time is the registration fee combined with the cost for prescription.

The brochure provided by the Ministry said that the actual cost per item for out-patients was up to $400 and a maximum of $500 where two or more items cost between $400 and $1,000.

A day after questions regarding the overcharging were sent to Permanent Secretary, Grace Allen-Young, the Ministry issued a release calling on health workers "to adhere to gazette fees for health services rendered".

To date no sanction or disciplinary action has been taken by the Ministry against the hospitals and clinics that charged more than the gazetted amounts.

The Ministry also said that it had sought and obtained an increase in user fees in January 2005, in part to discourage institutions from charging more than the gazetted amounts.

"This was a move designed to make the fees realistic and to discourage institutions from charging more than was gazetted," read the Ministry's response.

But the Consumer Affairs Commission (CAC) stated that the customers must be recompensed. "They need to be refunded, once it has been proven that they were overcharged, no doubt about it, people should be refunded," said Dolsie Allen, chief executive office at the CAC.

She encouraged persons with evidence of payment to visit the CAC offices for help in getting their money back.

But the Ministry said that reimbursing all the patients who were overcharged "would have been time consuming and impractical".

"If patients can produce their receipts the institutions would be prepared to waive their fees in the amount for their next visit or a visit of a family member," the Ministry said.

New user fees were introduced in January 2005 after remaining at the same since 1999 -

Call CAC at 926-1650-2