Perhaps Mr. Horace Dalley, the Health Minister, may not have noticed it and would perhaps consider the matter far removed from the wider debate on corruption in Jamaica.

And that is substantially part of the problem - the narrowness of the discourse and the fact that we only appear to be offended, if at all, when the hands are caught deep in the cookie jar.

So, there was this report on the front page of this newspaper on November 8, about a consulting company's report which highlighted the fact that Jamaican state-run hospitals and clinics routinely overcharged their patients. That is to say, people are asked to pay more for the services they receive than the prices officially set by the Government.

Indeed, reporters from this newspaper observed, firsthand, such behaviour at the Kingston Public Hospital. Out-patients were being charged registration fees 17 per cent higher than the gazetted amount.

What was clear in this episode, is that it was deliberate, calculated behaviour, which, we can assume, was being perpetrated on the public with the connivance of hospital officials. For workers would waive the additional and illegal hike when it was seriously challenged by people who insisted they could pay no more. They, however, made it sound as though they were doing a favour for the patient rather than fulfilling an obligation and operating within the law.

Cashiers, apparently on the instruction of their bosses, defended the extra charge as a 'contribution to hospital improvement.'

That was precisely the tone adopted by the Health Ministry in its own response to the illegality. It claimed that a "a few institutions" overcharged "in order to meet their obligations to provide quality health care for the Jamaican people."

In other words, it cost more than the formally gazetted price to deliver decent service at hospital and clinics, so patients are asked to help make up the difference. And the administration sees nothing immoral in the action. There is no sense that by its behaviour it is building institutions on foundations of lies.

We do not question that it costs more to deliver health services than people are asked to pay - even at the higher prices. We are aware, too, of the competing priorities for the tax dollar, which limits the allocation to the health sector.

What we are concerned about is that people are in barefaced fashion lied to. Which is essentially what happens when one cost is placed in brochures and people are charged another at hospitals.

Administrators and politicians believe, we suspect, that they are being smart by slipping higher costs via the back door, rather than telling the truth upfront. But that, to us, is corrupt behaviour which seeps right through the process of governance.

It is not enough, having been caught out in the corruption to sanctimoniously ask institutions to rollback costs, when, if the central authority was doing its job in the first place, it would have been aware of the practice of over-charging. We believe they knew.

When the state's central governmental authorities countenance such corruption, it is natural that it mushrooms throughout the system and morphs into problems far worse than what happens at KPH. Which is what is captured by organisations such as Transparency International.

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