Partnership to help improve tertiary health care

Jun 21, 2010 News

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– says President Jagdeo

Although there remains a strong will, the quantum of resources spent in the local health sector is simply not adequate. This declaration was made recently by President Bharrat Jagdeo even as he addressed a gala affair to mark the opening of the Eighth Caribbean College of Surgeons Conference here in Guyana.
According to the President, the system is currently far from perfect and reflects the fact that health care has a limited allocation despite the untiring efforts to improve services. And in order to address this dilemma, he revealed that measures have been engaged to move towards universal primary health care. “We have made it clear that we cannot afford tertiary health…We can’t afford it in the public system. So what we have done with a number of groups and people from abroad, like the Caribbean Heart Institute, which is now here, is that the state bought some of the equipment at CHI and in exchange for that there is a reduced fee because it is a partnership.” Through such partnerships, the President revealed that patients are allowed to pay a reduced fee when they access the services, adding that a similar undertaking in the area of cancer care and dialysis is currently being embraced by Government.
“The state partnering with the Private Sector is to deliver tertiary care, and the state’s input, because it is a subsidy, hopefully, we will bring the cost down so that it becomes affordable.” According to him, affordability of service will soon become a major issue across the Region and not just in Guyana. “Frankly speaking, I see our dynamics moving in the right direction but you have heard us argued for debt relief for middle income countries and the rest of the Caribbean countries…without debt relief for the OECS countries, mainly for Jamaica, then there would be practically no viable medium-term economic strategy.”
It is the belief of the President that debt is “sucking the energy and life out of those countries”, a situation that he anticipates will only become worse because a lot of the countries borrow on commercial terms. The President asserted that since surgeons and doctors have to work in such an environment, they can in no way divorce themselves from the reality of the situation in which they work. He further underscored that there are going to be major challenges that will arise with the economic situation in any of the countries. “I am speaking not just about the short term problems because there are short term fears now that there will be a double-dipper recession – those will be overcome, but I am telling you about long term underlying structural problems within our economies that will see more and more money going towards sustainability issues; servicing debts rather than to social services. So you will have to confront that situation.”
In addition, he revealed that there is another looming challenge which many countries of the Region have not even factored into their respective planning process. This state of affairs, he revealed is a looming disaster associated with climate change.
“Although we can’t fix climate change, because we are in terms of global green house gas emission, negligible emitters, we have to advocate for binding global agreements that are fair and that would help to mitigate this situation. We will have to get enough funding for adaptation and mitigation purposes so that we can deal with some of the consequences of climate change.”
The consequences, according to the President, are going to come in the form of the way of life, a development which has already begun to materialise. According to President Jagdeo, the crops that we grow, “we are not going to be able to grow them; a single weather related event, and they are becoming more frequent, could wipe out the equivalent of 80 percent of Gross Domestic Product… Now that is catastrophic, that is systemic and it is not like the limited impact like Katrina in the US where it affected one state.”
In fact, he speculated that the hurricanes are going to occur with more frequency. The President theorised that even diseases will change even as climate becomes warmer; the presence of different sorts of vectors will arise and it will become a challenge to medicine.
According to the President, it has been estimated that the cost of adaptation in Guyana alone just to raise the sea defences, given the fact that the entire coast here is below sea level, and to fix the conservancies to have better flood control and water management, is close to one billion dollars. For this reason, he said that Guyana has been able to work out a deal with Norway. “Because we have something to trade, we are trading our ecosystem services from our vast forest and we will earn $250M over the next five years, which could go up to about US$400M a year if our carbon market gets going.”
However, he noted that many Caribbean countries do not have that possibility as they will be stuck with huge cost of adaption and they have not even factored that into their planning process as yet.
As such, he noted that this could become another huge challenge that will demand money coming from a limited purse that has a narrow base. And this base, he said, will become even narrower in many countries because of the practical white-out of the financial services sector. This, he said, will be coupled by the changes in the European Union to the preferential regimes, thus many sectors are being eliminated without countries even knowing what to replace them with, as in the case of the sugar industry in most of the Caribbean. “I don’t want to paint too bleak a picture of the policy environment or the economic environment within which you will have to work and because you have to find paying clients to survive, it will become harder and public investments in health are going to suffer because of these demands.”
“We have looked at our unique challenges here in Guyana and we are looking at ways to confront these challenges.”
Apart from the issue of having small health huts in every village in remote areas, and having medical workers, efforts have been engaged to bring a dedicated fibre optic cable from Brazil, which will be here with funding from Government. Another cable will also arrive soon through the efforts of the Guyana Telephone and Telegraph Company. But according to the President, “our fibre optic cable will have enough bandwidth for us to do a number of things including e-Security, e-governance and most important e-health care. So with probably small units, in one of the villages with enough bandwidth, we will be able to perhaps have doctors sitting in Georgetown who will be able to give advice and see patients. Maybe tele-medicine might become a more important part of our arsenal in terms of delivering better health care to our people.”
However, he noted that this move is not likely to be easy to bring into being, adding that the government is currently working towards ensuring that “our health care expenditure keeps going up. Many times I argue we don’t get value for money too so it is not just about spending more money but also getting value for money,” the President asserted.

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