EWMSC now under strain

As with the provision of universal secondary education under the UNC regime, this was a measure that, even if it was well-intentioned, had the political motive of being a good election campaign boast. But hasty implementation and lack of forethought seems to have created additional problems, while it is not clear that citizens have actually benefited.

A telling example was provided by Dr. Joshua Scipio, clinical director of the Dental Hospital, when he spoke to the Commission of Inquiry into Health Care last Thursday. According to Dr. Scipio, it takes eight months to get one package of amalgam, which has to be ordered from overseas. Presumably, this means that any patient who needs a filling must wait several months before getting it. Contrast this with the service at any private dental clinic in the country, where fillings can be put in at once. Dr. Scipio also said that the Dental Hospital had not received any teeth-cleaning equipment for two years and that much of the equipment it used was so old that replacement parts weren’t even available.

Now part of the reason for this state of affairs, it seems, is that the status of the Dental Hospital is indeterminate. Dr. Scipio himself didn’t know whether the institution he heads falls under UWI or the Regional Health Authority. The Commission was also told on Thursday that the EWMSC’s computer system had crashed six years ago and that the staff had been keeping medical records manually since then.

These problems existed before the directive to the EWMSC to offer free services, and should have been attended to prior to that. But that such relatively simple bureaucratic issues have been allowed to fester reflects the fundamental problem underlying this country’s health services. That problem is one of administration.

It cannot be argued that lack of money is the core reason for the parlous state of this country’s health services. But no government from 1956 onwards seems to have realised that some of that money should have been spent on expert administrators. Hospital administration is an extremely specialised field, and many of the problems being highlighted by the Commission would never have arisen if professional administrators were in place or if the political authorities took the advice of those administrators they do have.

Perhaps the core problem is that State-run institutions are almost mandated to be inefficient. Other countries have confronted this problem and dealt with it by contracting private sector organisations to run public institutions, such as hospitals. The RHAs were a half-hearted attempt to create such a system, but this clearly has not worked - and it has not worked at least partly because the RHA chairmen were often political appointees, thus undermining the whole point of the exercise.

If we are to really improve our health care, we need a new approach to the whole system. We doubt the Commission will make any findings that aren’t already known, but we hope that they can make some innovative recommendations.