Hylton Dennis | Pay attention, Minister Tufton

What the Health Minister Christopher Tufton is presiding over is a humanitarian crisis in the public-health sector that has been worsening for decades.

My keen observation has never detected greater presence of patients referred to as social cases than the very seriously sick ones who are just too many for the neglected infrastructure of the public-health system.

Over the years, I have had dialogue with supervising doctors and senior ward nurses in major public hospitals where I repeatedly witnessed reckless discharge of very sick patients by what seemed like a process of raffling lives. Patients requiring long-term care to full recovery have been targeted. This included those in a coma, others who suffered a major stroke, and some with chronic respiratory infections.

In 2008, or thereabout, I threatened then head of the Department of Psychiatry at the University Hospital of the West Indies, Dr Winston De La Haye, that I would get a court injunction to block the early discharge of a patient in Ward 21, the psychiatry ward. My historical knowledge was that this patient, who I had witnessed being admitted and discharged from that facility from the 1970s, always attained complete recovery prior to discharge.

The patient, a retired man, much loved and highly respected as an exemplary Christian and teacher who spent 42 years in the profession, had also become the private patient of Dr De la Haye, who had also later ascended to leadership in the Ministry of Health. The conditions of his release were that he should be discharged to family; he should never resume living independently at his own residence; he should take his medication; and he should keep his appointments with Dr De La Haye to complete his recovery.

Everyone familiar with his history knew he would go into total relapse if released early since the stress that usually caused his breakdown would increase as he tried to comply with the restrictive terms of his release. He was expectedly very strong-willed and often not compliant.

He left the family home in Kingston to ensure that a residence he owned in St Elizabeth was included in a titling programme then under way. Though succeeding with that, he had a breakdown, wandered off through the woods from the south to the north of the parish, and was brutally beaten by some savages in different towns he passed through as he sought places to lay his head at nightfall, having by then been reported missing. He would eventually die from sepsis in Black River Hospital before his transfer to Kingston for more appropriate medical care. Ironically, this was because they delayed releasing him urgently.

LIFE SIGNS RESTORED

A furniture maker of Spanish Town got electrocuted at work, arriving “dead” at the hospital there. Life signs were restored by electric shock. I had him transferred to Intensive Care at the University Hospital of the West Indies. Three months later, he was on the regular ward and soon after, the supervising doctor wanted him discharged to a nursing home that could tube-feed him. With none found, improvisation at home with a full-time nurse and visiting doctor was substituted. He was still discharged and died after seven months in coma.

Cornwall Regional Hospital work costing billions is endless. It isn’t solving the bad air quality that triggered it. The money could build a new hospital.

Except for replacements in Falmouth and Mandeville, a new public hospital has not been built from the sixties. A few, like May Pen and recently, Chapelton, were renovated at inflated costs.

Portmore has none though qualified now by size to be a parish. There are thriving private medical centres where patients of Spanish Town Hospital have go and pay for expensive diagnostics tests that not provided at the hospital. This escapes scrutiny of the national corruption watchdogs like the Integrity Commission while the poor and pensioners are the most affected.

Adequate public financial resources are available to address this using the Ministry of Finance model to address financial accountability, procurement, and treasury management in the public sector, supplemented by social and public-private partnerships, consolidation, and amalgamation.

A bequest by a single wealthy family, Thwaites, built the private Tony Thwaites Wing of the University Hospital of the West Indies. The medical staff are the same ones serving next to it in the public facility connected to the University of the West Indies.

PALTRY WAGE

Majority workers in Jamaica earn the paltry minimum wage or marginally higher. Most cannot qualify alone for a National Housing Trust mortgage. Joining up, even with family, is risky. NHT contributions are involuntary. Only no-interest refunds at intervals of several years are received by most contributors. Their money is borrowed without benefit for the convenience of the high-income apex of the labour force, and more recently, of predators that include government and private-housing developers.

The National Housing Trust must be compelled to finance a National Endowment Commission for Health and Retirement (NECHR), amalgamating the National Health Fund, the National Council for Senior Citizens, the Golden Age Home, National Health Insurance Administration (US Medicare/Medicaid/Obamacare model), and Jamaica Drugs for the Elderly Programme. The commission’s main mandate will be weaning the health system off the capital of the Government by partnership with JSE/Social Stock Exchange, capital market players, financial institutions, multilaterals, charities, and developers to build hospitals, nursing homes, and retirement communities to be privately managed.

Global populations are ageing. Jamaica has seven its Vision 2030, targets to reach to be “The ideal place to live, work, raise a family and retire”. The deliverables are 500 pages long. Quick grasping of the value of my proposals and their implementation will recover the lost momentum to meet the target.

Regional health authorities must be scrapped. Grow corporate-model cultures with attractive careers and family work environments across the health system.

Develop curricula for doctors, nurses, and allied professionals under the NECHR to match manpower goals and priorities.

Match health system pay scales to the private sector by making hospitals and facilities executive agencies with supplementary health-tourism capacities.

Essential staff of medical institutions, care facilities, and retirement communities should live or stay on property.

These reforms should provide incentive to entrepreneurs across Jamaica to return to investing in industries that provide supplies and services for the health system.

The migration of doctors, nurses, medical technicians, and other critical health workers should reduce significantly, with more foreign nationals seeking to work in Jamaica’s health sector.

Whoever considers this a pipe dream is a toxic pipe smoker. Naysayers are a dime a dozen in Jamaica because of the political culture of samfie, the seeds of which were sown during the pursuit of self- government now called independence. This must be uprooted and a new culture of confidence and trust sown.

I believe the Minister of Health and Wellness, Chris Tufton, has the attention span to stay up and study my advice, and afterwards, to take it and make it a paradigm-changing reality or renaissance.

Minister Tufton is not a narcissist. He is not blinded by conceit or flattered by his own deceit. Therefore, I am not merely hopeful but confident that this is going to be the basis of a game-changing dialogue and action plan.

Members of the public, the media, the business community, academia, and the diaspora must encourage this in the national interest.

Let’s build a new Jamaica by making a healthy, socially secure population its centrepiece.

All things are truly possible if we just believe.

- Hylton Dennis is a publisher and a former vice-president of the Press Association of Jamaica. Send feedback to columns@gleanerjm.com and denscriptions@yahoo.com.