Patients falling through safety net

H.K. was a sinewy, hard-working, 65-year-old carpenter/mason/general repairman, so I was shocked when he struggled to make the 20 or so steps from the waiting room into my office. He sat and tried to catch his breath after his short, slow walk.

Nostrils flared and arteries pounded visibly as engorged veins stood out against his straining neck muscles trying to assist in his respiratory efforts. It took several minutes before he could speak and his worried look betrayed the seriousness of his rapidly declining health.

The sole cardiologist at the Kingston Regional Hospital (known as KPH), was so unsupported and swamped that he was about to demit his post. I managed to beg him to do an 'emergency' cardiac ultrasound and it confirmed the diagnosis of a severely malfunctioning mitral (heart) valve. H.K. was urgently referred to the University Hospital of the West Indies (UHWI) but they, too, are perennially swamped, so he was put on a very long waiting list.

H.K. had lost his only son/protégé/financial helper and was unable to afford heart surgery privately. He died horribly, simply because he was poor and our health-care system is badly underfunded and, therefore, inefficient.

Long lists of patients

More recently, I saw 55-year-old H.G., who is out of work (like many others in this depressed economy) but came to me because he was experiencing chest discomfort and shortness of breath with relatively mild exertion. He was sent to UHWI for further management but, as usual, they remain overwhelmed with long lists of patients. So, although H.G. was seen in mid September 2010 and despite his very vital need for early life-saving investigation and care, he got an appointment for an 'urgent' mandatory diagnostic heart test at the end of February 2011.

Friends and family chipped in when we identified an affordable test and the suspicion of a 'high probability of significant coronary artery disease' was confirmed. Ironically, H.K. and H.G. happen to share the same first name. H.G. got a break with a fairly early tentative admission date but he needs to come up with $30,000 and pray for bed space or he may also share the same terrible fate with H.K.

In spite of our well-trained physicians, hard-working Ministry of Health and other health-service personnel, there are numerous other patients in similar dire straits who are suffering because of a lack of available diagnostic services, drugs and needed care opportunities. More people are accessing a system that has become less efficient because it is extremely underfunded and was never upgraded to support increased usage.

Underfunded health-care system

Overbooked services, overworked staff, non-existent or malfunctioning equipment, unavailable laboratory investigations, overburdened pharmacies and deficient public-health amenities leave many patients falling through the flimsy, torn and tattered health 'safety net' and an undetermined number are dying because of it.

As I pointed out in a previous article, ('Free health-care nightmare' published in The Gleaner November 30, 2009), public health services were always accessible to all that could not afford to pay. This administration threw away $1.7 billion annually when it instigated 'no-user-fee' health care for everyone (even those that can afford to pay something). In addition to no user fees, this administration promised significant upgrading of the existing public health-care system ... but that is now an impossible dream.

As it was prior to September 2007, people should be allowed to contribute whatever they can towards their own health care. Patients are suffering and dying because of our underfunded public-health system. The so-called safety net is not as safe as they want you to believe.

Garth A. Rattray is a medical doctor with a family practice who may be reached at garthrattray@gmail.com or columns@gleanerjm.com.