Gordon Robinson | Brain haemorrhoid

Now that the day of decision has been set I can remind voters the most important issue in this election is Constitutional Reform.

I know. The standard response will be “Wha’ dat?” In my not-so-humble opinion, that reply is the most significant indicator of governments’ mismanagement of Jamaica’s affairs. For 63 years, there are some incontrovertible facts which political puffery cannot obfuscate:

1. Jamaica’s average annual growth rate since 1962 is 1.6 per cent. It was 4.3 per cent from 1963-1972 which exposes Governments’ abysmal performance over 53 years. Average global growth rate since 1962 is 3.1 per cent;

2. Education outcomes have fallen dramatically. GCE pass rates, over 70 per cent in the 1960s, are now (CXC) less than 40 per cent. If you isolate secondary students passing five subjects including mathematics and English the results are more depressing;

3. Despite life expectancy (from 64 to 75; 69 in 2021) on the rise and infant mortality (5.7 per cent to 1.1 per cent) on the decline, healthcare management and delivery, which needed marked improvement, has steadily deteriorated According to the latest PAHO/WHO assessment “Traditionally, management of equipment and technology has been an area of weakness within MOH. Lack of financial resources; trained technical personnel; parts and equipment for repairs; and management are the leading problems.”

70 per cent of deaths in Jamaica are caused by Non-communicable diseases (cancer; diabetes; heart and lung disease). Maternal mortality increased by 19.1 per cent since 2000. Primary healthcare is essential in addressing these issues.

Health Ministry published a document called Primary Healthcare Reform for Jamaica 2021-2030. It addressed (oops, sorry, promised), inter alia, upgrading of infrastructure; adequately staffed and resourced facilities.

A recent(ish) PAHO report began:

“It’s 8 a.m. and a long line has formed outside the St Ann Bay health centre. A large group huddles against the wall to catch the fast disappearing shade. Everyone has something in common. They all have diabetes. We know this because it’s Wednesday, one of only two days per month that doctors are available to see clients with diabetes….”

PAHO continued:

“Health centres face multiple challenges such as a lack of personnel, inadequate infrastructure, and outdated information systems which have led to reduced quality of care especially for those with chronic conditions.….”

In 2021, public spending on health accounted for 7.19 per cent of GDP. In 2025 MOH says it’s “above 6.0 per cent” but “sustainability is not guaranteed”. Jamaica has 318 clinics. Latest numbers (2020) are 2,400 doctors, 5,100 nurses/midwives (“AI-overview” says only 3,890 are nurses). Since 2020, many have bolted for better opportunities leaving Jamaica with less than one nurse per 1,000 residents.

So what do these irrefutable facts tell us after 63 years?

We need change. Let’s stop calling it constitutional reform so we can stop hearing “Wha’ dat?” After a post-colonial hangover passed, Governments failed miserably for five decades. All we’ve done about it is “vote dem out!” By now it should be obvious that we need fundamental governance (not government) change. According to Haemorrhoid, who told a story about politicians making choices to convince the Dunce to be patient before cutting his own double, sometimes political leaders need your instruction:

The President, the First Lady, a boy scout and a pilot are on a plane.

Suddenly, a bird gets stuck in one of the engines causing it to burst into flames. The pilot tells the passengers the plane will crash but there are only three parachutes on the plane.

The President grabs one and says, “I’m the most important man in the country! The people need me!” and quickly jumps out of the plane.

The First Lady grabs another and says, “How will the president be able to manage his children without his wife?” and also jumps out of the plane.

Only boy scout and pilot are left. The pilot says, “You should go. You have more of your life ahead of you than I. Go on. Change the world.”

The boy scout says “We can both go. There are two parachutes left!”

“How is that possible? There were only three parachutes!”

“The President took my backpack. C’mon, let’s go now!”

After rolling on the floor guffawing, Haemorrhoid advised the Dunce not to be like politicians who tended to suffer from a particular type of brain bleed known to medical science as brain haemorrhoid. Trust me: politicians aren’t going to change the world. They can’t. In any event they don’t want change. So you should take a parachute; jump from the defective governance plane flying since 1962; and make the change. Insist candidates stop promising handouts while perpetuating a corrupt, autocratic governance system. Insist they start detailing a proposed new system. A Monarch by any other name will smell as tyrannical

If we keep doing what we’ve been doing for 63 years, while changing only the shirt colour worn by those leading the doing, we’re headed for the asylum.

Peace and Love.

Gordon Robinson is an attorney-at-law. Send feedback to columns@gleanerjm.com