WRONG_WOEID WRONG_WOEID

National Health Policy Needed Now

National Health Policy Needed NowWe are celebrating our 29th anniversary of Independence, but one aspect of our national existence that is stuck in a bygone era is our health care system.

This has become part of our national reality and national shame, even though we brag about our high ranking on the UN's human development index, and how we have become the IT hub of the Caribbean, and how we have this wonderful state-of-the-art hospital on the hill top.

The truth is, Antigua & Barbuda has been blessed with enough resources that our health system can be a model for our Caribbean neighbours; but we have not come of age. We are locked in an archaic way of doing things. Like West Indies cricket, we have talented players but no consistent delivery.

We go to one of our lovely, and even clean, district clinics, but there is no doctor. So we go to the wonderful hospital on the hill to wait for a whole day before we see the doctor. What we are not realising is that the second problem stems directly from the first.


The glamorous battle may be on the hill top, but the war is won in the trenches. Hence, when we get our district health service properly organised, it will prevent a lot of the frustrations experienced by doctors, nurses, and patients at Mount St John's.

In developing a national health care policy, we first have to understand that it is a general integrative process. It  has several different aspects, all of which are important. It is an essential service; it has its economics; it is humanity; it is science and technology; and it has to be available to all.


This policy should not be controlled exclusively by any medical association, any hospital board, any political party, or any social group or person. The voices of every class of our society must be heard, because this affects all, and in some way we all pay for it.

We have to take into account the needs of the urban groups, rural groups, families, seniors, children, the chronically ill, the physically challenged, the mentally challenged, athletes, and those who are apparently healthy. Therefore, at every level, the reforms have to be made.

In other words, fixing the problem of health care will involve reforms in agriculture, business, insurance, workplace organisation and ergonomics, home and public building designs, emergency and disaster management, utility delivery, and the Medical Benefits Scheme and Social Security. By now, you get the picture - that every facet of our society will be affected. While being wise and thoughtful, we have to be bold.

So now for some specifics. In terms of our human resources, we have to find the way to get all trained personnel involved in the national effort. The foolish notion that homeopathic and naturopathic physicians should remain in the bush has to be quelled. They have to be as mainstream as conventional physicians. This will enable regulation of their practices; deepen and widen health delivery scope; open up insurance coverage for patients seeking their services; and hence give each patient more choices.

We have to stop denying our own culture and our own medical traditions that have worked for hundreds of years. Antiguans should be writing internationally recognised manuals on natural and plant medicine. Naturopathic physicians should have a more prominent place in our national health set up.

Likewise, the myth that the Cuban-trained general physicians are not qualified to work in this country has to be stamped out. Any general physician who studies in any medical school anywhere on this planet will have to be supervised by some doctor of superior status in the hospital where he works. This is not unique to Cuban-trained doctors.


Those who are preventing the Cuban-trained doctors from working are not only doing a great injustice to those doctors, but they are also robbing this country of its riches. These doctors represent some of the most brilliant young minds of this society, and we are losing the positive influence that they could have on other youths of Antigua & Barbuda.

Having myself studied in both the Cuban and University of the West Indies systems, I can testify to the merits and demerits of both systems. This denial of employment of Cuban-trained general physicians is nothing short of a travesty.

Touching on the Mount St John's Medical Centre, this enigma needs some deciphering. It is my impression that even the minister of health is not entirely sure as to the relationship between  the country's lone "public" general hospital and the government. There was also talk from the same minister about reopening Holberton as a diagnostic center.

The only conclusion I can make of all this is that at the administrative level, we are severely lacking. And this certainly does not imbue confidence in the people of this country, especially those who cannot access elective health care outside of this country.

Every day, we hear conflicting stories, even from those in authority, as to the level of public access to services at the hospital; who pays, who does not, what is paid for. Recently, certain user fees went up, while the list of tests not being done gets longer and longer. Also very disconcerting is the long wait for the results of certain tests. As a physician, I have firsthand accounts of consultants refusing to see patients referred by their personal physicians.

I am therefore calling on the  powers that be to start working without delay on the development of a national health care policy. No longer should the citizenry accept less than what this country can offer. It is high time for all the other elements of a good health care system be put in place so that each patient can experience the humanity element. If our government is serious about the development of its people, especially where health is concern, now is the time for action.

Dr Jerry Simon ( NSA Medical Surgical and Rehab Centre, This email address is being protected from spambots. You need JavaScript enabled to view it. , 462 0631).

Hits: 2282

21 Comments In This Article   

HEADER   

So right Dr. Simon

#21 Dr. SPOCK » 2010-11-08 12:15

The news on Observer today about MSJMC seems to bear with witness to what the doc wrote about. Did not the health authorities see this coming? Why is not this doctor in some advisory position?
0
0
+
−

Dr. SPOCK

car park

#20 Wham » 2010-11-02 08:02

When I look at the car park, I wonder if there was a better way that money could have been spent.
Let me guess, public library, upgrade some clinics, water system, roads, housing project.
Yes UPP go, waste money then tax the people. Great economic plan, Nobel prize for Cort, Lovell and Baldwin.
0
0
+
−

Wham

#19 alp to me bone » 2010-11-02 05:51

Dr. Simon - good article as usual. "Ask your Ministers how much money was spent in the last election campaign. Did any come from the national treasury ?" In response to your question, yes some came from the national treasury - just ask Bruce Goodwin. The same students who are having a problem and will have a problem when they graduate were transported via the national treasury to win the seat in Barbuda. This came straight from the xxxx's mouth.
0
0
+
−

alp to me bone

Proud of Our Healthcare Sofar part 4

#18 JR » 2010-11-01 15:10

Because as I said before, there are many interests at stake. A Doctor with a private practice should not as a result of this lose his income. On the other end doctors who opt to get in to the system should be rewarded for doing so. Which means they should be properly compensated. Why should a carpenter make more money than the person that will save my life? Implementation of a national healthcare is a daunting task but nevertheless one that has to be done sooner rather than later, cause we cannot as a respectful nation deny any person healthcare when they reach at the door of our hospital no matter the color or class or where they’re from. But the price tag will have to be paid in the end. So I’m not trying to put stumbling blocks in the road but these issues need to be highlighted. We already have a foundation to build on. We can do it gradually rather than all at once.
0
0
+
−

JR

Proud of Our Healthcare Sofar part 3

#17 JR » 2010-11-01 15:08

I must say I was very surprised by the medical system in Antigua when I was here on vacation in 1981 and my son age 3 had an accident. He was rushed to Holberton and was treated without questions asked. And when I inquired for the bill, because I was insure in my Home land, I was told there was none. I felt that was the weirdest thing that a underdeveloped country, as Antigua was grouped as, could provide free healthcare. Dr. Simon you made quite some good suggestions as to how we can fund it. We need not to reinvent wheels in Antigua. I always say look around, there are many systems that are running. Some have already passed the test of time. And I know what works abroad not necessary works in Antigua. But at least you do not need to start from scratch. You have worked and seen the Cuban system. What we need is a committee of all interest groups to sit and put a working paper together for the government. I even think we can get funding for that through the development assistant funds from Europe.
0
0
+
−

JR

Proud of Our Healthcare Sofar part 2

#16 JR » 2010-11-01 15:07

Clinton Foundation is given large donations to eradicate aids in the underdeveloped world and so are many numerous organizations. Somebody is getting rich of all of that. Follow the money. We in this age have also become less tolerant and less our brother or sister’s keeper. It’s all about self. Why should I pay for your family’s’ healthcare? Etc. It’s everyone for himself and God for us all. And to ease our conscience we will put a donation in the church basket when a special collection is held for someone that needs to go abroad for medical treatment. I really don’t know why we still call ourselves a SOCIETY. Not many things we do in the common interest. When the education levy was past we demonstrated and up to now many that don’t have children think it unfair that they have to pay this tax.
0
0
+
−

JR

Proud of Our Healthcare Sofar part 1

#15 JR » 2010-11-01 15:04

First of All Doc once more you provoke Antiguans not just to talk politics but about things that affects all of us rich or poor black or white. But as you will see not many people will contribute because it is not political. In any society healthcare is one if not the most important social delivery of a government. There are many interests that come in to play. We have seen in the USA how healthcare reform was the biggest stumbling block for many Presidents. And Obama is now feeling the wrath of the interest groups. And believe me if they win the elections that bill will be repealed. Even in communist Cuba it will sooner or later become a hot item. European countries have been able to find a marriage between all the different interest groups to work side by side. Although I can tell you not always happy. And the price tag to the public purse is very high. It seems that neither the Communist/Socialist nor the Democratic/Capitalis tic system has the answer. As the illnesses in the world are increasing so is healthcare. And somebody has to pay the bill.
0
0
+
−

JR

@ Socrates, Tenman, Morris, Uncommonsense, Prevention, Beauty et al.

#14 Dr. Simon » 2010-11-01 12:01

Thanks for the positive contributions you make with your blogs. I never write an article with the intention to attack any personalities, rather to discuss ideas to effect positive social changes.
I am glad to see you blog in that manner as well.
No one person in this country has all the answers, but I do believe that together we can make it a better place.
I just hope that our governmental system can come of age, soon enough, so positive ideas can be more readily converted into positive changes.
0
0
+
−

Dr. Simon

(3) I agree, New health Policy!

#13 Socrates » 2010-11-01 07:10

The funding aspect of it for these ideas are already covered in the millions taken from workers and not being utilized for research, and cure but for unethicals to use in the name of the people. Medical benefit funding has the financial capacity to do more than it is used for presently. Antigua and Barbuda needs significant health reformation creating new taxes will not be the solution, but using the Medical Benefit Resources to develop drugs search which will make Antigua exemplary in the region and the world over.

Later for more- Au revoir
0
0
+
−

Socrates

(2) I agree, New Health policy

#12 Socrates » 2010-11-01 07:00

The use of Physician Assistants and Nurse Practitioners might sound repulsive to many in the medical field, but the God-like syndrome is quickly dying in the medical field. Simply, because many physicians are being overworked, hence becoming more susceptible to grave errors. In making errors such physicians create a double dilemma for themselves in that they lose the public's trust and credibilityas well as obedience to the Hippocratic Oath of doing no harm.
The time has come for significant change to be initiated where the delivery of healthcare is concerned. Now is the time for centralization and automation of patient records. Now is the time for implementation IRB's committed doing local research indigenous to our particular localized situation in Antigua and the greater Caribbean
0
0
+
−

Socrates

(1) New Health Policy Sounds Good!

#11 Socrates » 2010-11-01 06:49

Again Dr. Simon you are bringing greatest insight to the table. You will recall not too long ago I wrote you a personal email thanking you for you candor as well as your insight. Here is my input:
In the new era of the new health Policy( no pon intended) it will be necessary to include the use of Physicians' Assistants, and Nurse practitioners as part of the medical team. This is necessary in order to meet the demands for medical professionals- while Nurse Practitioners as in some jurisdictions might be able to function independently, it is generally the practice to have Physician Assistants operate under the supervision of a registered physician. The latter can be easily accomplished by having senior medical Officers overseeing processes. I do agree with you that the battle is won in trenches- that is, medical professionals in the field will be able to identify and treat illnesses within short periods, than spending entire days at the Mountain top.
0
0
+
−

Socrates

#10 club med » 2010-11-01 05:50

do we still have a minister of health// cmo ? where are these people ?
0
0
+
−

club med

@ Dr. Simon

#9 Beauty » 2010-11-01 01:23

Very well said, I agree and thank you for this article, you have touched on all aspects of our health care system.

Very important are the functioning of primary health care system (district clinics), relationship of the lone public hospital (MSJMC), medical scheme (MBS). The politicians create all these and have no clue how all of these are to function and relate to each other. We need to either have one system or have all these systems relating so the entire system can function.

Our policy makers must show they are serious about health care and they would insist doctors are in the clinics, the hospital does not turn away people who cannot pay. Our tax money should be used for things like these, proper health care.

I also like that you speak of the naturopathic doctors, whether doctors or not, we have been using naturopathic methods from our grandparents and parents and they have worked.

Education seems to be ok, we need to get Health and Sports a proper policy. Doc you should do a part II to this article.
0
0
+
−

Beauty

Prevention and Cure

#8 tenman » 2010-11-01 01:12

Prevention and Cure, I also think one method to cut costs is to reward persons for doing the right thing. Incentives need to be given to persons to take care of their body. I believe that measures like this would help in lowering costs. I also recall the Medical Benefit judges stating that the current medical benefit contributions would be sufficient to cover full health care. The negative they pointed out was the lack of government contribution from its workers. However if they are wrong, that should not stop us from providing something that is needed ie increase the contributions if need be.


..
0
0
+
−

tenman

now we pay

#7 Prevention and Cure » 2010-11-01 00:39

How to pay for it? MBS contributions,existi ng tax revenue, private contributions from those who opt for more national health insurance, small co payments for services to prevent abuse
and if you need more cultivate revenue from the sales of medical grade cannabis for pharmaceutical use.
check Jamaica for data on that.

PREVENTION you don't have to treat what you don't have so staying healthy is key, PE and sports as well's some close attention to our aging population would serve as well. don't get fat and stay active that's how we save money on heath care.
0
0
+
−

Prevention and Cure

1 aks your minister of health abouth this.

#6 Prevention and Cure » 2010-11-01 00:37

First of Medical benefits must be transformed into a general health insurance.
first part of mandatory contribution on an index linked to income, gives you basic health care .prevention care , physicals and basic medical consultations as well as surgery and trauma. second part options above basic health care like extended dental vision , rehabilitation. wellness, some elective surgery and again preventative health.( you get what you pay for)

second.
Proper infrastructure and staffing of all district health clinic,s the should function as poly clinics and primary health care providers. heavy again on prevention. must include basic dental and vision and rehabilitation.

thi rd . attract specialist to MSJ on a rotation basis and set up strategic alliances wilt additional specialist who function locally in a private setting.
fourth.
Ful l integration of mental and social health (physically and or mental disabled) all patients are equal.

The key is to control cost and deliver a functional health care product.
0
0
+
−

Prevention and Cure

@ UncommomSense

#5 Dr. J Simon » 2010-11-01 00:36

In this country we tend to see barriers when it is convinient. It does not seem hard for non-Antiguans doctors and other health care workers to be empolyed in this country with all the befenificial perks of employment ( even non- Antiguan doctors who study in Cuba ). We do not seem to wonder where the money is going to come from to do projects that are politically expedient but socially useless.
But as soon as some meaningful social reform needs to take place,some one starts to sing " the where is the money going to come from chorus."
Ask your Ministers how much money was spent in the last election campaign. Did any come from the national treasury ? And if they have that great ability to attract private fund for a party's good,why not start attracting that fund for the country's good.
Trust me UncommonSense the answers to all your questions are already known. It just takes the political will to get it done.
0
0
+
−

Dr. J Simon

@ Tenman

#4 Morris » 2010-10-31 23:54

I agree with you.
0
0
+
−

Morris

Great Article Doc

#3 UncommonSense » 2010-10-31 23:32

Give me an example of how your proposed health policy will deliver health care services with higher efficiency and in a more cost effective manner. How will nurses and doctors, the best and the brightest be recruited? Would goverment and private care givers be working hand in hand and on what terms? Who will pay for what if you have benefical benefits? Help me with some more specifics though I value your general outline.
0
0
+
−

UncommonSense

as usueal

#2 tenman » 2010-10-31 22:50

As usual well said Dr. Simon. Persons fail to realize how essential health care reform is. I am told expenses related to health are the number 1 reasons why persons in the US end up going bankrupt (see "Study Links Medical Costs and Personal Bankruptcy", June 4, 2009, business week url: www.businessweek.com/bwdaily/dnflash/content/jun2009/db2009064_666715.htm. We need to stop this thing where persons are left to beg the the public or some government minister for moneys when there is a serious health issue. We had a Medical Benefit hearing, over eight years ago, that recommended that Medical Benefit be turned into a national insurance scheme, it is time we take this recommendation seriously.


..
0
0
+
−

tenman

Great article

#1 Morris » 2010-10-31 13:54

Great article Dr. Simon! I admire your passion for reform, but as long as our leaders are able to catch a flight out of Antigua to address their medical concerns in some other developed country like the US, they will continue to neglect their responsibility to improve our health care system. I do agree that it is indeed a disservice to deny those physicians who have studied in Cuba the same privileges to practice their skills as is granted to other physicians who have studied in different locations.
0
0
+
−

Morris

Add comment

Dr. Jerry Simon

Dr.Jerry Simon,a general physician, is a graduate of the University of the West Indies and Villa Clara (Cuba) Medical School. He has previously worked in Internal Medicine and Psychiatry. Presently he is Medical Director of the NSA Medical Surgical Rehab Centre and is a certified member of the American Society of Addiction Medicine.

Follow us on Facebook

Spotlight on Education

Previous Next
Govt to give Two Uniforms
Antigua St. John's - Minister of Education Dr Jacqui Quinn-Leandro has confirmed...  Read more

Latest Opinions by Dr.Jerry Simon

App

Android LogoDownload Caribarena's Android App Click To Download

Find us on Twitter!