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The deck has been shuffled but the jokers remain

Published:Sunday | November 8, 2015 | 12:00 AMMichael Abrahams
Dr Michael Abrahams
Dr Kevin Harvey, permanent secretary in the Ministry of Health, and Dr Marion Bullock-DuCasse, chief medical officer, are under pressure to go in the wake of the damning health audit.

Following immense and unrelenting pressure from the Opposition, the media, the private sector, civil-society groups and the general public, embattled Minister of Health Dr Fenton Ferguson was relieved of his post, and reassigned to lead the Ministry of Labour and Social Security.
The extraction of the dentist from Health coincided with the release of the full results of the public-health audit that he and his technocrats had withheld from the public for more than two months. The documents revealed alarming systemic procedural breaches, shortages, infrastructural deficiencies and malfunctioning equipment, among other issues, placing the health of patients and staff at risk.
The findings of the audit were requested by the media as far back as September this year, under the Access to Information Act. After 30 days, the ministry asked for an extension, claiming that it was waiting for advice from the attorney general. After a further 30 days, the ministry communicated that it still had not received the requested advice.
During this interval, the crises resulting in the deaths of 19 newborns from bacterial infection outbreaks came to light. It was revealed at this time that the response of the ministry may have been delayed, and this, coupled with the nonchalant attitudes displayed by ministry hierarchy, and insensitive remarks by the minister himself, fuelled public outrage and discontentment.
After reading the results of the audit, one has to question not only the competence of the health minister, but also the chief medical officer, the permanent secretary, and others who have allowed the chaos in the public-health sector to happen under their watch.
One is also led to question the integrity of the leaders of the regional health authorities who, last week, wrote a joint letter defending the minister, stating concern about the "insensitive" manner in which the matter was being dealt with in the public domain, and claiming that, regarding public health care in Jamaica, “it is highly irresponsible for elements and agendas to try to undermine this excellent service delivery, which has made us the envy of the world".
Perusal of the health audit leads one to wonder which world they are referring to. The litany of woes exposing the horrid state of our public-health system makes it difficult for anyone with a functioning and rational brain to trust the former minister of health and his advisers, and the bosses in the regional health authorities.
Labourites have been pressuring the Government over the ineptitude of the minister and his team, as they should, and have been very effective in doing so. But the Jamaica Labour Party has to shoulder some of the responsibility for what has transpired over the years, as it was they who removed user fees in 2008. This system is unsustainable, and they should have known this.

But the bulk of the blame must lie with the present administration. As the audit revealed, insufficient resources have significantly contributed to the dismal state of our public-health system, and this Government has had ample time to address the issue, even by instituting minimal user fees. We are a poor country, trillions of dollars in debt, and affected by violence (e.g., stab and gunshot wounds, fractures, head injuries) that contributes significantly to emergency-room visits, hospital admissions, and the use of operating theatres, which alone places a significant burden on the public-health sector.
What is also unfortunate is that the Government still does not get it. Removing Ferguson from his post was a good move, but sending him to lead another ministry smacks of stubborn adherence to party politics, and rewards incompetence.
To be fair to Dr Ferguson, sections of the media have sensationalised the latest debacle, and the opposition has partially politicised it. But it is a fact that during his tenure as minister of health, he had demonstrated poor leadership skills that he is likely to carry with him to any ministry that he is asked to head.
Also, he may have left the ministry, but what of the technocrats who have been advising him? Why do they still have their jobs? For example, in May 2012, more than two years before the chikungunya outbreak in Jamaica, 15 representatives from our country attended a meeting at The Jamaica Pegasus for three days, along with persons from 21 other countries, to discuss chikungunya. Most of the Jamaican attendees were employed by the Ministry of Health. But despite this, the country was grossly unprepared for the onslaught, which resulted in several deaths and disabilities, and dealt a significant blow to our economy.
And if the endorsement of Dr Ferguson, and praise of our public-health system, by the regional health authority bosses early last week seemed strange, their remarks in light of the revelations of the audit become even more outlandish, irresponsible and dishonest. Why are they still in their positions?
The audit report has made it clear that the free health care, in its present form, in Jamaica today, is unrealistic and impractical and places the populace at risk. The public-health system is severely cash strapped. If both political parties truly care about our country, they will admit this, and commit to addressing this issue by pledging to reinstitute user fees, at least for those who can afford it, should they win the next election. But do they really care?

-Michael Abrahams is a gynaecologist and obstetrician, comedian and poet. Email feedback to and, or tweet @mikeyabrahams.