Overhaul looms for regional health authorities
Published:Tuesday | July 12, 2022 | 12:11 AM
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Health and Wellness Minister Dr Christopher Tufton has signalled that the time has come for the decades-old regional health authorities (RHAs) to be restructured, noting that Jamaica was too small to have almost semi-autonomous zones operating with...
Health and Wellness Minister Dr Christopher Tufton has signalled that the time has come for the decades-old regional health authorities (RHAs) to be restructured, noting that Jamaica was too small to have almost semi-autonomous zones operating with duplication of some services.
“It is something that we have to look at more deliberately going into the future as part of the financing arrangement,” Tufton said at a recent Gleaner Editors’ Forum at the newspaper’s North Street offices in Kingston.
The minister has appointed economist Dr Damien King to review healthcare financing in Jamaica.
As part of a health sector reform programme implemented from 1997 to 2003, RHAs were introduced to decentralise services from the parent ministry.
Tufton noted that the RHAs brought the healthcare providers and leaders closer to the people, as opposed to a top-down approach.
The RHAs were first developed in other jurisdictions, such as the United Kingdom (UK). The health minister said that the UK has evolved in terms of its regional configuration multiple times to improve its health services. However, Tufton said that Jamaica had not done anything to change its model.
He told The Gleaner that the ministry had asked the Pan American Health Organization (PAHO) to assess the structure of the RHAs to determine their effectiveness and propose necessary changes.
PAHO has since provided the ministry with a report. According to Tufton, the ministry had started to implement some of the recommendations of PAHO but it was stalled with the onset of COVID-19.
In its recommendations, PAHO suggested that the structure of the RHAs be reviewed to simplify organisational arrangements with a greater focus on health outcomes instead of financial and administrative outputs.
The international agency recommends that the Ministry of Health consider centralising some functions of the RHAs for efficiency, highlighting the procurement of health technologies, medical devices, and health supplies, maintenance of equipment, and infrastructure.
Further, PAHO has suggested that the ministry consider the outsourcing of certain ancillary general services such as laundry, cleaning, security, and food services. It added that “the optimal level of centralisation of some of those services (national, regional or at the facility level) should be evaluated”.
Additionally, PAHO is suggesting the development of policies and regulatory frameworks for intra- and inter-regional health resource management and sharing.
“The legal structure of the RHAs as they currently exist does not facilitate this integration,” the health agency said, noting that this is particularly noticeable in areas such as human resources, materials and supplies and transport services.