They may not like it but they make use of it because it's free. That's the view of the average Jamaican about why they use public hospitals. In a Gleaner-commissioned poll conducted recently by Johnson Survey Research Ltd, Jamaicans continued to complain bitterly about the poor state of the health-care system, but a significant percentage say they continue to use it because of the no-user-fee policy.
Polling 1,200 men and women between ages 18 and 65 and over during the month of September, the survey sought to gauge Jamaicans' view of the health-care system and the improvements needed.
Twenty per cent said the main reason they felt Jamaicans had access to good-quality health care was because "health care is free to everyone", while 22 per cent said what they liked about the country's health-care system was "free health care, no user fees". Additionally, 10 per cent said they liked the idea that they could get treatment at public hospitals with or without money, and seven per cent said they welcomed the free, inexpensive medication.
But generally, a high percentage bemoaned the poor service; long wait times; appalling treatment from staff; terrible, outdated, filthy facilities; inadequate resources; and shortage of staff, medical supplies, equipment and medication as some of the critical issues they had with public health care.
Ever since the Government abolished user fees in public hospitals in 2008, it has been a contentious issue. Many have expressed the view that health care has got worse since the abolition, as the Government failed to implement the necessary systems to make up for the shortfall in revenue, which led to inadequate resources to deal with the increase in numbers that were now making use of the free service.
The strong belief has been that 'those who can pay, should pay' because free health care was not sustainable and only led to a more ineffective, inefficient system.
The survey revealed that although the no-user-fee policy led to increased use of public health services - particularly among the poor - the lack of funding resulted in poor service, overworked staff, lack of supplies, lack of proper equipment, among other things. Hence, although more persons were seeking health care, they were unable to get proper, quality health care.
"We have a lot more persons coming to the hospitals, a lot more persons wanting the free medication. More persons are just showing up for the least little thing that they wouldn't have come for, but because it is free they just come," public health nurse Karen McKenzie, who has worked at three of the island's hospitals in the last 17 years, told The Sunday Gleaner.
"When they stopped charging user fees, you would not believe the number of persons who started showing up. Way more than we used to see. But we never got more supplies to deal with it. We were still getting the same amount of supplies to take care of more people. The pharmacies didn't even start to get more medication. And this is what we have been complaining about. I'm not against persons getting free health care, but the Government must give us what we need to deal with the increase, and that must also include more nurses."