Xinyu Addae-Lee | We are all frustrated – public health dilemma

The Gleaner recently published an article ‘Tufton: Health sector not giving value for money’, in which Health Minister Christopher Tufton was quoted saying, “We have a situation where we are less than efficient in our administration of service delivery, … management is failing to put the necessary arrangements in place …What it means is that we run a risk of not realising the benefits of the sacrifices of the taxpayer … to fix a system without the commensurate benefits of that system providing for them.”

The minister said he was ‘bawling out’ – seemingly frustrated, demotivated, stressed and worn out as he struggles to get the healthcare system off life support, and the organs within it fail to work together to heal itself. His statement was raw and revealing. It showed a weakness and a failure on his part, because as he called out managers and leaders, he failed to recognise that he is the chief manager and leader, he is the one appointed to make the hard decisions, to excise the rotting and infected areas, to apply a tourniquet to the haemorrhaging vessels and to supply effective treatment for salvageable units. This failure he is pointing out, is his.

Most are outraged by his statement but as I processed it, there was less outrage and more empathy for the minister of health. He exposed the humanness that exists in any leader that remains engaged. His frustration is a sign of an individual that is not calloused by the monumental issues he faces and has not checked out. He has personally experienced our system during his admission at one of our top hospitals, he has been visiting each facility, taking each complaint, experiencing every discomfort and, it seems, inadvertently found himself overwhelmed with the insurmountable problems that have come together to break healthcare in Jamaica. As commendable as this is, the minister of health should step back into the role he has been given, one that calls for fearless action, not complaints. The fact is, if not him, then who? As a realistic optimist, let’s not go down the road of desolation and despair, instead examine and encourage. Something can be done!

EXAMPLES

Let us take examples from the article.

1) “A recent report he got from the Savanna-la-Mar Public General Hospital in Westmoreland, where a brand new air conditioning unit that was installed at the facility last year is currently not working.”

Such a failure could stem from inadequate maintenance plans, substandard equipment, or lapses in quality control by those responsible for procurement and installation. It is essential to hold accountable those tasked with maintaining this equipment. Additionally, maintenance contracts should include regular, verifiable inspections, with penalties for contractors who fail to meet these standards. A proactive approach to maintenance would help prevent repeated failures and unnecessary costs.

Launch a thorough investigation into the failure is essential for pinpointing the root causes and preventing future issues. This investigation should seek to answer key questions: Was the equipment up to standard? Were proper maintenance schedules and protocols established and followed? Were there oversights in quality control or contractor accountability? We must seek to identify each issue, we must place them at the feet of those responsible, we must demand an acknowledgement of this failure and a resolution to prevent any further failures. That is what accountability is, and we must have it. We cannot continue without it.

2) “I am feeling let down by a process that is supposed to deliver more for the people.”

We have all indeed been let down by this process. Let this be a call to action for a thorough review and restructuring of the processes, policies, and mechanisms meant to support healthcare delivery. Implement more effective checks and balances, establishing clear goals, and empowering frontline workers and patients to report inefficiencies. This honest acknowledgement from the minister could be a pivotal moment for Jamaica. This may be an exceedingly optimistic statement to make, but I consciously make it. I believe that frustration can fuel the energy, the drive, the determination and the no excuses attitude that is needed to re-evaluate and reinforce one’s commitment to a healthcare system that truly serves its citizens.

Whenever there is any radical change, we must expect growing pains as there will be a fight to remain the same. But one must not be dejected or afraid. There needs to be a resolve to shake off those that fight and to double down with those that support this change. When those at the helm express disappointment in the system’s capacity to meet public needs, it underscores the urgency for reform, for something new, effective and powerful to drive our health system out of its coma and bring it back to life.

3) “… management is failing to put the necessary arrangements in place … or those who management have engaged are failing to deliver on the repairs and the maintenance that is necessary.”

Addressing systemic failures in Jamaica’s healthcare system requires not only acknowledging shortcomings but also holding individuals and organisations accountable. When Tufton points to failures in management and delivery, he must then scrutinise and, where necessary, penalise those responsible for not meeting their obligations. Accountability is critical; without it, mismanagement and neglect will continue to undermine patient care, damage public trust, and demoralise healthcare workers who are forced to operate under inadequate conditions.

Penalising those responsible for these failures – whether through fines, contract terminations, or administrative sanctions – would send a strong message that the healthcare system cannot afford inefficiency and neglect. This approach would not only set a precedent but also encourage contractors, facility managers, and all stakeholders to take their roles seriously, ensuring that resources are used responsibly and that facilities meet safety and quality standards.

The question remains, can we handle it? The readiness of those in administration to embrace this level of accountability is crucial to the overall success of reforming our healthcare system. A shift toward stringent accountability will require a cultural change within administrative ranks, demanding that managers and decision-makers accept responsibility for their roles in maintaining facility standards, ensuring timely maintenance, and upholding service quality. Without administrators who are prepared to be answerable for their decisions and actions, any attempts at reform will be superficial at best. It’s time for those in administration to demonstrate that they are ready to lead by example, to hold themselves to a standard of excellence and to serve Jamaica’s healthcare system uncompromisingly.

Dr. Xinyu Addae-Lee is a medical doctor and attorney-at-law. Send feedback to services@jaxinja.com and columns@gleanerjm.com