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Controversy Over Hospital Privatization

Image of Prime Minister Allen Chastanet

CONTROVERSY is brewing between the main opposition St. Lucia Labour Party (SLP) and the Government of St. Lucia over which one of them first mooted the privatization of hospitals in St. Lucia, particularly the Owen King European Union (OKEU) Hospital.

Prime Minister Allen Chastanet this week told reporters that his administration is favouring privatization, and so too was the opposition.

Image of Prime Minister Allen Chastanet
Prime Minister Allen Chastanet

“We’ve made that point clear…that (we) would prefer to go into a private structure.

St. Jude is privatised and so is Tapion. In fact even the former Government also agreed to that,” Chastanet said.

But the SLP was quick to denounce the Prime Minister’s comments of its involvement in the privatization aspect of the hospital.

“It is convinced that there are no limitations to the Prime Minister’s disregard for the truth,” noted the SLP.

Image of SLP Political Leader, Philip J. Pierre
SLP Political Leader, Philip J. Pierre

The release from the SLP claimed that “this untruth can easily be debunked”. It went on to cite the Millenium Heights Medical Complex Act that was passed in the House of Parliament in 2015 which read that the aforementioned was “An Act to establish the Millenium Heights Medical Complex and provide for the establishment of the medical complex and for related matters.”

The party promised to issue a full statement on the matter at a subsequent press conference, however prior to press time yesterday, claimed that it was reliably informed that the Government of Saint Lucia is on the verge of signing an agreement with a foreign entity to privatize the OKEU Hospital.

“The Opposition urges the government not to pursue such a policy without the widest possible consultation with all parties including the doctors, nurses and other health-care workers. Privatizing health services can come at a huge price to the people of Saint Lucia particularly the lower income earners and the poor of the country,” noted the SLP release.

Political leader Philip J. Pierre urged the Prime Minister to enter into serious dialogue and consultation before making any undertaking to any foreign or local entity that will lead to privatization of health services in the island.

The government’s decision to go along with privatization of the island’s premier health facility came as a surprise since Health and Wellness Minister Mary Isaac, last September stated that “Right now we do not envisage any privatization of our national hospital”

She stated that government was still accepting people who wanted to bring proposals in, in terms of coming in as a partner. The Senator reemphasized that “that will not cause the hospital to be privatized.”

17 Comments

  1. Both parties are glad to have this fake controversy. It’s the same crooked game being played all over again!

    The real debate is why no-one is talking about a referendum to find out what citizens want and need!

    In a real democracy, the citizens/voters are the masters, and government officials are paid to be stewards of the citizens’ common resources; and to do the will of the people. When will St. Lucians open their eyes to the fact that they are being played by both parties, which consist of professional con artists and liars, who are only out to use their positions for their selfish gains?

    Here’s what privatization entails:

    A private corporation comes in and gets the franchise for one purpose only – to make as huge a profit as they will be allowed; because a government official or officials will get kick-backs for granting the corporation the opportunity to make their target profits, plus enough over the top to pay government officials off.

    1. Nudge, you hit the nail squarely on the head: “…being played by both parties…”

      Both parties are headed by smart persons with a sound grounding in the foundations of the private sector.

      MBA101: ‘The one mission of a business is to grow shareholder value’.

      This is not said in a judgmental way. It is a simple fact of life. It is also why thee are certain roles for government.

      While there may be room for so-called two-tiered health care, there also remains a moral and social imperative for government involvement in establishing a social safety net and establishing a so-called ‘floor’ that facilitates responsible, effective, and timely health care for all.

      That investment would result in economic benefits to St. Lucia’s social fabric. otherwise stated, a healthy population is a productive and functional population.

      Also, one should not lose sight of the fact that many of those who are 60+ and aren’t blessed with wealth were the trail-blazers that ‘worked the fields’ and helped get us to where we are today. On the other end of the demographic spectrum, it is in the national interest to establish a ‘floor’ of basic health care and education for our children — they are this nation’s future, and we have a very solid history in our educated children accomplishing fantastic things both in St. Lucia and abroad in widely assorted fields.

      God bless.

  2. Here’s one question that should be asked in the referendum:

    Citizens of St. Lucia, how do you feel if a private company, and the government officials you vote for, profit from your misfortune to be in an accident or to become ill?

  3. HUMANISM ought to be analogous to a spinal cord that informs our socio-economic policies.
    A small island nation as St.Lucia, needs humanism centered fiscal regimens in order to stimulate SYNERGY and SUSTAINABILITY across its limited resources.

  4. This comment is a test to ascertain whether the Voice has shut down additional comments about this article; or whether St. Lucians are just ultra-apathetic about the real impact on their lives, consequent to any decisions a sitting government makes – that those citizens who actually vote care only for the temporary satisfaction brought on by a half-filled stomach of “chicken-and-rum” as exchange for giving up their collective power, each 5-year period, to a bunch of crooks and liars!

  5. Here’s one reason why the crooks and liars you cede your power to every 5 years, for some “chicken-and rum”, will never act in your interest:

    Copy the phrase – A Timeline of CIA Atrocities.Global Research – into your favourite search engine, and read the article.

    Hopefully, it will not drive you to be even more apathetic toward the actions of your very own “crooks and liars” in St. Lucia.

  6. How does the US prosecute its global war of terror and extort obeisance to its program for controlling the world’s resources to enrich the oligarchs who control its military & government?

    Copy the phrase – The Worldwide Network of US Military Bases.Global Research – into your favourite search engine to find the article.

    Political parties control St. Lucia in much the same way; except on a much smaller scale, given St. Lucia’s size (think big fish in a little pond): Island-wide police force to keep in check criminal competition from individual citizens, while sanctioned criminality by their hoods goes unpunished.

  7. This idiot chastanet is a fool or what? Or is deliberately trying to mislead people as is his usual style? The question raised by the opposition is not whether or not privatizing the hospital is a good thing. It is rather no privatisation without first consulting st Lucians.

    Not too long ago he said SLP opposed independence which is false. It’s position was no independence without first an election. Why can’t he be honest to those people whose plight he is so quick to publicly shed a tear for?

  8. Meaninful, informed consultation and debate in Saint Lucia is as absent as water in the Sahara.

    How can we expect to make any progress that way?

    And don’t our politicians realize that this rabid unwillingness to resolve their differences and seek compromise in a reasoned and non-emotive manner may well be sending the wrong message to those who are prone to resolve their differences through violence?

    The core questions we need to ask on this issue are: (1) Can Saint Lucia operate and maintain two tertiary heath care on its own? (2) Are there public-private partnership models (fully local/local-regional/local-international) that can reduce the cost to the taxpayer of running these facilities while providing safety nets for the poor? (3) Can the cost of efficiently running these hospitals be recovered from fee-paying Saint Lucians? What level of subsidization will Government be required to carry and can it afford to do so? Are there lessons to be learned from other privatization models like LUCELEC and BOSL we can draw on in our consideration of appropriate privitazation models for the hospitals?

    With the right “privatization model”, I believe many Saint Lucians, Castrian included would be prepared to buy shares in the OK-EU. But I would do so only on condition that legislation is enacted limiting foreign ownership in these entities to 20%.

    But there’s another critical issue. Can the cost of running these entities be recovered from the potential client base?

    In considering this issue, we need to take a holistic view of Government’s fiscal situation. Several other critical State-owned entities have perennially been “in the red” and need a predictable infusion of money to survive. WASCO, SLASPA and National Solid Waste Management Authority immediately come to mind.

    One thing is patently clear to this Castrian. We’d better find robust solutions to the fiscal challenges facing our country, otherwise cwapot go smoke we pipe.

  9. Castrian,

    Is there a considered privatization model that eschews profit?

    Once profit is involved, the St. Lucian citizen has already lost!

    The current situation reflects an immature citizenship in St. Lucia; and an even more immature, but mercenary cadre of public administration & project management talent in St. Lucia.

    These issues should have been in the public domain, and settled long before the hospital project was financed by the EU; long before the ground-turning, even!

    1. Nudge, I fully agree. We ought not to be only now discussing these issues. But things are what they are. And we can’t now demolish what’s there so we can discuss.

      Is there a privatization model that eschews profit?

      My preference is for a model that keeps the majority of the profit in the pockets of Saint Lucians. This is the model in place in companies like Singapore Airlines and Singapore Telecommunication (Singtel). Singaporeans are majority shareholders in these companies.

      But Nudge, what you call “profit” is essentially a surplus of revenue over expenditure. Regulations can be used to ensure that OK-EU does not seek profit for its own sake or at the expense of quality service. Regulations can prescribe that a part of the profit from a “privatized” OK-EU should be used to subsidize services provided to the poor.

      The NIC and CCC generate significant reward from their investment in LUCELEC, which they use to invest in public sector projects.

      This is why I strongly urge the Government to not rush headlong into privatizing the OK-EU without examining all possible options that would yield the higest benefit to Saint Lucia and Saint Lucians and without prior consultation with us. Personally, I don’t much confidence in the Cabinet as constituted to make the right decisions in this matter.

  10. @Castrian,

    A key referendum question I asked above was, “citizens of St. Lucia, how do you feel if a private company, and the government officials you vote for, profit from your misfortune to be in an accident or to become ill?”

    No doubt, the answer would be that their misfortunes and ill health would be compounded!

    ANY privatization of healthcare (or any essential services required by the citizenry of St. Lucia) is wrong; even if 100% of shareholders are St. Lucian.

    St. Lucia does not have a consumer base that can support profit-taking from the provision of essential services for St. Lucians. Because of this, the Singapore models will not work. In the NIC/CCC-LUCELEC model, all we create is more excessive taxation on the citizens (which factors into increasing health problems for them – physical and mental); and a pit of corruption, as also found at WASCO, SLASPA, and National Solid Waste Management Authority!

    There is NO right privatization model that can be applied to the provision of essential services.

    1. OK, Nudge, what if a referendum is held on this question: “Fellow Saint Lucians, would you support the creation of a private Health Facilities company with legislated safeguards, that: (i) ensure you retain 100% of shares in this company; (ii) limit returns on your investment to no more than 5% of the profits of the company; require the remainder of the profits be reinvested in capital improvements etc?”

      I believe such a referendum is likely to yield a more positive result.

      I believe there are privatization models that can and ought to be explored.

      I cited the Singapore models only to show how, if the political will is there, the interests of Saint Lucians can be safeguarded in any privatization scheme. I did not cite the models to show their profitability.

      I absolutely agree with you that the “consumer base” does not exist in Saint Lucia to guarantee the profitability of any private-run hospital which is why I’m dumbfounded by the decision to spend hundreds of millions of dollars on 2 “state-of-the-art” hospitals when the consumer base is not there to ensure even the recovery of the basic costs of operating and maintaining ONE hospital.

      But perhaps Nudge, we can agree on one thing. If Government is unable to fully fund the satisfactory operation and maintenance of these hospitals, then we will be faced with “business-as-usual” where Saint Lucians are forced to pay through their pain for healthcare at privately-run hospitals at home (Tapion) in the region and even as far as the US.

      The way I see it, a fair amount of heathcare services in Saint Lucia is already privatized anyway. Many people of limited means use private doctors, dentists and labs. Alternative health care services is 100% private. All of this is unregulated. I believe many of these clients will likely return to a well-run OK-EU. Question is: will they be as ready and willing to pay for the services they receive from OK-EU as they now do from private healthcare providers? This has been a serious issue at Victoria. Ironically, St. Jude had a much better payment record than Victoria.

      A final word about LUCELEC’s privatization. I fully support it both as a consumer and as a shareholder and I am happy that at least 50% of the profit of LUCELEC remains in Saint Lucia, compared with the previous CDC arrangement. I do not agree the privatization of LUCELEC is increasing the tax burden on Saint Lucians. In fact, I argue that it has relieved the burden on the Government and by extension on taxpayers, and has provided much-needed income to the Government, CCC and NIC.

      NIC desperately needs this revenue to cover actuarially-determined deficits in its revenue-to-claims situation. Without the revenue from LUCELEC dividends, NIC would be forced to increase contributions from workers and employers, in addition to increasing the age for payment of retirement benefits.

      Thank you for engaging me in this debate. Hopefully, it will be repeated with the same degree of civility in our Parliament and Senate and in the media.

  11. @Castrian,

    Smart citizens would see right through the nonsensical referendum question!

    They would say, why should we agree to double taxation, and also open ourselves up to the inevitable grift of administrators, much like the governmental corruption we have now?

    You wouldn’t mind, however, because you already admit to supporting the gouging of consumers by LUCELEC.

    1. There are thousands of local shareholders like me in LUCELEC whose dvidends help offset what they pay in taxes. I am clueless about the basis of your double-taxation claim. I like many ordinary sensible Saint Lucians reasoned that if we are going to pay for a service anyway, we might as well take what we can in return instead of letting others benefit.

      You are I are obviously approaching this debate from different perspectives. Yours appears to be driven by ideology while mine is rooted in reality by an clear understanding of what Saint Lucia can and cannot afford.

      I am not enamoured with the idea of privatizing any essential service. But I have a sense of what these services cost. And I know that our Governments don’t have the means of support every essential service on the narrow revenue base while building social and economic infrastructure, like roads, schools, airports, seaports etc. I’ve paid close attention to the budget of revenue and expenditure and I see the dramatic and worrying surge in Saint Lucia’s debt profile. I see the frequent issuance of bonds, T-bills and I worry. I am not at all convinced this money is being put to the best use.

      As things now stand, Saint Lucia is owned by foreigners as foreigners are its primary holders of sovereign debt.

  12. @Castrian,

    My double-taxation claim is broken down thusly:
    A St. Lucian tax-payer pays into NIC, for the opportunity to be charged exorbitant rates and taxes for essential services.

    When will you see the stupidity of privatizing essential services, where maximizing profits maximizes pain for the St. Lucian citizen; while all private businesses that can generate profits derived from foreigners are allowed to be wholly owned by foreigners, tax-free, as long as a government official uses his/her position to get a little “something” under the table?

    I had a good laugh at your concern-trolling in the paragraph, “I am not enamoured…to the best;” wrote no doubt while you were smirking over the prospect of continuing to earn selfish profits from the misery of your fellow citizens!

    We don’t have a democracy in St. Lucia; what we have, since so-called independence, is a KAKISTOCRACY! (cue the music which restarts the game of musical chairs played on St. Lucian voters by SLP, UWP. and LPM)

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