Anatomy of Hope

MOST Saint Lucians know that the Throne Speech delivered by the Governor -General Dame PearletteLouisy in Parliament is written by someone else. One supposes she may suggest a few corrections here and there, but that’s about it. She cannot change the core content of the message, even if it doesn’t sit well with her.

Former Governor-General Sir George Mallet learned this the hard way when, in his first Throne Speech under an SLP administration in 1997, he was handed a script that contained some unflattering things about his former Party and government. Perhaps in the hope of keeping his job, he read the Speech. He read it quite well. He was fired anyway.

It’s one thing that the Governor-General has to say things she may not want to say; but it’s another when the media claim she said things in her Speech that she didn’t say.

Take for example this excerpt from an article captioned “New Hospitals Will Make St. Lucia World Class” carried in the May 2, 2015 issue of this newspaper:

“Two new hospitals will be in operation within the next 12 months, and along with other initiatives undertaken in the health sector, they will transform health care in the country to world class standards. That is the view of Governor General Dame PearletteLouisy as espoused in her Throne Speech Tuesday at the joint sitting of parliament.”

In fact, the Governor-General shared no such view. What she said was:

“It is our hope that by the next session of Parliament, Saint Lucia would have opened two high standard, world class health facilities, namely the Dr Owen King-EU Hospital at Millennium Heights and the new St. Jude Hospital.”

The difference between what the Governor-General is reported to have said and what she actually said is subtle but important. The first quote omits a critical word “HOPE.” Also, the Governor-general referred to “world-class facilities” and not to “healthcare at world class standards.”

The “hope” expressed by the Governor-General refers to the opening of the two facilities within a year, and so it would be unreasonable for her – or her speech writer for that matter – to expect that so soon after their opening, the facilities will attain world class standard, or that the facilities would transform healthcare in the country to world class standards.

What makes a health facility world-class?

For starters, it is not its newness; nor is it the availability of state-of-the art equipment. According to the Throne Speech, the government is aiming to ensure that these facilities are safe, effective, caring, responsive to people’s needs, and well-led. Achieving these aims would require the presence of highly-trained, capable, competent, committed and caring staff who CONSISTENTLY provide a world class service. This consistency is dependent on several factors, including, job satisfaction, money to repair and maintain equipment on a timely basis, and to purchase drugs and supplies; strict adherence to healthcare protocols; the competence of members of the Board of Directors in the key areas of hospital management; and the quality of support services such as emergency management.

The money bit deserves more attention.

Let’s face it. Over EC$270 million in two hospitals in a small island like Saint Lucia is a staggering amount of money. At the rate money is being pumped into St. Jude, by the time the facilities are up and running, this figure could well exceed EC$300 million. Would any foreign investor sink that kind of money into two secondary health care facilities 30 miles apart, for a population of 180,000 people. No way! He/she need only look at data like average occupancy levels at the two facilities and average annual unemployment, poverty and income levels over the past decade to realize that he/she would not “break-even” for some considerable time; possibly never.

Nothing written here should be taken to mean that Saint Lucians do not deserve high standard, world class primary and secondary healthcare facilities. We most certainly do; as do people everywhere. The main concerns of this writer are about scale, magnitude, and financial feasibility.

If there is a business plan for either of these facilities anywhere on Saint Lucia’s 238 square miles, it would be good to know what it says about the financial burden our government will have to carry and for how long? What does it say about the probability of filling the 300 + beds at these facilities or about prospects of Saint Lucia becoming the preferred location for medical research and education?

“He that lives upon hope will die fasting” wrote Benjamin Franklin.

Hope will not cut it. It will not ease the burden on government’s coffers and it will not make Saint Lucia the preferred location for medical research. And for that matter, neither will a Quality Care Commission, however important it is. The Commission may identify areas of weakness but the money must still be found to address them.

It’s good that government is preparing laws and regulations to govern the use of the hospitals as teaching research facilities. It would be interesting to see what governance model is recommended for them as medical research centres (MRCs) and how compatible this would be with the model in the Millennium Heights Medical Complex Act. In most places MRCs are owned and operated by the same entity, which is not the case in Saint Lucia.

It would seem that in Clifford Chance, government has chosen a competent and experienced consultant to prepare these laws.

If it has not done so, government should also commission an experienced firm to prepare a Business Plan and Finance Management Strategy for the two facilities. It is absolutely critical that government has adequate funds on hand at all times to support the operation of these facilities. A one day delay in sending money to these hospitals can irreparably wreck their reputation and dash any hope of them becoming “world class facilities”.

The Virginian