REGULAR readers of this column will know that I have addressed this subject before. However, after the passionate exchanges in our House of Assembly regarding the plight of the OK-European Union (EU) Hospital, I decided to return to the matter. This “debate” like its predecessors, focused more on which Party-in-Government Is responsible for things not being OK at the OK-EU.
The appointment of the eminently qualified, former Minister of Health, Dr. Damian Greaves, as the new CEO of the Millennium Heights Medical Complex (MHMC) and the Government’s injection of EC$11 million to clear part of the hospital’s longstanding debt to suppliers of goods and services, are positive developments. However, it’s unlikely this double tourniquet will stop the bleeding at the OK-EU long enough for the application of permanent solutions to be affected.
There are no short-term fixes for the fundamental ailments of the Hospital. Dr. Greaves’ first task would be to ensure the situation doesn’t worsen while he tries to improve it. However, that’s easier said than done. By now, he would have realised that until the OK-EU receives adequate and predictable funding, it will intermittently be afflicted by a shortage of doctors, nurses and medical technologists; increased indebtedness to suppliers of drugs, medical equipment and services; and a chronic shortage of beds. Consequently, it will not fulfil the expectations of Saint Lucians.
The MHMC has been mired in debt for some time. When it was created, it had a debt burden of EC$15 million. Information shared by MHMC officials at a recent Town Hall meeting in Gros-Islet revealed that the OK-EU needs at least EC$100 million to adequately cover its capital and recurrent costs. However, every cent of the annual subvention of EC$60 million that the MHMC receives from the Government is consumed by payroll commitments. Moreover, the OK-EU cannot cover its financing shortfall from patient fees. It provides healthcare to a long and growing list of exempted clients identified by the Government, for which it is not reimbursed. Clearly, this is a recipe for unsustainable debt and failure of the facility. It will help if the National Insurance Corporation (NIC) meets its obligations to the hospital in a timely manner.
No hospital can suspend any part of its operations and services without losing the trust and confidence of its clients. A hospital can function without an MRI machine, but it cannot function without drugs. While this may be stating the obvious, it makes it clear why the OK-EU MUST always have the money it needs to maintain an adequate stock of drugs. So, whatever else the Government does, this MUST be a priority. Indebtedness to the OECS Pharmaceutical Procurement Service (PPS) weakens the viability of that service and compromises the healthcare programmes of other Governments. The special arrangement agreed between the MHMC and the PPS to permit the supply of drugs outside of the Government’s central procurement system, on the same terms enjoyed by Governments, should be maintained.
Resolving the bed crisis will require more money and time. Presently, the OK-EU has a 30-bed deficit. Recently, a dear friend spent five days in the corridors of the A&E Department at the OK-EU, before he was moved to a ward bed, where he spent three days before he was discharged; despite there being no improvement in the conditions for which he sought hospital care in the first place. The inclusion of beds at the refurbished Victoria Hospital is meant to ease that burden. However, the ideal solution would be for the Government to build an additional block (finger) at the OK-EU. It’s understood such a plan is in the works. If so, once the funding is secured, the bed crisis can be speedily addressed, especially as full designs are readily available. Obvious sources of funding include the Health and Security Levy and the CIP. Use of the latter should “go down well” with the EU and give its members good reason to continue to support the CIP.
The financial support that the Government gives to the MHMC and St. Jude Hospital (SJH) must consider the surge in non-communicable diseases (NCDs), and accident-related injuries which are placing immense pressure on our secondary healthcare system. Dealing with the NCD crisis–which is afflicting all Caribbean countries–will require immediate strengthening of the island’s primary health care (PMC) system. Some public health professionals believe the system needs a complete overhaul if it is to effectively deal with the changing dynamics of healthcare spawned by the NCD crisis. To this end, they recommend the speedy implementation of the plan to convert select health and wellness centres into polyclinics and sustained public education campaigns about the benefits of preventive health care.
Arresting the carnage on our roads and highways must be made a top priority. The PM’s recent statement reflected his awareness of the core problem and its impact on our hospitals. Saint Lucia recorded 23 road fatalities in 2022 and 2023. So far, 16 fatalities have been recorded in 2024. Hundreds of accidents resulting in serious injuries have occurred over the past 3 years. Implementing road safety/responsible driving campaigns, erecting speed limit signage, putting more traffic police on our roads and imposing stiffer penalties for reckless driving might help. Still, one would expect that the graphic images of accident scenes, some fatal that appear on our TV screens and cell phones would send a stronger message than any of these measures. Alas! Our hospitals will not be able to cope if this situation is not brought under immediate control.
The human resource crisis that’s afflicting the entire healthcare system demands a comprehensive response strategy. The agreement reached between the MHMC and the Sir Arthur Lewis Community College (SALCC) to utilise student nurses who have completed their Degrees and are awaiting formal certification holds great promise. The shortage of doctors and medical technologists must be approached with the seriousness it deserves. Until that happens, the overall situation will not improve.