Shelly-Ann Thompson, Freelance Reporter 
Parents queuing to pay the new user fees for their children at the Bustamante Hospital for Children in May last year. - Ian Allen/Staff Photographer
THE REGISTRATION fee at public hospitals islandwide might be a mere $300 per patient. However, it contributes significantly in providing health care at some hospitals, according to Nigel Logan, principal finance officer at the Health Ministry.
"Each registration fee contributes to providing goods and services at the hospital such as drugs, dietary food for in-patients (admitted patients) and cleaning and porter services," Mr. Logan informed The Sunday Gleaner.
At the Bustamante Hospital for Children in the Corporate Area, the registration fee contributed to almost half of the hospital's total fees for last year, reported Chief Executive Officer (CEO) Beverley Needham. "For the 2005/06 financial year, total fees collected amounted to $91 million. Of that amount, registration fees accounted for $31 million," related Ms. Needham. "The portion of our recurrent expenditure that is financed by fees is about 13 per cent, relating to total fees and not only registration fees."
'A DROP IN THE BUCKET'
In contrast, at the Princess Margaret Hospital in St. Thomas, the registration fee "is a drop in the bucket," reported CEO David Coombs. He said the registration fee is channelled into the consolidated or general expense fund and used to finance the daily operations of the hospital.
"The registration fees collected form a small portion of the revenue generated by the hospital and when an account of all the fees is taken into consideration, it is only a drop in the bucket," said Coombs. "It is not enough to provide drugs and other medication for the patients, let alone to purchase much-needed equipment and maintain them," stated the CEO.
The registration fee, however, should not be mistaken for the hospital bill given to a patient on release from the hospital, said Mr. Logan at the Health Ministry. "The bill covers a patient who needs other services such as drugs and treatment as part of medical care. The registration fee is just similar to when a patient visits a doctor in private practice."
He disclosed, there are persons who are exempted from paying a registration fee, pointing out that where a patient falling outside these categories is unable to pay, a consultation must be done with an assessment officer. "The assessment officer will ask the patient, or whomever accommodates the patient, for background information such as where they live and about their income to ascertain if the fee should be waived or paid in part," explained Logan.
At the Bustamante Hospital, Ms. Needham stressed that in all cases, patients should receive the necessary treatment, as Government policy states that no one should be denied health care because of inability to pay. Outside of the policy, specific guidelines are followed at this institution. "If the patient is assessed and has the ability to pay, but at the time of accessing the service, does not have the required fees, then this is entered in the billed register with the bill stamp clearly affixed to the documents," she outlined.
GRADING SCALE
Mr. Logan also noted that in cases of emergency, such as gunshots or a heart attack, a nurse at the hospital will determine the severity of the situation based on a grading scale and speak with whomever accompanied the patient. "That person will do the processing for the patient and will be informed if a registration fee needs to be paid."
Whether it's an emergency or otherwise, no patient should be turned away or denied care due to lack of financial resources.
"If you are not satisfied with the assessment, find someone who is in authority. Ask to see the hospital administrator, CEO, or the regional director at some hospitals they are called a regional authority," advised Mr. Logan.
Registration
fee exemptions
Programme for Advancement Through Health and Education (PATH) beneficiaries.
Wards of children's homes.
Persons earning below the poverty threshold.
Poverty stricken persons.
