HEALTH MINISTER Ruddy Spencer last year ignored a warning by a task force he set up to review the island's regional health authorities (RHAs) by pressing ahead with the abolition of user fees in hospitals and health centres.

The task force, led by Dr Winston Davidson, had cautioned that the move would have very serious health consequences and significantly impact the financing of the budget of the authorities.

The committee had also warned that the abolition of user fees would weaken the Government's bargaining position for public/private partnerships as it would undermine investor confidence with respect to return on investment in a business climate where health services are essentially free.

It cited that the RHAs were starved of resources and were only able to survive through delaying the payment of statutory deductions and pension-scheme contributions.

The health budget was increased to $28.2 billion by the Jamaica Labour Party (JLP) Government in its revisedestimates presented in Parliament last month.

The Government had initially budgeted $24.8 billion to be spent on the sector, a shade above the $21.9 billion spent during the 2007/2008 fiscal year.

However, the task force wants Government to spend 10 per cent of the national budget on health, which would amount to just over $50 billion of the current Budget.

Spencer received the 215-page report in February 2008, two months before the JLP administration fulfilled its manifesto promise to scrap hospital user fees.

The task force had warned that the user-fee abolition policy would undermine the primary health-care system and push the country into a service-delivery tailspin as 80 per cent of the patients who should be seen in health centres would develop health-seeking behaviours in the free hospital-service system.

"The result of eliminating user fees at hospitals would be the same as a policy of free health care to the entire population," the task force said in its report.

The health minister could not be located for comment yesterday.

But Spencer earlier said the report, which also speaks to organisational bungling and a waste of public resources in the health sector, was never intended to be made public.

The JLP, in its election manifesto had also pledged to re-establish mobile clinics for preventive screening and basic treatment of chronic illness in rural areas and promised to upgrade strategically located health centres to improve primary health-care delivery.

But the report said, as part of delivering quality health care, Government should consider retaining user fees for secondary and tertiary care with sensitive systems for exempting the indigent.

Patient load increase

The People's National Party administration had earlier abolished user fees for children to access health care. The end result, according to the task force, was a threefold increase in patient load at the Bustamante Hospital for Children.

Yesterday, the Medical Association of Jamaica (MAJ), while steering clear of calling for a review of the no user-fee policy, said problems within the system, such as underfunding, poor infrastructure, and erratic supply of goods, have worsened because of the initiative.

"We said that abolition of the user fees would magnify all of those problems and so said, so done," Dr Rosemarie Wright-Pascoe, MAJ president, told The Gleaner yesterday.

daraine.luton@gleanerjm.com