Gareth Manning, Staff Reporter

ANOTHER LEADING member of the local medical community has warned that the public-health system could collapse under the weight of free health care.

Dr Winston Dawes, former president of the Medical Association of Jamaica (MAJ), has joined other persons in the sector who feel strongly that enough money is not being allocated to health.

This, despite claims by the Bruce Golding administration that health is one of three priority sectors to get special attention this fiscal year. The other sectors are education and national security.

According to Dawes, the Government needs to allocate at least $10 billion for the non-salary portion of the health budget this fiscal year if it expects the country's health-care system to operate efficiently.

The Government has allocated $30 billion of the $547-billion budget to health. This is five per cent of the total budget, or 13 per cent of the money, that the Government will spend on non-debt expenditure.

Of the allocation, $14.7 billion is for the compensation of employees, $1.3 billion for travel expenses and subsistence, and $3.8 billion for grants and contributions.

Buckling under pressure

But, Dawes says, the money allocated is not enough. He charges that the public health-care facilities have been buckling under pressure from patient overload since the Government made good on its promise to allow free access to health services at most public facilities just over one year ago.

"If they are going to continue the no-user-fee (policy), then they must fund the health service, and so far. they have not been funding it," argues Dawes.

He says while the Government appears committed to improving health-care facilities, the money has not been provided.

Dawes says the removal of the user fees has created a hole in the budget at many facilities, as the money collected from patients had been used to support day-to-day operations while state funds were used primarily to pay salaries.

"You take that (user fees) out and then you put the hospitals a very very serious crunch," Dawes explains.

The veteran medical practitioner says the increased demand on health facilities since last year has resulted in a severe shortage of pharmaceuticals in many hospitals and has put a strain on laboratory services.

He says these are critical areas which the Government must urgently fund if the system is to operate efficiently under the new policy.

New measures

The health ministry has already admitted the increased demand, but claims that measures have been implemented to address any problems.

According to recent figures from the ministry, between April and September 2008, there was a 69.9 per cent increase in visits to clinics while there was a 38.7 per cent increase in visits to pharmacies in April 2008 when compared with the corresponding month in 2007.

The ministry has also claimed that its "vital, essential and necessary" list of drugs has also been expanded by 142 items, pushing the total figure to 738, while it has stepped up the training of pharmacists and pharmacy technicians.

In addition, the administration has allocated mild increases to the budgets of two of the four regional health authorities to purchase pharmaceuticals and medical supplies. The others will have to make do with what they spent last year.

But this is not enough for Dawes: "The laboratory services are in a mess. A lot of people order tests and they are not done because there are no reagents," he says.

"We are going to have to set up a proper emergency service," he adds, noting that the competition for equipment and bed space in some hospitals has worsened due to increased patient load.

Private arrangements

He says the Government should carefully consider making arrange-ments with private entities to shore up the shortfall in medication and turnaround time of laboratory tests.

He argues that while such a partnership will mean Government will have to spend more, it is necessary.

Attempts to get a response from Minister of Health Rudyard Spencer were unsuccessful up to press time yesterday, while other ministry officials declined to comment.

gareth.mannimg@gleanerjm.com