“SILENT REVOLUTION” IN HEALTH CARE
HEALTH IS A RESOURCE
Good Morning again, citizens of Saint Lucia, I hope you had an enjoyable
weekend and that you are in the best of health.
I have cast my salutations this way because I want us to talk about health and
I get the impression that when we speak about health, we only think of the
absence of diseases. But health and health care are much broader, much bigger
than just the absence of diseases. It also involves a state of physical, mental,
social and spiritual well-being or if you prefer the term in vogue these days,
“wellness”. Health is a resource – a very, very important resource. It is a
resource that enables people to take control over and improve their lives - a
resource without which a country cannot hope to develop.
It is often said that the “health of the nation is the wealth of the nation.”
You may have heard this saying so often, that you may now take it for granted.
Have you ever stopped to think of the possible impact of an unhealthy population
on the development of Saint Lucia? Frankly, the consequences are too dire to
even consider. So I prefer to adopt the position of those wise persons, who
often say that prevention is always far better than cure. Hence the reason we
are investing so much in the health sector.
EXPECTATIONS OF THE PUBLIC
As we continue to adjust to changes in the health sector, we cannot ignore
the expectations that, you the Saint Lucian public, rightfully demand of your
health sector. I know that you want a health sector that is capable of providing
quality services when and where it is required. You want a health sector that is
capable of supplying timely and quality diagnosis and treatment at all times.
You also want a health sector that works for everybody; rich, middle class and
But I know too that you are also concerned about how much of your tax dollars is
spent on the health sector. I have to tell you though, that it is very difficult
to put a price tag on health care. You see, we are working with limited
resources, and every dollar spent on health care is a dollar that cannot be
spent on education, roads or the legal system. The health services we want must
be paid for, whether by taxes or by you, the consumers of health care. It cannot
be provided entirely free of cost. We simply do not have the means to do so.
Nothing in life is free, they say.
SILENT REVOLUTION IN HEALTH CARE
This Government has embarked upon a programme of health sector reform which
is broad and far reaching both in scale and in scope. These changes are
occurring almost unnoticed and without fanfare. Indeed one may say that a
“Silent Revolution” is underway in the Health Sector.
You may ask, what are the features of this “Silent Revolution”? Well, let me
tell you. There are four clearly identifiable pillars of this “Silent
Revolution”. Firstly, there are Infrastructural Developments to be undertaken.
Secondly, there are initiatives to introduce Universal Health Care. Thirdly,
efforts are underway to change the system of Governance of the health System.
Fourthly, efforts will be made to empower the community and health service
workers in the management and delivery of health services.
Let us quickly review the proposed infrastructural developments. In an
attempt to relieve the ever mounting pressure on secondary care institutions,
(Victoria Hospital in particular) and to further deepen access to health care,
the Government has begun major renovation and expansion of all health centers
island wide. But that is only the tip of the iceberg.
I am sure that most of you have heard but for those of you who still do not
know, we will see the commencement of the construction of two new hospitals in
the next year, a new general hospital and a psychiatric hospital.
The Government and people of Saint Lucia are once again the recipient of the
goodwill and generosity of the Government and People of the People’s Republic of
China, with whose assistance a new psychiatric hospital will be built. So, we
must, once again, thank the people of that great country.
Whereas it is true that Golden Hope Hospital served us well for many years, I am
certain that you too will agree that it is no longer capable of meeting the
island’s mental health requirements. For a very long time mental health did not
receive the type of attention it deserved. As a society we treated mental health
issues as a social taboo. We even mystified mental health issues. We are ashamed
of those who become mentally ill, even our own relatives. We must understand
that mental illness is a medical condition. It is time that we make a fresh
start and treat our psychiatric patients with dignity.
I must warn you though, that the construction of the new psychiatric hospital is
meaningless if we do not change our perception, attitude and awareness of mental
health issues and the way we treat persons who suffer from mental disorders.
With the assistance of the European Union, construction will also begin sometime
late next year on a new modern general hospital. I know that this is a
development that you keenly await. The construction of a new general hospital
will permit the existing Victoria Hospital to be used as the Castries
polyclinic, rehabilitation hospital and step-down facility. Moreover, the
construction of a new general hospital would allow for the conversion of Saint
Jude to a community hospital offering a range of services but referring to the
main hospital for most elective and sophisticated services.
INTRODUCTION OF UNIVERSAL HEALTH CARE
The second pillar of this “Silent Revolution” is the introduction of a
Universal Health Care System. Basically, Universal Health Care will be
introduced as a mechanism for financing and sustaining the health care sector.
It will make health care accessible to all. The Universal Health Care System,
which this government proposes to introduce, will address all aspects of health
care be it general, mental, emergency, diagnostic, pharmaceutics and overseas
care. But the broad intention of the introduction of a system of Universal
Health Care is to deliver an improved quality of health care to the nation
through the implementation of standards and the performance of regular health
audits at the various service providers. The introduction of a system of
Universal Health Care will ensure that the public interest is protected by
making compulsory the licensing and monitoring of medical practitioners and
health institutions and holding service providers accountable for the quality
and quantity of health services.
GOVERNANCE OF HEALTH SECTOR
The third pillar of this “Silent Revolution” is about the governance of the
health sector. The Government intends to give the public and medical
professionals an active role in health matters. How do we intend doing this? To
begin with, the management structures of the health institutions are in for a
major overhaul. Already St. Judes Hospital has been statutorised, that is, a
board has been appointed by law to manage the affairs of the hospital. A similar
system will be introduced to manage Victoria Hospital. In effect, the Ministry
of Health will no longer be directly responsible for the management of the
EMPOWERING THE PUBLIC
New rules and regulations will be introduced to protect the public interest
and to empower the community and health personnel in the management of the
hospital. This is the fourth pillar of the “Silent Revolution”. As a Government
we want to empower you because we know that you have a stake in the efficient
delivery of health services. This is why we seek to put in place clear rules for
all players and practitioners. We will also seek to empower key groups by
further training and development. We will seek to establish a basket of health
care services and overseas care. We will introduce measures to ensure standards
and quality assurance. We will also introduce health and information and
management systems. Laws and rules will be introduced to govern the operations
of persons and institutions involved in the health sector. The new legislation
will strengthen the management of health personnel, define their functions,
provide for surveillance of their performance and set education and competence
We have already established a Health Services (Complaints and Conciliation)
Commission as a means of oversight, and to give you an avenue to address your
complaints about the professional behaviour of doctors. We must ensure that the
health system works for everyone, not just those with money.
OTHER OCCASION FOR HIV/AIDS
Incidentally, I have not touched HIV/AIDS. That is a big issue. It deserves
special attention. So it will be addressed in another Conversation with you.
Meanwhile take care of yourself, until we meet again, next Monday. God Bless!