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Editorial: The Health Of A Nation, Is The Wealth Of A Nation

IT WOULD appear that Prime Minister Minnis is unwilling, embarrassed or unable to muster the courage to address the “pink elephant in the room”. While some may be relieved to learn it is not an Immigration, U.S. crime warning, OECD black listing or global pandemic spread by some highly infectious disease, in reality it is a far more deadly, insidious and immediate threat to our country.

Everyday we learn more and more about what Dr. Duane Sands informed Parliament during his 2017-2018 Budget contribution. He described it as a painful toxic combination of “politics, entitlement, systemic corruption, lack of accountability; the unethical award of public procurement contracts [some based on reports that don’t even exist] and misuse of public office for private and/or party gain”, which has adversely affected the lives of thousands of Bahamian families.

If the award of cleaning contracts to the Abaco Health Clinic and Exuma mini-hospital - neither of which were open - to the tune of $500,000 and $424,638.84 per month was not enough to get one’s attention, allegations of “bid-rigging”, supply conflicts and the myriad of other revelations contained in UHY Bain’s forensic audit would be cause for sleepless nights.

According to a scathing report by Costa Rican health consultancy firm Sanigest International, patients at Princess Margaret Hospital were 353% more likely to die than those in Jackson Memorial Hospital or other comparable US based institutions.

Sadly, as a result of any effort to repair the damage by Hurricane Matthew [2016], that figure has risen to an astounding 821% in some areas of care.

While the then Minister of Health, Dr. Perry Gomez, confirmed the findings in Sanigest International’s report; he readily admitted that the Princess Margaret Hospital’s standardized mortality rate in its public wards were “well over” 100% higher than private wards. However, Dr. Gomez urged Bahamians “not to rush to any judgment as making a comparison of public versus private care at PMH was like comparing apples to oranges.”

It should come as no surprise to hear that Bahamian children suffer the same fate. Dr. Upton Allen, Division Head and Consultant in Infectious Diseases, Paediatric Cancer / Blood Disorders at Toronto’s Sick Children’s hospital states that “..survival rates for Bahamian children are 50+% less than those children diagnosed with similar cancers and blood auto-immune diseases in Canada.” Frankly when infants, toddlers and children wait for days in the Accident and Emergency Department for a bed – only to end up being stuffed like sardines in the Princess Margaret Hospital’s sole operational ward – many find such healthcare as “morally repugnant”.

Even PLP Englerston MP Gleny Hanna Martin during the 2011 Budget debate invited Bahamians to look at the state of health in this country.

“I took the opportunity,” she said, “to research our standing globally. We may be the third highest something in the western hemisphere but in 2000 the health system of The Bahamas was ranked by the World Health Organization as number 94 out of 190 countries. In the Caribbean we ranked behind Dominica, Barbados, the Dominica Republic, Jamaica, Trinidad, St Lucia, St Vincent, Grenada and Antigua and Barbuda. This is food for thought. I believe the data also shows that The Bahamas pays a high cost for health care but with a lower quality of care delivered than in many other countries: the Pan American Health Organization report states that we rank 22nd in expenditure per capita but 94th in quality of health care.”

Just when we thought we’d heard it all, along comes the news that the Princess Margaret Hospital Foundation is actually not a foundation. Unbeknownst to many benefactors it is a company that is not owned, operated or under the control or purview of the Board of Directors of the Public Hospitals Authority. In fact, although a search has been done, our lawyers can find no evidence of registration of this organisation as a Foundation — as a company, yes, but not a foundation. Where is a certificate of good standing; authorization to use the name Princess Margaret Hospital or yearly financials as documentary proof of how these donations may have been used?

Nothing fruitful will ever emerge from such an association or engagement with those who have placed our public health care system in the deplorable state it is now in. It’s now time for the Cabinet to consider the merits of a Public/ Private Partnership for healthcare similar to the agreement we have for the operation of the airport, Port of Nassau, BTC and BPL. Thankfully we understand a team from Johns Hopkins Medicine arrives later this week to discuss the merits of a Health Services Agreement with the Government of the Bahamas.

Such discussions could transform the delivery of healthcare in our nation and lead to these islands becoming the “Centre of Excellence” of health care for the Caribbean.

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