EDITORIAL: Health system problems not dealt with in decades

THE problem with kicking the can down the road is that a day will come when there’s no more road.

In today’s Insight section, Malcolm Strachan points out that when an actuarial report on the health of the National Insurance Board landed on the then chairman’s desk in 2001, that was the same man who now has to deal with the crisis predicted in that document – current Prime Minister Philip “Brave” Davis.

Mr Davis has been part of several administrations since then, and no significant action was taken by either PLP or FNM governments to deal with the problem. Now here it is on our doorstep.

And that’s not the only can that has been kicked down the road.

In our lead story today, former Health Minister Dr Duane Sands talks about the need to find sustainable funding to tackle the problems facing our healthcare system.

On Thursday last week, Dr Sands’ successor in the new administration, Dr Michael Darville, reported that Princess Margaret Hospital (PMH) was “bursting from the seams” after an influx of patients. This surge is not from COVID patients. COVID may have played a part, with delays in regular treatment as our healthcare system has struggled to tackle the pandemic – but these are patients with all manner of other ailments.

Dr Darville has talked of more nurses, more beds, two new hospitals, but Dr Sands says the problem is the model used to tackle health concerns is “broken.”

Whether it’s PMH, or the Rand Hospital, or the Public Hospital Authority (PHA), he says there are issues of capacity and funding that stretch back decades.

For the PHA, he says it is underfunded by about $35-40m a year, causing problems with maintenance, new equipment, staffing and more.

He said: “What ends up happening is because this system is functioning on the edge – so if you get a few extra COVID patients, a few extra gunshot wound patients, a few people call in sick, etc, the ripple effect is magnified.”

For his part, Dr Sands was minister at a time when that capacity, and the country’s finances, were sorely tested through first Hurricane Dorian, then the pandemic.

But, as he says, the issues go back decades.

It’s the same pattern as with NIB. Those in charge of running the country have seen these problems first-hand, but somewhere along the way, it passes to the next government to deal with, and the next, and the next. It’s a recipe to make sure nothing ever gets done.

How do we change that? The obvious step is to ensure there are long-term plans in place to remedy the situation, but with our one-term-and-done governments in recent history, that’s a challenge. A bi-partisan approach ought to be the way to go, where we map out our future together, but our political landscape isn’t terribly welcoming to bi-partisan efforts, as the dispute last week over the National Development Plan showed.

Whichever way it does get tackled, we need to do so. Kicking this can down the road isn’t just measured in extra financial cost, it’s measured in lives. Lives lost when hospitals are full, lives lost when people can’t get early diagnosis of conditions, lives lost when it’s too hard to see a doctor or it takes too long to get treatment.

It needs fixing, not for today or tomorrow, but for the decades to come, and make up for the decades we’ve lost.


If you turn to today’s Insight section, we recommend you read the article on disability and job discrimination by Sasha D Smith.

She gives a clear view of the problems facing a significant portion of our population – and the way in which those problems are largely ignored.

It goes from simple issues, such as tickets and fines not being issued to people who don’t have the right to park in a disabled parking space, to the failure to follow through on legislation making buildings accessible.

In many ways, it resonates with the stories we talked about above, with years of not dealing with problems, storing up more difficulties for further down the line.

Significant effort was put into creating and passing disabilities legislation in 2014, so why are we not acting on it?

More, why do fellow Bahamians who have disabilities have to deal with discrimination in the workplace, in educational institutions, and more?

Why do we put barriers in the way of our fellow Bahamians’ ambitions?

That’s even before we get to issues such as support services, availability of careers as needed, and so on.

Ms Smith’s article is a clear-sighted look into the problem – we suggest you turn to page ten today and read more.


birdiestrachan 1 year, 4 months ago

No excuse for Dr Sands the FNM has had enough time to correct the problem and so has the PLP. PMH problems started long before Dorian.


Sign in to comment