Caribbean Neurosciences Symposium Opening Remarks by Dr. Fenton Ferguson

Thank you for inviting me to this symposium. I take this opportunity to congratulate the Caribbean neurological association and the department of surgery at the university hospital of the West Indies for holding this symposium for the 10th year.

The ministry has an interest in the information that is shared at symposia of this nature and the evidence that is presented which we may be of use in informing policy.

It is important that our practitioners are kept up to date about changes in the various specialties. The University of the West Indies must be acknowledged for the role it continues to play in training and development in general and more specifically in the advancement of a truly professional and highly skilled workforce.

As the only neurosurgical training programme in the English speaking Caribbean, your university continues to be the standard bearer of excellence in teaching, service and research in the health sector.

I have a keen interest in strengthening the collaboration between the ministry of health, and our academic institutions. Most importantly, i intend to deepen the collaboration between these institutions and my ministry. This is essential if we are to keep pace with the rapidly changing health conditions both locally and in the global domain.

The health sector has always relied on and has always been driven by the advances in scientific and technological research. Indeed this conference is the culmination of your work in this area over the past year. This forum provides the platform for objective and rigorous critique which is the hallmark and essence of good scholarship.

The advances in neurosurgical procedures and techniques have resulted in not only saving lives, but have contributed to greater efficiencies in the use of our limited resources. Excellence in service delivery is the essence of my ministry’s mission as it goes to the heart of the principle of putting the patients at the center of all my ministry’s activities. Nowhere is this more vividly demonstrated than during the clinical encounters.

 Indeed the government which I have the honour to represent is not only patient centered in its approach, but encourages the principle of dissemination of as much information as possible to the patients. How else would it be possible for the patient to practice the principle of informed consent? An academic colleague of mine challenges his colleagues that every scientific principle or concept can be understood even by a child and if the academic is unable to explain this complex principle to a child then the he or she really does not understand it.

Patient information is a very important principle of my ministry as it goes to the heart of the principle of a patient centered health delivery system.

The advancements that are made in technology, science and medicine are only are of use value if they translate to  informing, teaching, training and service delivery or contribute to the advancement of the policy formulation process.

The range of issues that will be explored in the various presentations this morning demonstrate the inextricable link between research, theory and practice.

 I would like to take this opportunity to share some aspects of our present vision for achieving optimum health status of our population with you. This government based our health policies on a number of fundamental principles which include the following:

1)      A state of health, is a fundamental national asset and a healthy population is central to the development of this asset.

2)      In the delivery of healthcare services there must be a balance between preventive and curative care; however preventive care must always take precedence.

3)      The access to basic health services must never be determined only by a patient’s ability to pay

4)      There must be the continuous application of scientific and technologic advances and innovation if the health is to remain viable or to be developed on a sustainable basis

5)      The application of technology must always be appropriate to the needs and conditions of the country

6)      At this stage of the development of Jamaica’s health service, the introduction of public / private partnerships are essential and necessary to advance both its mission of a higher quality of service delivery to our people, while at the same time keeping abreast with the rapid technological advances in health care delivery in the global domain. None of this can be achieved without new investments in the sector and this must be enabled by strategically developed public / private partnerships.

7)      The policy initiatives that the government will pursue include the efficient and effective renewal of primary health care services. This will focus on a number of specific areas including:

a.       Community participation

b.      The development of a modern health information and communication system infrastructure to enable better cost benefits and greater efficiencies in service delivery

c.       Integration of the services for seamless referral of patients to secondary and tertiary health care entities and vice-versa

d.      The provision of adequate diagnostic, laboratory and pharmaceutical services,

e.       The renewal of the health team approach to primary health care delivery indeed throughout all levels of service delivery

f.       The necessary logistical administrative support for best practice service delivery outcomes must always be in place as a means to an end and never an end in itself.

g.      The modernization of the infrastructure of the health sector must including the utilisation of mobile community health services where necessary to serve inaccessible deep rural areas.

In keeping with the principle of a health sector that is not based on the ability to pay, this government has committed to universal free primary health care. This will be introduced after a formal review has been completed on the impact of the abolition of the user fees policy on critical areas of the primary health care delivery process.

This review will determine the gaps in the system across a number of areas including human resource, finance and the provision of medical, nursing, pharmacy, allied health and auxiliary health services.

I do not wish for this gathering to conclude that there will be a neglect of secondary and tertiary care. Nothing could be further from the truth. Indeed i am sure that you are all aware that a house without a strong foundation cannot stand. The neglect of primary health care is the achilles heel of the health care sector and we ignore this at our peril.

We intend to establish centres of excellence in our regional hospitals on a phased basis utilizing the principles of public – private partnerships.  We intend to encourage investments in this sector as we build capacity to enable the development of medical tourism to contribute to the financing of a high quality hospital sector that meets the highest international standards.

In addition, the time has come to establish a creative incentive programme aimed at attracting and retaining health care providers in the system including opportunities for training in the varying specializations.

We will pay special attention to health services that are available to children and adolescents. The Bustamante Hospital for Children is a fine institution of which all of us can be proud. Some expansion will be carried out with the construction of a cardiac unit but there is need for a facility in western Jamaica that provides similar services to the nation’s children. This is a passion of our prime minister and this policy initiative was adequately funded in 2007. Presently has not found favour as a policy position, at your fine hospital.

I know the difficulties which your hospital suffers at this time and have a strong commitment to supporting this very important institution which is too important to be allowed to falter or fail. Nevertheless i think a no user-fee policy for children and adolescents at the UHWI was analysed by leading scholars in this area to be a necessary and affordable policy. Even more so is the fact that it affects the most vulnerable and dependent age cohort in our population.

The prime minister has consistently expressed, in a most passionate way, the need for this policy to be fully implemented. I am therefore requesting that this policy  of user fees for children and adolescents be reconsidered by the new board of management of the university  hospital. 

I am prepared to begin consultation with the private sector and with the Jamaican Diaspora to see how we can proceed to make the development of public private partnerships become a reality. In addition, I shall suppoprt the university hospital of the West Indies in undertaking the necessary repairs to the child health clinic, as well as the construction of a psychiatric ward for 12-18 years old.

I must confess that having now assumed the position of minister of health, after having been the minister in waiting for over four years i am seized with the urgency of making an intervention in respect of cancer treatment.

I have started the dialogue with the non-governmental as well as with the donor communities. The feedback so far has been very encouraging. However, government cannot sit idly by in the face of impending crises while awaiting the expected investments in the sector. We must work together and relentlessly to find solutions, and to begin to address these critical areas of concern, in a timely way.

Whatever the allocation to the ministry of health for its capital a budget for the 2012/2013 fiscal year, there needs to be an investment to realize short term improvements in cancer care treatment. This new government does not intend to give up in the treatment of those suffering from cancer because of an absence of treatment facilities in the public sector. So long as there are facilities in the private sector we shall use what means we can afford to assist in the treatment of patients suffering from cancer. There is much scientific evidence to confidently support the claim that medical scientific intervention when combined with a positive attitude and spiritual fortitude there is a higher rate of five year survival of our cancer patients. This minister will never cease in his search for workable solutions on behalf of anyone who desperately seeks health care.

Finally I am under no illusion that the task of reforming and modernizing the health sector will not be a difficult one but i intend to take the necessary measures including the strategic investments at the primary health care level and targeted investments in specific areas at the secondary and tertiary levels to assist in making this happen.

I am confident that this approach will give us some quick wins and put us on a path of sustainable improvements and developments in the sector.

Once again, I congratulate the organizers of this event and the presenters and I know that what you do here in this symposium will redound to the benefit of the health sector in Jamaica and the region and contribute to better health outcomes for the peoples of Jamaica and the Caribbean.

 

I thank you.