Gov’t. First Year Review
Gov’t. Honours Commitment to Abolish User Health Fees

Honouring its undertaking, on assuming office in September 2007, to provide unrestricted access to basic health care, the administration, on April 1, abolished user fees at all state-run medical facilities, save for the University Hospital of the West Indies (UHWI).
The abolition of the fees, which formed part of a larger and comprehensive health policy by the Government, seeks to remove a major impediment to poor Jamaicans, in particular, in accessing healthcare, and seeks to level the playing field, insofar as health in the public sector is concerned.
Additionally, it seeks to reposition primary health care as the foundation of creating a good and sustainable health system. Further, the policy seeks to free some categories of staff, from having to undertake assessment of patients and collecting monies, thereby enabling them to concentrate on patient and customer care, and challenge policymakers and techno-bureaucrats to explore alternative financing and service delivery models.
Services currently available, free of cost, are: registration, doctors, examination, surgeries, medication, diagnostic services, haematology, services for mothers and children, including family planning and pregnancy tests; ambulance service, physiotherapy, blood transfusions, and laboratory tests.
Health and Environment Minister, Rudyard Spencer, said that this move by the Government, must be seen as the single most significant policy intervention in the social sector in Jamaica over the last 30 years.
A sum of $100 million was allocated by the Ministry of Finance and the Public Service, to enable the Health Ministry to undertake precursory work, to ensure the smooth implementation of the initiative. Activities were undertaken through the four Regional Health Authorities, responsible for health administration in the south-eastern, southern, western, and north-eastern sections of the island.
At a media briefing in March, Mr. Spencer explained that the funds would be used to assist in filling immediate infrastructure needs, such as the upgrading of patient care areas, providing additional furniture, appliances, medical equipment and supplies, and erecting directional signs.
“It will also be used in the transportation of some patients, staff, and laboratory samples to and from health centres and hospitals, for diagnostic and emergency purposes,” he informed.
Implementation teams were also established, a command centre put in place, and training undertaken for front line members of staff, as part of the implementation effort.

Health and Environment Minister, Rudyard Spencer (at podium), outlines details of plans to abolish user fees at all state-run medical facilities, except the University Hospital of the West Indies, during a media briefing at the Ministry’s King Street offices in Kingston in March. Others from left are: Chief Medical Officer of Health in the Ministry, Dr. Sheila Campbell-Forrester, and Permanent Secretary, Grace Allen-Young.

Permanent Secretary in the Ministry, Dr.Grace Allen-Young, advised that health care workers would be trained to manage queries from staff and patients about the policy.
“We have been sensitising our key stakeholders. We have also been sensitising our professional team, our doctors, nurses, radiographers, pharmacists, and medical technologists,” the Permanent Secretary informed, pointing out that there would be flexi-opening hours at some primary health care facilities.
She added that the cashiers’ role would be extended to include customer service, in order to strengthen that arm of the public health sector.
“We’re not going to need you to collect money, but we’re going to need you to be the face, the hands, the voice, and the direction to the clients, so that they’ll know what to do, where to go; you’ll be able to guide them,” Mrs. Allen-Young said.
Mr. Spencer gave the assurance that all of the relevant stakeholders had been engaged, and were on board, ready, and committed to ensuring the policy’s success. The groups targeted included: the Medical Association of Jamaica (MAJ), Nurses Association of Jamaica (NAJ), Jamaica Medical Doctors’ Association (JMDA), and Pharmaceutical Society of Jamaica (PSJ).
“We have met with every critical player in health care in Jamaica, especially those working with the Ministry of Health and Environment. We have met with the paramedics, various councils, and we have met with all staff members of the Ministry, all in an effort to bring about the team spirit and the understanding that is needed for the way forward,” he pointed out.
The Ministry of Health, as a part of its monitoring relating to the abolition of fees, undertook a user satisfaction survey. The findings revealed that upwards of 80 per cent of the users questioned, expressed satisfaction with the abolition of the fees, and the overall quality of service received since.
Speaking at a media briefing four days into the implemented abolition, Mr. Spencer said the elimination of the fees was a sustainable venture, that would continue to improve.
“This (fee removal) is sustainable. There is a team in place that continues to monitor, and will be monitoring, and whenever there are any deficiencies or problems, we will address those. This is a work in progress and we will continue to improve until it is better,” Mr. Spencer said.
Meanwhile, the Health Minister commended the island’s hospital staff for “going beyond the call of duty”, to ensure that patients received care and attention, thereby guaranteeing the policy’s success.
“As Government, we had the vision and put things in place to implement this critical move. But it was you, the staff, that ensured that on April 1, everything went smoothly. We have to continue doing what we have been doing, to ensure that our people have unimpeded access to health care,” he stated, while addressing staff at the Mandeville Hospital in May.
He noted that staff, who worked overtime to facilitate extra opening hours at the island’s medical institutions, must be compensated, adding that he would be paying keen attention, to how workers at medical facilities are paid for additional work.