My Thoughts on Technology and Jamaica: Audit of Public Health Care System revealed - How the Minister of Health plans to correct these problems

Thursday, September 3, 2015

Audit of Public Health Care System revealed - How the Minister of Health plans to correct these problems

“We have not woken up this morning and decided that we are going to put these interventions in place. It is quite deliberate that we are so far advanced despite being so early in the fiscal year”

Permanent Secretary in the Ministry of Health, Harvey commenting during the Press Conference held at the Jamaica Pegasus Hotel in Kingston on Wednesday, September 2nd 2015.

The long-awaited audit of the Health sector that was ordered by the Minister of Health Dr. Fenton Ferguson since May 2015 as reported in the article “Major Hospitals And Health Centres Audit Results Next Week”, Published Thursday August 27, 2015, The Jamaica Gleaner.

Folks, this may not be to your liking, so at this point you can stop reading and go back to whatever you were doing before.

This as, not surprisingly, it reveals major problems with the infrastructure as well as resource supply problems as reported in the article “Health Facilities Audit Reveals Several Problems”, published Wednesday September 2, 2015, The Jamaica Gleaner.


Alas, my dear reader, I couldn't wrangle an actual copy of the audit that was revealed by the Minister of Health Dr. Fenton Ferguson at a Press Conference held at the Jamaica Pegasus Hotel in Kingston on Wednesday, September 2nd 2015.

Still, if a copy happens fall in my lap from one of my confidential sources, I'll be sure to upload it to my blog for a complete reading by all.

Instead, like everyone I only have a summary document which revealed the nine (9) major findings of the Audit:

1.      Inadequate systems and infrastructure for Infection Prevention and Control, in particular for the MOINA areas (Maternity, Operating Theatre, Neonatal Units, Intensive Care and Accident & Emergency)
2.      Inadequate hand hygiene practice, promotion and infrastructure throughout
3.      Inadequate and consistent supply of pharmaceuticals and sundries
4.      Inadequate supplies of linen, including drapes, gowns etc
5.      Inadequate numbers and functional medical equipment (various types)
6.      Inadequacy in stock management (pharmaceuticals, sundries etc)
7.      Inadequate and inconsistent documentation of critical needs list
8.      Inadequate supplies of PPEs such as plastic aprons used to prevent contact with waste or body fluids
9.      Major defects in infrastructure

Good to note the original Jamaica Gleaner report lists eight (8) major findings, but I counted nine (9), actually.

Ok, so now the Health audit is out, putting to paper what the Doctors have been saying all for quite some time now as noted by President of the Medical Association of Jamaica ( MAJ),  Dr. Shane Alexis in the article “MAJ Demands Specifics, Solutions Following Damning Health Sector Audit”, Published Wednesday September 2, 2015, The Jamaica Gleaner, what’s next?. 

Audit of Public Health Care System revealed - How the Minister of Health plans to correct these problems

So what does the Minister of Health plan to do to correct these problems, including the shortage of pharmaceuticals, also a long-standing problem as pointed out in my blog article entitled “JMDA laments bad conditions in Public Hospitals - How MOH Audit will reveal Doctors and Pharmacists stealing Supplies for Private Practice”?

According to the Jamaica Observer, he's already made the move to do so as noted in the article “Sick health system”, published Thursday, September 03, 2015 by Alphea Sauders, The Jamaica Observer.

The Minister of Health Dr. Fenton Ferguson pointed out that they'd been aware of these problems for quite some time. However, a complete audit now gave them a clearer picture of what the problem were exactly and where they were located, quote: “The piecemeal approach of the past has not served us well. We have acknowledged that the health system is in need of some reform to meet the changing health care needs of the population”.

To his credit they'd started addressing some of the concerns:

1.      JA$1.5 billion infrastructure upgrade over the past three years
2.      18% increase in the health budged to over JA$50 billion
3.      JA$3.8 billion contract signed to ease the shortage of pharmaceutical and medical sundries
4.      JA$6 billion on pharmaceuticals and sundries for the Financial year overall
5.      JA$2 billion on reagents for the Financial year overall
6.      250 pharmacists and pharmacy technicians employed in an effort to improve service delivery  
7.      JA$14-million spare parts for critical biomedical equipment e.g. X-ray, CT scan and MRI machines
8.      18 new ambulances are being bought into the island

Those ambulances are thanks to contracts signed with Toyota Jamaica, PROMAC (Programme for the reduction of maternal and child mortality) and the National Health Fund.

Also the procurement of the pharmaceutical and medical sundries, signed mere weeks before Wednesday September 2nd 2015, was a part of a larger order for the 2015-2016 Financial year, quote: “This is an initial procurement as we expect to spend close to $6 billion on pharmaceuticals and sundries, and $2 billion on reagents in this financial year alone. In addition, since April 2015 we have provided the regional health authorities with an additional $130 million per month from $50 million previously”.

Additionally, he's started to track changes, something that's novel for the Ministry of Health known for making promises but not actually doing anything, to quote MOH, D. Fenton Ferguson: “We have started to implement a pharmacy management information system which will help us to track items, their availability, expiration and order levels”.

They've also wrangled a medical microbiologist as a part of an ongoing assessment to visit the various health facilities to make sure they are up to the necessary standard required for a Hospital. Whether that'll mean also be firing doctors for malpractices complaints, being as that's a standard, remain to be seen.

I cannot say I've heard this all before, as this is the first islandwide audit I can recall in recent memory as well as from research. So this may actually mark a new beginning. 
We'll just have to wait and see if changes have been made.




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