“It Cannot Be Business As Usual”

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Health Minister, Donville Inniss

According to this island’s Health Minister, Donville Inniss, it cannot be business as usual with health care in Barbados, or more specifically, the Barbados Drug Service (BDS).

Referring to upcoming changes to the Barbados Drug Formulary and the reintroduction of the dispensing fee for private pharmacies in particular, Mr. Inniss pointed out, in a recent interview, that modifications had to be made.

"I think we have been burying our heads in the sand on these matters for too long and we now have to wake up and smell the roses. It cannot be business as usual.?? We cannot continue with the system the way it is.?? It is a recipe for disaster and I will not be held accountable for driving a nail in the coffin of the health care system in Barbados," Minister Inniss emphasised.??????????????????????

Figures from the BDS show that the department’s expenditure rose steadily from $11.2M in 1988/1989 to more than $50M in 2009/2010.??

"For many years, the Barbados Drug Service has been providing medication free of cost to citizens and permanent residents of Barbados.?? So, you go to a doctor, whether it is private practice or in the public sector, receive your prescription and once the items on the prescription are on the Formulary you go to either a public or private sector pharmacy and you receive the medication and there is no charge.??

"However, what Barbadians did not realise, or did not know, is that apart from the cost of the medication, the BDS has been paying private pharmacies in Barbados, approximately $1.2M per month to dispense the medication to those who come for prescriptions to be filled. In light of the tightening fiscal situation, we had to take some decisions," the Health Minister explained.

Noting that the decision had been made after much detailed discussion, the health care head reiterated that the changes were made after careful deliberations with pharmacy owners, pharmacists, patients, physicians, and a range of stakeholders.

"These are no pie in the sky, airy fairy ideas of a Minister who is not trained in health care clinical matters.?? There are competent people in the public service and in the private sector whose expertise and knowledge we have drawn on and we have also listened to what people would call the average person out there, the citizens of Barbados, and we have done what we deem to be in their best interests," Mr. Inniss said.

He noted that alternatives had been considered, but the final decision was deemed to be the fairest of the options.

"One recommendation is that we should go back to what was happening perhaps in the 1980’s and have a co-payment for everybody.?? [Both] public and private sector – everybody would pay a portion of the cost of the medication…?? Another recommendation was that all patients whether you attend a public or a private facility should be charged the dispensing fee or the cost to the pharmacist for filling the medication.?? We negotiated and deliberated for a while … and we came to what I consider a very informed decision," he maintained.

The final outcome was that for citizens and permanent residents who have their prescriptions filled in the private sector, government will pay the cost of the medication but the dispensing fee would be borne by the patient.???? However, if a person opted to go to a public pharmacy, they would continue to receive the medication on the Formulary free of cost and no dispensing fee would be charged.??

"I find this to be the most equitable situation. The other option really is to go back to the tax payers and say give us another $20M to $25M a year, to run the [Barbados] Drug Service and I don’t think that is a fair approach to take," the Health Minister remarked.??

If you are not a Barbadian but have citizenship or permanent residence and are seeking to be a beneficiary of the BDS, you should either produce a certificate of citizenship or permanent residence or your passport bearing a stamp to the effect that you have been granted citizenship or permanent residence.????

lbayley@barbados.gov.bb

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