Despite the challenges facing the health care system, this island’s Health Minister is adamant that the Government, his Ministry, and by extension the Barbados Drug Service (BDS), "will never be penny wise and pound foolish."

??Minister Donville Inniss made these comments last Saturday evening, while officially launching the Knights Health Advantage Club, an initiative of the company to offer members free health checks, discounts, counseling and invitations to educational seminars.

"There are those doubting Thomases who believe that the system is so broke that it cannot be fixed and there are those who have a vested economic and financial interest in maintaining the status quo.?? Knights Pharmacy has shown that it is prepared to think outside of the box, be proactive and do things differently. This is the attitude that should prevail in both the private and public sectors of Barbados," he stressed.

Though Government must make an effort to contain spiralling health care costs, the Health Minister promised that this was being done without compromising the quality of patient care.

??"No Government in this island has ever, and will ever be so irresponsible, as to enact measures which would deliberately cause harm to its citizens, especially when it comes to health care," Mr. Inniss emphasised.

Describing the BDS as "one of the major cost centres of the Ministry", he clarified the rationale behind the recently announced modifications to the Drug Formulary and the re-introduction of a dispensing fee at private pharmacies.

"Effective April 1, 2011 a dispensing fee will be re-introduced in order to reduce expenditure under the Barbados Drug Service and to contain the wastage, therein. Patients can continue to access drugs free of cost in both the public and private sectors, with the Barbados Drug Service continuing to cover the cost of drugs dispensed in both sectors. However, persons filling prescriptions at private pharmacies islandwide will be required to pay a dispensing fee to the said pharmacy.?? Those filling prescriptions in the public sector will continue to receive their medication without having to pay a dispensing fee," Mr. Inniss explained.

The Minister, however, made it clear that it was the policy of the Health Ministry that only citizens and permanent residents were entitled to free health care, except in cases where a certified communicable disease existed.?? "We have kindly asked individuals whose place of birth is not Barbados to present evidence of their Barbadian citizenship or permanent residence next time they visit the polyclinic or public health care facility," he pointed out.

In his address, Minister Inniss also outlined that in the interest of patient care and the sustainability of the Barbados Drug Service, the Ministry had also made continuous and concerted efforts to provide a more relevant and efficient Drug Formulary. To this end, the Barbados Drug Formulary is revised annually by the Barbados Drug Service, with additions or deletions to the Formulary being made, where merited.??

"This review is necessary to provide an analysis of the medicines included … [and] to make expert recommendations for rational prescribing and drug use.?? Selection is also made taking into account the pattern of prevalent diseases of the country, and with due consideration to data on efficacy and safety of the medicines, based on clinical studies.???? The annual revision of the Drug Formulary is not an ad hoc process.?? There is a Drug Formulary Committee which is duly established under the Drug Service Act and the recent thorough review of the Formulary was undertaken by the Drug Formulary Committee in consultation with the Pan American Health Organisation," he maintained.

Minister Inniss noted that the selection process for the Drug Formulary involved extensive consultation with specialists in different areas of medicine to seek their guidance in ensuring that there is consideration of patients with special needs/conditions. ????He added:?? "Of importance to the selection process is the need to make available a comprehensive set of quality pharmaceuticals that meet the desired standards of efficacy, effectiveness, safety, quality and cost- of not only an individual unit, but the cost of total treatment."

There is representation on the Drug Formulary Committee from the Barbados Association of Medical Practitioners; the Barbados Pharmaceutical Society; Barbados Registered Nurses Association; Barbados Association of Psychiatrists; Barbados Association of Pharmacy Owners; and patient advocates.

"Therefore, for any doctor or supposedly representative body of doctors to imply that this Committee would not act in the best interest of patients and society on the whole is but fodder for fools and an insult to the integrity and intelligence of fellow doctors and other committed health care workers," Mr. Inniss remarked.

The Health Minister praised the Knights Pharmacy staff for making use of the "abundance of intellect and experience among health care professionals in Barbados" and training its cadre of pharmacists to provide a wide range of value-added services beyond dispensing medication.??

Highlighting the initiative as a desirable boost to the health care system, he lauded the club card as a value-added service that went beyond the historical role of a pharmacist merely dispensing medication and advice.

"Given the need for interventions at both the individual and the community levels, the Knights Health Advantage Club is a welcome addition to our ongoing national efforts… Health care reforms and improved patient care is not just a matter for the Ministry of Health. All stakeholders, including patients, must begin to take a more active role identifying the challenges and addressing them," Mr. Inniss stressed.??

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