Chief Medical Officer (CMO) in the Ministry of Health, Dr. Joy St. John. (FP)

Instead of cutting spending on health care in these hard economic times, Chief Medical Officer (CMO) in the Ministry of Health, Dr. Joy St. John, believes that Government should look at ways of improving efficiency within the sector.

She made the comments while delivering the opening remarks at a joint seminar hosted by the Chronic Disease Research Centre and the Queen Elizabeth Hospital (QEH) entitled: The Cost of Healthcare in Barbados at the QEH’s Auditorium last Friday night.

The Chief Medical Officer pointed out that the $342 million allocated to the health sector for the 2011-2012 financial year, which was approximately four per cent of the Gross Domestic Product and 12 per cent of Total Government Expenditure, compared well with other developing countries.

However, she said it had been queried whether these funds adequately met the goals of the health system and whether they were allocated optimally or being used efficiently.

"The World Health Report of 2010 estimated that between 20 and 40 per cent of all health spending in most countries is currently wasted through inefficiency.?? In fact, Dr. Margaret Chan, Director General of the World Health Organization said: ???At a time when money is tight, my advice to countries is this: before looking for places to cut spending on health care, look first for opportunities to improve efficiency.’??

"I agree with Dr. Chan’s message that better procurement practices, use of evidence-based policies and practices, and better administrative procedures are measures that governments could employ to increase the impact of expenditures allocated to the health sector," Dr. St. John stated.

She said a review of a report on the Institutional Assessment and Expenditure Review of the Health Sector which was commissioned by the Ministry of Finance and Economic Affairs, had identified several strategies for improving efficiency. These included the rationalisation of posts based on existing responsibilities; the redesign of clinical services to improve patient flow and prevent bottlenecks; streamlining procurement; establishing a systematic approach to the management of long-term care cases; and the development of productivity benchmarks.

Dr. St. John explained that if these measures were fully implemented, they would contribute "immense value" to the output of the Ministry of Health, and therefore, would form part of the health strategy "going forward".

She also expressed some concern over the limited use of cost analysis in the public health sector, saying it was essential for planning and decision-making. This was being addressed, she disclosed, with the introduction of accrual accounting which provided a platform for collecting standardised cost data.

In addition, Dr. St. John said the Ministry had sought proposals to install a patient record information system to meet the clinical requirements of the QEH, polyclinics and laboratories.

"It is expected that funding for this system will be provided by the World Bank and already the bidding document has been submitted to the bank for approval," the CMO explained, adding: "These initiatives highlight the fact that the Ministry is undertaking a process to strengthen decision-making, improve accountability, and to rationalise and improve mechanisms for delivering better health outcomes for the people of Barbados.?? The current financing constraint is an opportunity for us to put the health care system on a more sustainable path."


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