The 72nd World Health Assembly (WHA) was held in Geneva, Switzerland last month, May 2019 and the delegates adopted 3 resolutions relating to Universal Health Coverage (UHC).
The resolutions are expected to be acted upon by delegates when they return home, since these are the recommended approaches to strengthen our health systems and provide quality health coverage for the entire population. These resolutions require member states to implement recommendations agreed upon in 2018, which would strengthen Primary Health Care (PHC) to “have quality, integrated health systems and empowered individuals and communities.” It also suggests that attention be placed on community health workers, who should be in the frontline of delivering PHC. The resolutions supported the organising of a high-level meeting at the United Nations in New York during September 2019 to discuss Universal Health Coverage and finally the resolutions asked Member States to “accelerate progress towards universal health coverage with a focus on poor, vulnerable and marginalised individuals and groups”.
We should all agree that the health of a nation is its greatest wealth. It appears however that this NNP administration is squandering the oil and gas wealth of our nation and steadily compromising the health of our population. What have the people of Grenada been hearing from our government? Instead of reporting on the resolutions on UHC, as agreed to in Geneva, the Minister of Health is selling National Health Insurance (NHI) as the approach to improve our health system. While individual responsibility is extremely important in maintaining a good health status, the policymakers are responsible for ensuring a health system that is holistic and works for the benefit of all. Implementation of the NHI is only a part of, not the final answer to, alleviating our troubles in the health sector. In fact, without a broader focus on UHC, the NHI scheme will collapse. Implementing UHC is essential to guaranteeing the population comprehensive quality and effective health services.
When we look at the state of Grenada’s health services, it has never been worst. Our health indicators over the last 25 years show a constant increase in the prevalence of diabetes, hypertension, cancers, heart disease and depression, among others. People are hardly using our community health services and are having tremendous difficulties seeing a specialist and most cannot afford to pay them. Poor people have to endure all kinds of stress to access health care services today, having to resort to motorcades and donation sheets to pay for health care.
Our hospital services are constantly under pressure with quality of service deteriorating rapidly. Very little attention is given to mental health. Our nurses have not been treated with love and respect and are moving to greener pastures. Grenada is about to lose another batch of senior nurses and the government does not seem to care. The morale of health workers is at its lowest and staff are going through the motion trying hard to maintain their professionalism. The Primary Healthcare programme is not functioning and this government has no idea what to do.
Leadership of the health sector is a critical ingredient in maintaining a strong health system and this is the main problem with the Grenada health system today. The theme set for World Health Day by the World Health Organisation (WHO) for 2018 and 2019 was “Universal Health Coverage: Everyone, Everywhere.” This celebration took place on 7 April and we heard nothing from our Minister of Health to mark the occasion, but we will certainly see representation at the meeting in NY next September. Despite going on a Retreat on Health, the government is yet to state their position on UHC. The NDC calls on the government to have a national dialogue on UHC that approaches health reform in a comprehensive way rather than their limited focus on NHI. The resources currently being used on NHI can be spent much more effectively.
Despite the glaring situation in our health sector this government is acting in a heartless manner focusing all its attention on how people will pay for healthcare services when they are sick, rather than promoting policies that will keep them healthy. How can the government think of taxing people more to implement a programme that is not focusing on an integrated, comprehensive approach to health? The push towards NHI must be done within the context of UHC and the problems and solutions of our public health system must be clearly identified. While discussions on NHI is currently taking place with Grenadians, the course is already set for implementation in early 2020. This is another indication of the government’s lack of understanding of what genuine consultation is all about. The NDC is not convinced that this process will lead to successful implementation unless we follow the recommendations agreed upon at the WHA in May.
The NDC is committed to implementing UHC within the context of the 2030 UN Sustainable Development Goals (SDGs). The party believes in the importance of genuine consultation that will allow us to fully understand our realities and we are committed to going through that process. We will then be better able to develop policies consistent with human development. Dialogue with our health workers must be a priority and the NDC will listen to them. How can we speak of major health reform without appreciating the importance of their input? Our health sector lacks leadership and the NDC calls on the Prime Minister to replace the current Minister of Health with someone who appreciates the importance of people. The health of our nation is the wealth of our nation. Let us advocate for improved quality, accessibility and affordability that is provided in an equitable manner for all Grenadians. Let us discuss and implement Universal Health Coverage.