Public health realities and the JLP’s 2016 manifesto

Dr. Christopher Tufton

Gleaner Archive – January 5, 2020

“HOW MUCH easier it is to be critical than to be correct”. Canute Thompson’s recent assessment of the Jamaica Labour (JLP) administration’s achievements in health breathes life into this adage, while betraying a seeming lack of understanding of the complexity in public health.

His assessment takes only a snapshot of the health portfolio, when it is far more useful to look at the history and examine performance in the context of what has been done to reposition the sector to address 21st-century realities.

I must, therefore, set the record straight on the last three years and through the lens of the JLP’s 2016 manifesto referenced by Thompson; and in the context of new and emergent challenges, such as Jamaica’s changed health profile that is typified by the scourge of non-communicable diseases from which seven of every 10 Jamaicans die yearly.

For starters, the manifesto articulates a new strategy for health that facilitates the movement away from a reaction to getting sick to a proactive posture of well-being. This is in defiance of a health system that has, under too many earlier administrations, failed to receive the requisite resources to thrive. We are changing that, in pursuit of “universal access to effective and efficient healthcare for all Jamaicans”.


In keeping with its commitment to renew healthcare infrastructure, the Government has rolled out the most comprehensive capital expenditure plan for public health in more than two decades. It is to spend more than J$30 billion in the next five years on health centres and hospitals, including Cornwall Regional, Spanish Town, St Ann’s Bay, and May Pen. Works have begun with financing already secured and an overseas consulting firm selected for design work.

Bustamante Hospital for Children is also a beneficiary, with designs almost completed for additional bed space, a new pharmacy under construction and the Cardiac Centre and Catherisation Lab completed and in use.

Some six hospitals and health centres have been upgraded to the tune of more than half a billion dollars under the National Health Fund (NHF). Also, through the NHF, the Government has provided critical equipment for hospitals totalling $110 million and replaced, at cost of $58 million, four malfunctioning elevators at the Kingston Public, Victoria Jubilee, Spanish Town, and Princess Margaret hospitals.

Another 10 health centres – including Greater Portmore, Old Harbour, May Pen West, St Jago Park, Ocho Rios, and St Ann’s Bay – are to see major overhaul. Funding, estimated at almost $2 billion, is to be provided, in part, through the Inter-American Development Bank (IDB).

The promised Portmore hospital has not been placed on the drawing board, as a decision was taken to do a major overhaul of the Spanish Town Hospital with a nearly $3-billion expenditure secured and committed. Still, there are ongoing discussions to build a new hospital in St Catherine. More will be said on this later.


The first draft of the review of the Regional Health Authorities has been completed. This was done through a multi-stakeholder task force led by a team from the Pan American Health Organization (PAHO). The report was presented to Cabinet and an implementation schedule is being developed to address issues, such as performance targets, property maintenance and consolidation of services for more efficient administration.


The realisation of this promise is seen in two areas. One is in the Jamaica Moves programme, which encourages Jamaicans to exercise at least half an hour each day, eat a balanced diet and get a medical check-up at least once per year. Jamaica Moves has had significant reach and gained regional and international support, with endorsements from the Caribbean Community, PAHO, the World Health Organization, and the United Nations. There is also Jamaica Moves in schools, accompanied by the implementation of sugary drink restrictions to address the increasing levels of childhood obesity and premature illness.

This promise is also being fulfilled through primary care renewal, which is captured in the 10-year development plan for public health, tabled in Parliament last year. This plan is the first major road map for public health in two generations, addressing all the critical components of public health for the future.

In terms of primary or community health care, the changes will include more curative services, longer opening hours (currently in effect) and more doctors and nurses at the community level.

Already in the area of mental health, for example, we have trained and started to deploy more community mental health aides, with others to follow.


The Government completed a needs gap of healthcare personnel and is working on several programmes to increase and improve retention and training. Three specific programmes have been advanced. The first is increasing The University of the West Indies cadre of nursing students from 150 to 300 annually.

The other two significant programmes are for specialist nurses training through bilateral agreements with China and the United Kingdom. The first batches of nurses were sent to these countries with their local tutors for clinical rotation in 2018 and 2019. They have since returned and have been deployed to local hospitals.

Additionally, 1,500 posts have been approved by the Ministry of Finance, to end the contract worker employment of our nurses, which was a major cause for concern in the past and a negative incentive for nurse migration.


The manifesto also promised attention for a national health insurance scheme; medical tourism; the development of an effective health information network and opportunities to outsource services to the private sector. The Government went ahead and commissioned a technical study on the establishment of a National Health Insurance Plan and a Green Paper was tabled in Parliament early last year. We are now embarking on national discussions to graduate the document into a policy paper for implementation.

There is a draft Green Paper on Medical Tourism, which is shortly to be submitted to Cabinet, and we completed a plan and secured US$9 million for an initial roll-out of our hospital health information system. A consultant under the IDB-financed programme is on board and a contractor is to be sourced to advance that project.

As for private sector outsourcing, we have launched the Enhancing Healthcare Service Delivery project to provide diagnostic services for public patients through private providers islandwide. Ten providers have been engaged.

All users of the public health system can benefit, on the authorisation of their physician and provided the hospital is unable to deliver the service. We will shortly do the same for certain surgeries.

There is no doubt that more work is needed to be done in public health. Some may argue that this is one reason the JLP should be given another term: to complete the work it has started.

While I know that Mr Thompson’s position as chair of the People’s National Party’s policy commission would not cause him to agree, it is important, nonetheless, for his own credibility, to call it as it is, not on how he wants to think it is.

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