The public furor and persistent calls for the resignation of the Minister of Health, Dr. Fenton Ferguson, are reasonable in some respects and unreasonable in others. On the one hand if it is that the Minister is responsible for the administration, and management, of the Ministry of Health in totality, and the “buck stops with him” on all matters, then the call for his resignation is reasonable. However, if the Minister is not responsible for the administration and management of the Ministry of Health in totality then the call for his resignation is unreasonable. Of course the Minister is at all times fully responsible and accountable for what he says, and does.
The Minister is responsible for policy. The responsibility for management rests on the shoulders of the Permanent Secretary (PS) of the Ministry who is by law the accountable officer. In that respect the calls for the Minister to resign is unreasonable. However the PS is not responsible for the utterances of the Minister in Parliament or elsewhere.
The current fiasco in health care in Jamaica, in particular the deaths of 19 babies due to bacterial infections, is an administration/operational/management problem. It is not a policy problem. Nowhere has it been said, or established, that these deaths are the result of a policy emanating from the Minister or the Ministry. The current fiasco is result of decades of excuses, political interference and intimidation, rampant corruption, poor management together with a lowering of standards, and quality, in the provision of health care and the operations of some health care facilities.
Reporting protocols may be in place but the reports may be inaccurate. The report may say the ward was mopped, when it may not have been mopped, or it may have been mopped with water alone without disinfectant. Also the whole ward may have been mopped without changing the water. Yet the report says the ward was mopped. Why? Because standard operating procedures and policies mandate that the floor be mopped. The report may not say supplies, and consumables are not available because they are stolen. Yet no one is ever caught stealing the supplies that have been bought and paid for, but never available when needed because “it finish”. Those who carelessly damage, or destroy equipment are never held accountable. Equipment maintenance records have been falsified by reusing the old parts, rather using the new parts that are supplied. That culture has to change. Let’s call a spade a spade.
Those heading and providing services in the multi-faceted aspects of health care need to take responsibility for the provision of an improved quantity and quality health care in Jamaica. It can no longer be business as usual. Blaming the IMF or no user fee policy for not being able to meet at least the minimum standards recognized by Jamaican and some international standards will not solve the current crisis.
