Dr. Tony Gale Advocates an Approach of Health Over Profit

Submitted by Dr. Tony Gale (Retired)
Dr. Tony Gale (Retired)

Dr. Tony Gale (Retired)

This letter is a response to articles in the media discussing the concerns of the Minister of Finance about the urgent necessity of reducing recurrent government expenditures, as well as the concerns of the Minister of Health about the high and unsustainable costs of our hospital and other medical services.

A single measure, i.e. legislation prohibiting the production, marketing and sale of tobacco products on the grounds that they are lethal could be a remedy for both these concerns.

It would not be difficult to enforce such legislation; since only 6% of Males and 1% of Females in Barbados are tobacco smokers, and tobacco consumption is no longer socially acceptable in Barbados.

Let me explain.

According to actuarial studies by economists of the Centre for Communicable and Non-Communicable Diseases in the USA and the World Bank, the net loss caused by tobacco consumption in the USA is $3,391. per person per year and each packet of cigarettes costs the nation $7.18 in medical costs and reduced productivity.

Similar Actuarial studies have never been done in Barbados or the Commonwealth Caribbean but taking into consideration the differences in the prevalence of smoking between the USA and Barbados (22.7% vs 7%), the differences in the size of their populations (USA 284,797,000 vs Barbados 268,792), the annual costs of treating tobacco related diseases in the USA and Barbados, and the differences in the value of their currencies USA $1 = Barbados $2), the annual economic losses caused by the tobacco industry in Barbados can be crudely estimated to be at least $120,000,000. This is ten times more than the tax revenues currently collected from the tobacco industry.

This estimate is a measure of the magnitude of the economic burden imposed on the people of Barbados by the tobacco industry and the immense economic benefits to be derived from prohibiting the manufacture, marketing and sale of tobacco products. It is also likely that demonstrating the huge benefits of prohibiting the production and consumption of tobacco products would stimulate interest of both consumers and public and private policy makers in other measures designed to promote the pursuit of health at all levels of society e. g. the prevention and reduction non-communicable diseases. At least 60% of the morbidity and mortality in Barbados is caused by non- communicable diseases other than tobacco consumption; so since it is likely that the economic losses caused by these diseases annually is at least $360,000,000. Preventing and reducing these diseases, therefore, would obviously be preferable to the pursuit of “blue sky” scenarios such as medical tourism and the privatization of medical services currently advocated in the media and other public fora by persons who sanctify the market economy as the sole source of a prosperous, healthy and happy society.

The evidence to support these “blue sky” scenarios has never been stated explicitly. But contrastingly the success and benefits of the tobacco control program of the Barbados Cancer Society and similar programs in other countries are well recognized and well documented. For instance statistical analysis shows that since 1982 when this program was started the Barbados Cancer Society the prevalence of tobacco consumption has declined from 18% to 7%, and the annual cost of treating tobacco related diseases has declined by $102,579,750 from $167,845,500 in 1982 to $65,276,750 in 2015.

Similar programs in the USA, notably in California have produced equally impressive benefits. And according to an article in the journal PLOS Medicine August 26 2008 by James Lightwood, Alexis Dinno and Stanton Glantz; “The Effect of the California Tobacco Control Program on Personal Health Expenditures”, for every dollar invested in Tobacco Control measures, there has been a 50 Fold reduction in personal health expenditures, and a corresponding increase in the productivity in all sectors of the economy, public or private.

Are there any investments in Barbados, public or private that have produced or could produce such large economic benefits?

I believe that the pursuit of health not the pursuit of profit is the key to health, happiness and sustainable prosperity. And Furthermore that this shows that when Jesus of Nazareth, who was sent by God The Father to redeem Mankind told his disciples “That to him that hath it shall be given, but to him that hath not it shall be taken away”, his words applied not only to Spiritual Health but to all manifestations of health in our world, namely mental health, emotional health, social health, economic heath and above all the health of our Environment.

D.A.Gale, MB. ChB. Birmingham University, 1949
Retired General Practitioner,
Former Honorary Director Tobacco Control Program
Barbados Cancer Society, (1985 to 2008)

QEH Head Suggests “Rationing” to Save Cost

Submitted by Anthony Davis
Life Support

Life Support

The chief administrator at Barbados’ lone public hospital is suggesting that authorities may have to consider discontinuing treatment for some terminally ill patients… the question I want to ask . . . ‘is Barbados ready for a conversation and a debate around futility of care versus rationing?Barbados Today

Well, well, well. What next? The answer is a resounding NO, Dr. James!

How much is a life worth, doctor? What you should do is drum it into Chris Sinckler’s head that the Queen Elizabeth Hospital (QEH) needs the funds which he recklessly cut. The QEH was functioning very well until he came along and cut the funds to that institution along with the funds to the UWI and welfare. These are all things that are hurting the poor, the needy and the vulnerable in our society.

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Sick Healthcare

Submitted by islandgal
Ambulance shortage - photo credit: Advocate newspaper

Ambulance shortage – photo credit: Advocate newspaper

I have been waiting to see if any of the BU posters will at least post something on this very serious problem we have with our health care system. But as usual no one has come forward as yet.

Recently I was at Sandy Crest where there were two patients who needed to get to the QEH asap. The staff were calling around for ambulances and not one could be found. Finally one was located and it took the first patient to the hospital. The next patient was going into cardiac arrest and every attempt to find another ambulance was in vain. I asked if the first ambulance could come back and take the patient to the QEH and was told that it was no longer available. You could hear the frantic calls by the doctors to the QEH about the patient was in a terrible state. He needed to get to ICU ASAP but no one could find an ambulance. I read in the papers recently about the death of a patient who couldn’t get an ambulance to take her to the hospital while her family watched her painful death.

I heard on a call in program about another incident where someone’s family was in ICU and the drip had run dry. The family member asked if another drip was needed. The reply was that they have the drip but not the medication to put into the drip. This was another ICU case. The family member frantically called around and found the medication at Sandy Crest, bought it and took it back to the QEH. This caller said she had tears in her eyes.

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Doctors On The Take

Barbadian expectations were raised when the Queen Elizabeth Hospital (QEH) switched from being a department of government in 2002 to being run by a statutory board. We were convinced by the then government that the autonomy of a board was just what the doctor ordered for the QEH.

Successive governments have had to battle many challenges when asked to manage our premiere health institution.   To read the full-page ad which was placed by BAMP in the weekend newspapers detailing yet another conflict with the Board of the QEH would not have registered on the cognitive index of the vast majority of Barbadians. We have come to expect it. One is left to wonder why the industrial relations climate at the QEH always seem to ring of a discordant note.

Based on what BU has observed over the years the problems at the QEH are many and solutions difficult. The question which has to be asked is whether healthcare delivery is now being compromised as a result of unresolved issues between doctors and Board which have been outstanding for too long. BU’s sense is that there is a hardening of positions at the QEH. According to our sources the junior doctors especially are being asked to work extremely long hours which means there is no work life balance and a 12 hour day is not uncommon.  A spirit of cooperation which was part of a now distant culture has reversed to the detriment of the patient. As if this isn’t enough some in the know believe the quality of Interns entering the QEH in recent times is inferior compared to that of old.

Barbados has always prided itself on its standard of healthcare delivery, the unsettled industrial climate at the QEH over time is beginning to undermine it all.

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Are Bajans Jackasses or Jennyasses?

From the Facebook Page of Agyeman Kofi

Hermaphrodite for an ASS called Barbados

Today the following fell off a truck I was driving behind. I seek where possible to bring the facts uncovered without favor or bias. Neither do I hold any quarter or brief for any political party.

A pregnant 15 year old and her uncle arrived in Barbados with a letter from the St Martaan government for admission to QEH. Baby was born with complications and is still in ICU, mother and Uncle fled island leaving baby behind. Unfortunately, no one in St Martaan is returning QEH calls and we now have a child born in Barbados by a fugitive mother and with uncle as an accomplice.

Kidney patient turns with an admission letter to QEH and dies in A&E and no one in his country has come forward to claim body.

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Demystifying Government’s Healthcare Policy

Submitted by Trained Economist


Minister of Health Donville Inniss

Over the past few months there has been much discussion and media coverage of issues related to health care policy in Barbados.  Despite the volume of media coverage I remain unclear as to a number of issues, which  restricts my ability to adequate assess the health care policy issues being raised.

From what I have been able to glean there are three issues out there:

  1. Only nationals and permanent residents are now entitled to free health care in Barbados.
  2. Persons eligible for free medications who choose to purchase such medicines at a private pharmacy are now required to pay the processing fee charged by the pharmacists to public patients and previously paid by the government.
  3. A number of changes have been made to the drugs on the formulary and medicines previously available free of cost are no longer available free of cost.

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