2013 World Bank report damning – Cummings

A report conducted in 2013 by the World Bank on health services in St Vincent and the Grenadines has been described by the New Democratic Party (NDP) as damning and earth-shattering and shows the country’s inefficiencies in the area of health care.

And, Daniel Cummings, the NDP’s shadow health minister, said that although the final report was delivered to the Unity Labour Party (ULP) government in 2014,{{more}} it has never been made available to the general public.

The report is dubbed, “Regional disaster vulnerability reduction project, health service analysis for relocation of the Milton Cato Memorial Hospital (MCMH).”

“What is interesting is that this study was commissioned in 2013 for a 12-month period and delivered to the Government of St Vincent in July of 2014. We are now at the end of 2015 and this Government has remained absolutely mum on this revealing document,” said Cummings, as he addressed persons at the NDP headquarters on Wednesday morning during a town hall meeting.

He said that someone he described as “an angel of a special kind” delivered the report to him.

Cummings used the forum in Richmond Hill to talk about the contents of the final report from the World Bank, which he said was not placed on the Government’s website or anywhere where persons could have perused it, although it is a public document.

The report was written by a team of specialists who had as their objective, “enabling a clear vision for the future development of health systems in St Vincent for both emergency medical services and elective health care that would support the clinical effective and cost efficient delivery of quality assured services to all communities and enabling a clear strategy regarding the size functionality and potential location of a replacement acute hospital facility.”

The report was presented in several stages and Cummings quoted from the final presentation.

He said that section two or the inception phase of the study observed that crucial areas of data, specifically related to emergency medical services, are not collected here and therefore were not available to the team during the mission. As a result, the team asked the Government permission to do a survey to obtain this data.

“The availability of data to perform the required analysis on the health system was very low and there was a necessity to apply a survey to obtain this information.”

The data required spoke to socio, demographic, morbidity mortality, referrals and the problem solving capacity of the health care services.

“The requests to undertake this level of survey was not agreed by the client; the client is the Government of St Vincent and the Grenadines. The consultants requested a survey to hear from you the people of this country, your concerns about health in this country, critical to the analysis of the problems to find solutions. Your Government said to the consultants, hell no, no such survey,” said Cummings.

“The report showed a lack of a system-wide coordinated, health care delivery model from primary health care settings to the referral hospital (MCMH),” said Cummings, who stressed that the consulting team in analysing the system, broke it down into primary care, district and main hospital facility. He noted that information was obtained by speaking with key government agencies and the consultants set out the reports on three issues, the emergency management system, the main “acute” hospital and the accident and emergency department.

He stressed that all the levels were found to be functioning on an inappropriate level.

The shadow health minister said that while the consultants noted what an A&E Department should be, the local set-up is nowhere next to the suggestions.

According to Cummings, it was observed by the consultants that the emergency management service in St Vincent was inadequate and was not seen as a priority service which requires the appropriate legislations, management and resourcing.

He said also, that the current ambulance system was assessed as being very basic and requires professionalizing and modernizing in line with a clear direction and strategy. The report said that the control and dispatching of ambulances is currently undertaken by the health facility where the ambulance is located by way of a phone call, personal request or via one of the other emergency services.

“This approach does not enable the opportunity for emergency management services communication to optimize the emergency medical system patient care abilities while utilizing evidence based priority dispatching on a system wide basis”, said Cummings quoting from the report and adding, “what that says is that the ambulance system is archaic, out of date and inappropriate.”

The NDP man noted that the report said that although the importance of the health sector is highlighted in the national development plan, there is no specific mention of the improvement of infrastructure and equipment for the health care delivery system to our emergency medical services.

It was noted that the information also touched on health care in the Grenadines and it was observed that evacuation of patients from the Grenadines are clinically and logistically managed by a case by case basis, in line with both clinical and transport resources available at the time and are not to an acceptable clinical professional standard.

It also touched on the fact that non-communicable diseases, like hypertension, recorded the highest number of visits to facilities. Cummings said that this means greater attention must be paid to deterring harmful behaviours and educating people to adapt healthy lifestyles and practices.

He added that while members of the ULP and their supporters are criticizing the NDP’s proposed hospital that will be built in East St. George if the NDP is elected, the World Bank report has a section dealing with the location of this facility and the consultants had investigated six sites in Vermont, Pembroke, Ottley Hall, Arnos Vale, Diamond and Peruvian Vale.

He said that the first three were eliminated but it was noted that a hospital could effectively be built in Peruvian Vale, Diamond and Arnos Vale, “yet the ULP Government is rubbishing the sites.” Cummings said that a report that dates as far back as the 1970s shows the site that the NDP has chosen for the hospital is ideal.

“The current structure is oriented mainly to attend maternal and child health issues and the accident and emergency services are concentrated at Milton Cato Memorial Hospital. The country is heading one way and Government taking us another direction,” said Cummings, who stressed that the NDP has consulted with a number of medical professionals around the world and what passes here for health care is not what it is supposed to be.

“I am amazed that the Government got assistance from the World Bank to do that report and they buried it because it made them look like the idiots they are. It made them look like they don’t care because only a government that don’t care about its people will sit on this for so long,” said Cummings.

He said that the ULP Government will not be able to improve the health care system here, “so, thank God they will be removed.” He reiterated that the NDP is committed to building a new health care facility, no matter the cost.