Friday, November 06, 2009
Medical care in Fiji
The Fiji Times ran an article today about health care in Fiji and the upgrading. The story does not say much about pro-active health and community health awareness which I think is really important. Ninety per cent of health care is up to the individual, to make good lifestyle choices about food, exercise, etc. and only 10 per cent is about accessing the medical clinics and hospitals. Already there is some work done in Fiji in publicity and visiting villages with dental care etc. but this is where free treatment and awareness campaigns are really important. A couple of things I noticed about health care in Fiji is that some people go to the doctor for a small problem which ought to be dealt with by common sense, and at the other extreme some people tough it out and do not go early enough and then there is a tragedy. I'm not sure that very expensive equipment and specialists are the way to go in Fiji in using up the millions of dollars allocated, when there is so much more needed in the prevention side of medical care, such as in that 90 per cent of knowing how to care for yourself and cutting out the fats, sugars, smoking, alcohol and long sessions of kava!
I won't get into the argument about paying for medical care. I was fortunate in Fiji to get good care in the 60s and 70s for the birth of three children. (Ba Methodist Hospital and Labasa hospital). One hospital stay cost only 40 cents for two days in hospital! In Australia these days it costs about $4000 to give birth in a hospital! Thank goodness for the Medicare system though, and even those who pay insurance they still have to pay the 'gap'.
When paying will help
Saturday, November 07, 2009
THE planned upgrading of medical facilities nationwide will be welcome news to all who use the national health service. More than $9million is expected to be used by the Health Ministry on the purchase of equipment and the streamlining of services. The move will coincide with 22 Health Ministry officials graduating with Masters' degrees and rejoining the service in different specialist fields. All this is encouraging for doctors and nurses who have been forced to work with substandard equipment in decrepit facilities for years.
Last week, this newspaper highlighted the shortage of obstetricians in health facilities around the country. Even the ministry's head of obstetrics, Dr James Fong, agrees that there is a desperate need for doctors and nurses in this extremely specialised field. There was a stage when Fiji's midwives and obstetricians were the best in the region. Nurses from across the Pacific attended courses at the local nursing school and returned home to make pregnancy safe for mothers and their babies.
Over the years, however, the conditions in our medical centres, nursing stations and hospitals have deteriorated quite rapidly.
An increasing population has put tremendous pressure on operations in all these facilities. Better roads to remote areas mean it is easier for rural dwellers to have access to treatment.
But the Health Ministry has remained reluctant to charge for the services it provides. Unless a national health insurance scheme it established, it will be impossible for any government to provide quality medical care for the citizens of this country.
Foreign aid allows the purchase of equipment, maintenance of infrastructure and training of doctors and nurses.
In order to sustain optimum levels of service and maintain buildings and equipment it is, unfortunately, necessary to charge patients for the use of facilities and medicine.
We do not expect the health service to make a profit but it must cover costs. The time has come to review charges at health facilities. It's time to place realistic costs on and charge for services provided. Only when this is done will the Health Ministry be able to provide the best possible service to patients.
It is unrealistic of patients and their relatives to demand optimum service from the national health service when they pay nothing for medicine or the bare minimum for in-patient treatment.
The Health Ministry must take a tough stand on the issue if services are to improve. With adequate money, the central government will be able to provide more doctors, nurses and medical centres for everyone. But one thing is certain – it won't happen for free.