I
would like to bring to light some factors which I believe would be of obstacle
when transforming the current level of health facilities to fulfil the promise
of Health Vision 2050.
Firstly,
I would like to thank the brains behind the documentation of the NHP 2011-2020.
Surely preparation of such a document requires great planning, much resources,
and high determination. No doubt, you people have a heart for the health and
well-being of the people of PNG. I commend you for that.
Health
Vision 2050 is a forty-year strategy that will transform the current health
service delivery system in Papua New Guinea, and links to the National
Government’s Papua New Guinea Vision 2050 and the PNG Development Strategic
Plan 2010-2030. It includes the progressive introduction of community health
posts, district hospitals, regional specialist hospitals, and national referral
hospitals (Pacific Medical Centre)
What
interests me the most is how they are planning to merge Health Sub-Centres and
Aid Posts into Community Health Posts, introduction of Regional Specialist
Hospitals and National Referral Hospitals or Pacific Medical Centre. They
should consider the potential impacts such transformation would have on the
current system and the personnel already working. Following is the diagram of the proposed reform.
 |
| Transformation of the current health service system to future scenario. source: NHP 2011-2020 Vol.1 |
The
foreseeable impacts would mostly be a disaster in the lives of the health
personnel as well as the system itself. Transforming the current health system
would mean changes in health policies, administration structure, health
legislations, Human Resource Management, Financial Management, Logistics
Management, Assets Management, Office Accommodation and Health Information
Management System
When
that happens, health professionals and ancillary staffs are going to be faced
with problems in job Security, employment, qualifications, salaries, job distribution
and equality and job Satisfaction and
work performance
Furthermore,
creating Regional Specialist Hospitals and Pacific Medical Centre may seem as
duplication of services and waste of limited vital resources such as funds,
human resources, materials and equipments for the purpose of achieving Health
Vision 2050. Where are we going to get money to build these health facilities? Or
for the case of human resources, how many doctors, nurses, midwives, and
specialists health care workers do we have? What is the ratio of doctors,
nurses and midwives per population? What is the current rate at which PNG
students are selected to study health in the universities and colleges and will
these institutions be able to cater for all of them? Or are we planning to
recruit outsiders to come and work in these health facilities? These are some critical questions to be asked
if we want to transform the current health system. In addition, and I do not
want to mention it time and again, how can regional specialist hospitals and
Pacific Medical Centre be of service to the rural majority in terms of
accessibility and affordability? What is the current government’s spending per
capita in health?
We should follow examples of countries where
doctors and nurses live and work in the community they serve. Not to mention
the problem that doctors and nurses dislike working in rural areas where
majority of people live, maybe because best of life is not found in rural areas.
So how can we change that? One practical example is the health care system of
Cuba. Though it is a small economy like PNG, it has one of the best health care
system and best health indicators as compared to developed nations like USA.
The secret is, health care professionals like doctors and nurses live in
neighbourhood where majority of people live and they know their patients very
well. Cuban government invests in building and providing health facilities and
services which attracts and is conducive for health professionals to work in
those areas. They bring the services to the people and not the people seeking
health services.
Recommendation
So
why not bring the health services to where the people are and renovating or
scaling up services provided by the current health care facilities. I think
this would avoid spending resources in establishing extra new health facilities
and duplication of services. So it would be nice if we could follow that
example of Cuba.
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