Private partnership key to better health

Although the health system in Fiji is better than many other countries of the South Pacific, the private sector could help in promoting a higher standard of public health, according to a global body report.

A World Health Organisation (WHO) Survey said the Fiji Government’s five-year Health Strategic Plan (2007-2011) had envisioned strengthening cardiology, oncology, nephrology and hyperbaric medicine but strategies and programmes must be in place for promoting a better public health system.

“There is a need for strengthening clinical services for surgery, medicine, paediatrics, obstetrics and gynaecology, orthopaedics, ENT, emergency medicine and other relevant support services,” the 2008 survey said.

It said infrastructure development and maintenance was vital for delivery of quality and uninterrupted medical services. The Survey acknowledged new facilities established in recent years in Nadi, Levuka, Vunidawa, and Taveuni.

“New infrastructure development will include the completion of Labasa Hospital, relocation of Navua Hospital, construction of a new hospital in Ba, Nausori and the relocation of St Giles Hospital. As an ongoing activity, the Ministry of Health will continue to concentrate on maintaining and improving existing facilities,” it said.

But access to public health remains the privilege of the middle and high-income groups, with a large segment of the population unable to afford medical costs related to diagnosis and treatment, and more importantly, surgery.

Massey University Associate Professor of Economics Dr Rukmani Gounder said Fiji was in danger of increasing vulnerability of the poor.

“Addressing the challenges of poverty is becoming urgent as more people are falling below the poverty line. In the 1970s, about 10% of the population was living in poverty, increasing to 25% in 1990-91 and rising to 34.4% in 2002-03.

“With the current global economic crisis and decline in economic activities in Fiji, the rise in poverty would be close to 40%,” she said in an Indian Newslink article (January 15, 2009).

Her study accounted for the level of poverty, Government policies to combat the problem and the ways and means of helping the poor and the needy.

Dr Gounder said economic decline, inflationary pressure and high rates of unemployment have had their impact and that more people were finding it hard to buy food, pay for electricity and other basic needs.

“The way forward is to implement livelihood programmes to rekindle the public spirit. With the help of NGOs and international aid agencies, there is hope to meet social objectives. The government’s objective of reducing poverty levels will require urgent action with basic principles of and current discourse on policy coherence,” she said in her article.

Since the situation is so gloomy and getting worse, people must be helped out of their current mindset, which is, “The poor will always remain poor,” she said.

The WHO Survey said the public health care system in Fiji was heavily dependent on general taxation. The increasing demand for and cost of health care, compounded by limited resources, obliged the Health Ministry to accord special attention to health care and financing and cost-recovery strategies, it said.

“Increasing demand for services has led to an expansion in the number of private general practitioners and specialists practising in Fiji under the Fiji Medical Council.

“The immediate priority of the Government is to reduce long queues, long waiting lists and turnaround times and facilitate patient flow.

“People need secure livelihoods to improve their circumstances,” the Survey said.

According to Dr Gounder, the lessons of the last three decades should encourage the concerned to rethink and cultivate a genuine public spirit to get to the bottom of the problem and set development priorities.

“Strengthening national policies, addressing social sector development and creating gainful employment opportunities with a decent minimum level of living are vital to reduce poverty,” she said.

Photo : Dr Rukmani Gounder