Govt planning radical health sector shake-up
- four regional authorities envisaged

Stabroek News
September 6, 1999

The government has embarked on sweeping reform of the health sector which will see four regional authorities set up to manage and deliver services and the Health Ministry taking on a policy and monitoring role.

A Health Sector Reform Unit (HSRU) has already been established in the Ministry of Health to guide this programme.

Chairman of the Board of Management of the Georgetown Hospital, Dr Leslie Ramsammy has been designated as the Director/Coordinator of the HSRU which has been tasked with the development of a comprehensive reform strategy.

A release issued on Saturday by Ramsammy said that the Health Sector Reform programme is designed to strengthen the effectiveness and quality of health care services; heighten efficiency in the health sector and establish financial sustainability for the sector; to improve equity by ensuring that at least a publicly guaranteed portfolio of health care services is accessible by all members of society and to co-ordinate and maximise inter-sectoral and community participation empowerment.

Ramsammy said that the restructuring and reorganising of the Ministry of Health are among the strategies being implemented in the reform.

Under the scheme, the Ministry of Health will no longer be responsible for the hands-on delivery of health services. The new ministry will instead focus on establishing strategic directions for the health system, develop appropriate health policies, advocate on behalf of citizens, lead research initiatives and monitor and evaluate the effectiveness of programme delivery.

Other strategic moves being implemented, Dr Ramsammy said are to establish a legal and autonomous board to manage the Georgetown Public Hospital (already the Statutory Board has assumed responsibility for the Georgetown Hospital); to establish a legal and autonomous board to be responsible for a National Materials Management Agency that will be responsible for procurement and distribution of goods and supplies including drugs, equipment and services; to broaden health financing options in order to develop a sustainable financing mechanism for the health sector; to establish collaborative mechanisms and links with the private sector and non-governmental organisations (NGOs); and to establish mechanisms to ensure quality and effective delivery of services.

These strategies will be complemented by the establishment of Regional Health Authorities (RHAs), which are expected to contribute to a fundamental change in the structure and functions of the sector.

Dr Ramsammy said that the HRSU has been engaging the public in discussions on the reform programme. These discussions have been arranged with financial assistance from the Pan American Health Organisation and the World Health Organisation (WHO). Meetings have been held in Regions Two, Five and Six.

Meetings with community groups have been scheduled for Region One (Barima/Waini) between September 20 to 24 and for Region Nine (Upper Essequibo/Upper Takutu) between September 28 and October 2. Other meetings are being planned for Regions Three, Four, Seven, Eight and Ten. Meetings will also be held with interest groups such as the Guyana Medical Association, the University of Guyana and the media among others during this month and next month.

A major focus of the discussions is the establishment of the four RHAs. The four are the Berbice, Demerara, Essequibo and Hinterland Regional Health Authorities.

The RHAs will be responsible for accounting and planning, management, co-ordination and delivery of health services in a particular geographic area or region.

A task force working along with groups in the various regions will determine how soon the first RHA will be established. Dr Ramsammy noted that the report in some sections of the media that the Berbice RHA will begin operations in November is a misinterpretation of the agenda for implementation. It is intended that a joint task force will be established in each region to work out details. The workings of the task force, he said, will determine how soon each of the RHAs become operational. The joint task force will come from personnel from the Ministry of Health and the regions.

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