Health — 27 February 2016 — by Adele Ramos

BELIZE CITY, Thurs. Feb. 25, 2016–The national budget is due to be presented in Parliament in the coming weeks. There will be much debate on the numbers, and especially on where the Government plans to spend $1 billion it will earmark for the various Ministries and to meet the final tier of salary increase for teachers and public officers.

One critical Ministry is the Ministry of Health. Chief Executive Officer in that Ministry, Dr. Ramon Figueroa told Amandala that, “From the outset, we’ve been reminded at every occasion that next year is a lean and mean year.” Figueroa noted that they have had to cut their budget to fit within the assigned ceiling, and this has meant scaling back on medical supplies—an area which appears to have been abused in the past. Figueroa said that the budget process is “a very rigid and straightforward process,” and they were given a ceiling from last year of around BZ$120 million, including the budget for the Karl Heusner Memorial Hospital (KHMH).

The new budget would include the salary adjustment approved for KHMH workers, who were given an increase financed by a grant in this budget year from Central Government, which provides an annual subvention to the statutory body.

We asked the CEO about the highlights of next year’s health budget, and he revealed that one of the milestones they would like to achieve is the establishment of a pharmaceutical registry which would cover both the public and private sector. Figueroa expressed concern about “the importation of too many medications that are known not to be good… from countries that mass produce.” He told us that their inspectors have found that certain drug retailers have been selling cheap and ineffective medications from the Middle East and Asia with labels written in foreign languages that consumers can’t read.

“We have found medications on shelves that are in Arabic and no English label. They are cheap—cheap and no good. Our right, our constitutional right is to ensure we regulate this industry,” the CEO said.

“We tell them they need to pull it off the shelf but we don’t have legal authority to force them to do so,” said Figueroa, noting that those establishments tend to comply because they rely on the Ministry of Health for their letters of compliance to be able to obtain their business licenses.

New legislation would give the Ministry of Health the authority to pull those meds from store shelves or maybe to shut those pharmacies down.

According to the CEO, a major area of focus in the new budget year would also be revisiting the procurement of medication and hospital supplies by the Government.

“We are having serious budgetary problems with that area because of past purchases. We bought a lot and we owe a lot to the pharmaceutical companies right now,” he explained.

A cap of $17-$18 million has been set for medical supplies, as part of their effort is to streamline the purchase, monitoring, and supply chain of pharmaceuticals.

“That is going to be one of our main thrusts for this coming year—to be more efficient and more effective in the way we handle medical supplies and pharmaceuticals,” he said.

New legislation is also in the works to address tobacco and alcohol consumption and abuse. The Ministry is working on tobacco legislation which would limit smoking in public places, disallow sales to young people, and set guidelines for advertising. Similar legislation would be drafted for alcohol and there is already a draft policy document, the CEO indicated.

We asked the CEO about plans for the roll-out of the National Health Insurance (NHI) scheme.

“Right now we are in the process of revising a policy document that has been prepared together with the World Bank and a consultancy firm. They did an assessment of NHI to look at feasibility of rolling it out to the rest of the country,” he explained. He added that “government does not have the finance to roll out NHI, but we have some options that we would need to convince government and the general public of, but at the end of the day it would have to be a separate contribution from the public.” The technicians propose that this contribution may come from an increase of half a percentage point in General Sales Tax, the creation of a new tax on alcohol and tobacco, or even a general contribution through the Social Security Board.

“It has to be a separate contribution for NHI; that is the only way we will be able to roll out NHI,” he said, indicating that the annual requirement would be in the region of BZ$40 to BZ$50 million.

The CEO explained that while the Ministry has purchased ambulances for most facilities and has ordered a few more needed at certain facilities, they are also in the process of purchasing basic equipment for all health facilities for this budget year. “We are trying to ensure that we have all the basic, standard equipment. We had to be creative in how we use our funds,” he said, adding that some facilities have been using some of the NHI funds to purchase their own equipment, resulting in savings for those NHI clinics.

We asked Figueroa whether they are working on any grant-funded projects for the new budget year. He told us that they are currently doing the groundwork for a project to build a 50-bed “smart wing” to Western Regional Hospital which will be high-energy, disaster resilient and energy efficient. The European Union (EU) has provided 10 million Euros (or roughly 20 million Belize dollars) for the project, which should see construction commence in 2017.

The Ministry of Health also plans to upgrade the health facilities in both the Punta Gorda and the San Pedro, and project proposals would be prepared to seek funding for those projects as well.

Figueroa said that the new budget year will be “a year where we are about efficiency, about monitoring, about auditing, about ensuring there is a change in the attitude.” He said that there will be a focus on curbing wastage, as “in the public service there is a lot of waste.”


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