Budget Debate 20133177 04 Apr, 2013
Mr. Hamilton: Mr. Speaker, I crave your indulgence and ask a request of you. After I am finished with the first five minutes of my presentation, could you allow the Hon. Dr. George Norton to rebut? I do not want him to carry the burden of one year to return to rebut me in 2014 for the 2013 Budget. It is an unprecedented request but I will leave it up to you to grant, if you will grant that request.
Mr. Speaker: If the request is made.
Mr. Hamilton: We, once again, come to discuss the National Budget. Yesterday we would have heard many speakers speak. Before I go into my presentation proper, I would want to clarify three matters:
1. This morning the Hon. Member, Mrs. Volda Lawrence in her presentation, indicated that in Guyana there is severe malnutrition and large numbers of children born underweight. The records regarding that matter suggest that low birth rate for live births in Guyana is 11.2%, under five years moderate to mild malnourished children is 7% and under five years severe malnourished children is 0.5%. Therefore it was total misinformation. If one goes on the net one will see the IDB, one will see the World Bank and the UN reporting on the figures.
The Hon. Member, Dr. George Norton, in his presentation, rebutting my 2012 presentation about him bringing his tears to the National Assembly… In his presentation he said that I am a “Johnny-come-lately” person to the healthcare system and he spoke about his longevity in the healthcare system, some decades, and he reminded me of two gentlemen in the hold book, the Bible; one Methuselah and the other being Jesus Christ. For Methuselah the only record is one line, “Methuselah lived 999 years and he died”, whilst Christ lived some 32 years and up to last week we were celebrating him. Longevity means nothing; it is what you bring to where you are placed. When you hear the Hon. Member, a health practitioner, speak – the point man for health of the Opposition, the APNU – and comes to the National Assembly, what are we regaled with? We are regaled with an overflowing sink; no programme, no plan. This is a health practitioner. 30 years of service he boasts of.
The health facilities that are managed by the Ministry of health in this country is some 360 odd. It is expected that if one is managing 360 odd facilities there were plumbing problems. I have three bathrooms at home and I too get plumbing problems so the point is that instead of coming to the National Assembly, making a presentation to transform the health sector… [Mr. Greenidge: That is not his job.] Yes, that is his job. He is a health practitioner and he is a legislator and he must come to the National Assembly to speak to the issues of the development of the health sector. That is his job. That is what he should be doing and not regaling us about toilette and sink and plumbing facilities.
When one hears Members speak, they give their gloom and doom of the health sector. The fact is that everyday tens of thousands of citizens of this country journey to the public health sector and are serviced by Guyanese doctors and nurses and health professionals because they have the confidence in the health sector.
I must mention this to make my point because it was prominently featured and it was a national matter. Mr. Speaker, you would know that some two months ago, unfortunately, the General Secretary of the People’s National Congress/Reform (PNC/R) was injured via an [inaudible]. The reports suggest that when that happened he was rushed to a private facility, St. Joseph’s Mercy Hospital. Within 24 hours he was transferred to the public health facility, the Georgetown Public Hospital Corporation. The point is if the General Secretary and his family did not have confidence in the public health system then he would not have been transferred into the public health system.
The other point is, we would know that some two weeks ago the Chairman of the Alliance For Change suffered a cardiac arrest in the Marudi Mountains. From Marudi to Aishalton to Ogle to Georgetown Public Hospital to Timehri International Airport it was the public health system that was responsible for that. If they were not confident in the public health system, I suggest to this National Assembly, they would not have presented themselves.
I am attempting to say to this National Assembly that daily thousands of Guyanese present themselves. The public health system takes care daily of their bodies, nourish them back to health, fix their broken bones, take care of these persons. When one stands up and suggests, as my good friend the Hon. Member Ms. Annette Ferguson that nothing has happened in the health sector and she read a letter about a person whose child wanted assistance from the Ministry of Health/Government of Guyana and that assistance was not granted. The fact of the matter is the relevant persons that she spoke to never ever made such a request to the Ministry of Health but the Ministry of Health, every year, assists citizens of all likes and strata with medical assistance. I have before me that the Ministry of Health provided $136,737,000 to the citizens of Guyana to help them with health care; 394 citizens of Guyana, inclusive of 59 children who were helped by the Ministry of Health to deal with…
I am seeking to correct this falsity that the healthcare system is not delivering to the Guyanese people. I have in my hand the USAID Health Sector Assessment 2010 and they are speaking about Guyana’s healthcare system. On page 17 this is what they talk about, “Service Delivery”:
“The health sector is making significant strides in providing equitable services, skilled human resources, infrastructure and technology, particularly through the strengthening network of laboratories, the outlining of the package of public guaranteed services and the strong contribution to the strengthening of HIV/AIDS service delivery.”
This is USAID speaking about the Guyanese health sector. Secondly, at page 15 of the same report they said:
“Guyana has seen significant health sector leadership that has supported innovative improvements over the past few years.”
Therefore, when one comes to the National Assembly and suggests that nothing is happening as regards taking care of the health of the citizens of this country, it is erroneous; it is unfounded and it is total misinformation.
The Ministry of Health presently, as I said, supervises and oversees some 353 health facilities around the country. Presently there are over 500 doctors who take care to the citizens of this country every day. There are over 1,200 nurses who take care of the citizens every day so when we come and we suggest via the attitude of denigrating their work… In my short sojourn at the Ministry of Health, I have seen these people climb the mountains, face the rapids in the creeks and the rivers to deliver healthcare to the length and breadth of this country and all of us, if we are honest, would know that presently in Guyana, wherever one resides, one can access healthcare. It has never been that way before.
The Member of Parliament for Region No.9 could not be living in Region No.9 and spoke that way; of course the Minister of Health dealt with that matter yesterday so I do not want to go over that matter.
The healthcare system, as I indicated, the public health system, will be staffed with more doctors and nurses this year. Presently we have 162 nurses who will be graduating in 2012. We have 21 medical laboratory technologists, seven x-ray technicians, audiology technicians rehab assistants, community health workers. Presently there are 314 registered nurses being trained, 110 nursing assistants, 29 basic midwives and 26 single-trained midwives that are being trained to come into the healthcare system.
To compliment the activities of the nurses and doctors, presently we have in training some 26 young medics who will be graduating in the next couple of years to compliment 89 medics that are had throughout the length and breadth of Guyana that are serving the Guyanese people, being helped by 314 community health workers. That is why I say every place in Guyana, whichever Region, whether coastal or hinterland, any citizen has the opportunity to access healthcare.
In the coastal belt it has never happened before where practically every health center in the coastal belt has a resident doctor; never in this country. In some instances the health center has a doctor and a medic. The healthcare system continues to deliver service to the Guyanese people.
The Hon. Member, Ms. Ferguson, indicated and spoke to the issue that the fact that the national health care strategy of 2008-2012 came to an end. We are well aware of that and I could report to the National Assembly that the Ministry of Health has started, since last year November, working to put together the new national healthcare strategy that we call Vision 2020, running from 2013 to 2020. In the next month, the health care strategy should be launched.
Some of the ideas, some of the matters that the new strategy will attempt to deal with, which we have already started, are the issues of legislation, updating of legislation… I can report to the National Assembly that in conjunction with the Ministry of Local Government – with the Local Government Ministry being the lead under the hand of the Hon. Members, Ministers Ganga Persaud and Whittaker. We have already placed in the Attorney General’s Chambers a proposed Bill to establish a Solid Waste Authority. At the level of the Ministry of Health we have, at the Attorney General’s Chamber’s, the new nurses and midwife legislation. We have the optometrist legislation and presently we are doing consultation to repeal the public health ordinance that we will call the health protection and promotion legislation. With all of those legislations it is our intension to have them by the second quarter in the National Assembly so that we can update the legislative framework to deal with the governance of the health sector in Guyana.
On the issue of governance of the health sector, the governance framework of the new strategy will be broadened and will include a wider stakeholder group which will include the Ministry of Amerindian Affairs, Ministry of Local Government, Ministry of Education, Ministry of Human Services, our donor partners, the Ministry of Natural Resources and stakeholders and other Non-Governmental Organisations (NGOs) because we want the widest involvement in the strategy that will drive Guyana in the next seven years regarding healthcare in Guyana.
At the level of training, recognising that there are some shortfalls in the way we dispense healthcare. Looking at the last strategy, the curriculum of the nursing schools are to be modernised to include training to deal with the issue of elderly care, to deal with the issue of mental issues, to deal with the issue of how one treats handicapped or differently able persons. The idea also is to make health centres what we call “Health and Wellness Centers” that would move beyond curative care and to involve ourselves in preventative care to teach and to train people about their lifestyle, about their nutrition and [inaudible].
Where it is possible, where we have the expanse of land the plans are that the wellness centre will deal with the issue of exercising, will deal with the issues of children and their recreation because we know that obesity is one of the issue that we are faced with now among the population because of all of the junk food we do consume.
The other fundamental is making health centres “men friendly”. Health centres are not “men friendly”. If one does a census and one talks to 100 men, I am sure that 99 men would say to you that they believe to you that they believe that health centres are for mothers and children so we have to make health centres “men friendly” so that a man can feel that he can seek medical intervention before he reaches into a serious… The idea also is to open health centres later than we now have them open, at 4.30 p.m. so that it would allow for the ordinary man and woman who is unable to leave that job and go to seek medical intervention. That man riding home on his bicycle or coming out of that minibus, after 4.30 p.m. or after 5.00 p.m., would be able to stop at a health facility to seek medical intervention.
The Berbice Regional Health Authority has lead the way and we hope to utilise some of the things that they have done, especially the issue of home visits by doctors. We hope to replicate that in all of the regions of the country where the elderly can be visited by our doctors and our health care professionals.
Berbice Regional Health Authority, as indicated by Dr. Mahadeo, the Chief Executive Officer (CEO) of that, has led the way in that regard.
These are some of the matters that will be foremost in the new health strategy. Of course, the Minister spoke to the issue of Non-Communicable Diseases (NCDs). That is one of the fundamental issues also in the new strategy. Some of the priority areas and strategic building blocks are to ensure that we have health across the life cycle.
Family health, a man’s role in pregnancy: Today pregnancy is the woman matter, how do we get a man to participate…?
The building blocks, as I said, in the strategy will deal with the issue of health right across the life cycle. One of the fundamentals we have to pay attention to is the issue of elderly care. Whilst the health sector did well and is allowing people to live longer, concomitantly we have not put in place a programme to deal with the longevity of persons and therefore, the new strategy will attempt to deal with. How do we deal with the issue of geriatric health care?
Non-Communicable Disease, as I indicated… Mental health is one of the issues I have heard many persons speaking to but what they have failed to understand is that presently it is not that simple to pick up someone of an unsound mind and have that person committed. The law presently does not allow. The lawyers will tell you, Mr. Speaker, that it is a family member who has to go to a magistrate or a judge and swear to commit that family. That is the law. If we want the laws to be changed then let us have a debate and a discussion about how we amend the law.
One of the recommendations can be, as the same way as how a citizen can make a citizen arrest, to talk to a health personnel or who believes that the person is a danger to himself and society, that personnel can seek to swear to an affidavit to have that person… As it stands, it is not that easy. Whilst we understand the problem and… [Ms. Teixeira: It is a human rights issue.] That is the other issue. Many of the persons who are saying today let us go and sweep up and pick up all of those people and commit them to Canje would be the same persons who will be with their placards the next day saying that we are breaching their fundamental human rights. The issue of environmental health, as I said, is a fundamental issue that we ought to pay attention to and, as I said, holistically, we are attempting to deal with that matter by bringing into play a solid waste authority to pay attention to that matter.
It is said that a healthy nation is a wealthy nation. Therefore we are delighted that, recognising the job that we have to do between now and the year 2020 with the new health strategy, the Ministry of Finance and the Minister have seen it fit to raise our budget, or to accept out budget presentation that we have presented, moving it from $17 billion to $19 billion dollars. There is a lot to be done, because there are new things to be done. There are innovations; there are recommendations: How we deliver health care to the people of Guyana? How do we ensure that our nation is healthy? How do we ensure that our nation is productive? It is by ensuring that our nation is healthy.
I would like to close by saying that I commend the Minister of Finance and his team for the budget that they have presented to the people of Guyana and I have no difficulty supporting the measure.
Thank you. [Applause]
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