Dealing with a sick health system

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Mata'afa Keni Lesa

When we are sick, we go to the hospital. But what happens when the hospital is sick? In this instance, we are referring to the entire health system in Samoa. 

Who provides the diagnosis? And who prescribes the medicine?

Judging from what’s being reported so far, our health system is not suffering from just a minor cold. It is more of a seizure of epic proportion threatening a heart attack.

And there’s more. It appears to involve tumours the size of Mars and anxiety as the result of bruised egos and hurt pride. 

These syndromes unfortunately don’t just infect individual patients, it has contaminated the entire sector so that today, it sounds like it needs all the help it can get. 

Initially, we didn’t think it was that bad. We thought it was just a sore. 

But that’s not what’s happening apparently. It appears the sore has been allowed to fester so that today there is a full-blown infected scab that needs an operation. Urgently.

So far, what we’ve been told is extremely disturbing. Take the story on the front page of the Samoa Observer yesterday as an example. Under the headline “Inquiry told of health woes” a picture that is not flattering of the health services was painted.

For instance, after all the years of talks about the re-merge between National Health Services and Ministry of Health, there was absolutely no consultation between the bodies prior to when a report was submitted to Cabinet for their review.  

That is what the Director General of the Ministry of Health, Leausa Dr. Take Naseri said. Asked who prepared the Cabinet paper recommending the re-merge, Leausa responded that it was he. Pushed on whether other stakeholders were consulted, Leausa said no. 

Why? Well according to the Director General, “the obvious body language by the parties is why there was no consultation.” 

Well isn’t that a tragedy? How can people who are supposed to be working together for the betterment of health services in Samoa not  communicate with each other? How on earth could they recommend a re-merge without a consultation? We can go on and on but we’ll stop here.

The point is that this is what we mean when we say the health system is sick. The tragedy of it all is that it seems the problems we are seeing at the lower end of the service begins from the very top where what appears to be a clash of personalities and egos have led to the problems we have today.

The problem is that such disunity affects the delivery of health services to everyone – including the most vulnerable and poorest members of this community.

The good news is that something is being done about it. 

Cabinet is obviously concerned about the diagnosis of our health system so that it has appointed a Commission of Inquiry to consider the proposed organisational structure in terms of going forward. 

Obviously the future involves the re-merge between the Ministry of Health and the National Health Services. For that to happen, there needs to be clear guidelines. Lessons, successes and failures from the past all need to be taken into account.

Former Attorney General, Taulapapa Brenda Heather-Latu, is chairing the Commission which is expected to report back to Cabinet with its findings. 

She is assisted by Commission Members including Professor Fui Asofou So’o and Fa’amausili Dr Matagialofi Lu’aiufi. Their task is three-fold. They are to: 

• Review the proposed structure for the new merged health agency which has been proposed by a high level taskforce;

• Consider the concerns about the structure raised by nurses employed in the N.H.S;

• Recommend options for the proposed new structure after consultation with the relevant stakeholders

Well let’s pray and hope that they get it right this time around. We don’t want to waste another $30 million only to have the same discussion in 2028?

Have a peaceful Friday Samoa, God bless!

© Samoa Observer 2016

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