In Guyana, health care is provided by both public and private suppliers. It is coordinated by the Ministry of Health to ensure a uniform health care system across the country. However, public health care is decentralised throughout the country and is administered by the Regional Democratic Councils with ministerial oversight vested in the Ministry of Communities.
It is primarily financed by the government, but contributions from donor countries also play a part. There are some 30 hospitals and many health care centres, diagnostic facilities, clinics and dispensaries in the country which offer both public and private care, with the former being free.
The public health care system is structured so that its proper functioning depends intimately on a process of referrals. Except for serious emergencies, patients are seen first at the lower levels, and those with problems that cannot be treated at those levels are referred to higher level in the system, but in practice, many patients by-pass the lower levels.
While there have been some remarkable improvements in public health care during the last two decades, there are still concerns that our health care system is grossly inadequate in terms of services to the public.
Data from the Ministry of Health shows public spending on health care in Guyana has increased significantly between 2005 and 2015. However, compared with other countries in the Caribbean, Guyana ranks high in terms of basic health care services. Basic health services in the rural areas of the country have been improving.
There are more doctors and nurses and midwives per 100,000 people who provide basic in-patient and outpatient care with limited diagnostic services, radiological and laboratory services and preventive and curative dental care.
The public health sector may not be able to offer certain sophisticated and specialised medical services, due to the lack of the technology and medical specialists in the country.
There are some barriers to needed public health care services; there is long waiting time, shortage of doctors, nurses and medical equipment in some locations, especially in the riverine communities.
This has not only placed the health of patients in jeopardy as they seek medical attention, but unfortunately, it has also led to several deaths. Many senior public officials and the wealthy have constantly sought medical attention in the United States, Canada, Trinidad and Tobago and Cuba. This is because they recognise that Guyana simply lacks a certain level and quality of service.
Inadequate infrastructure, inefficient systems, shortage of nurses and trained doctors, sloppy management, lack of drugs and poor customer relations in the hinterland are some of the major problems.
Overall, our public health care system is in need of continued improvements as it relates to services. The Minister of Health and by extension the government’s rhetoric that our public health care system is adequate, which may be an exaggeration. However, it is far removed from the days when doctors were so scarce that Guyana reached out to the Philippines and Sri Lanka.
Even nurses had to be imported even as our nurses were rushing to greener pastures.
Money is still being spent to construct medical facilities where none existed and there is the money to rehabilitate some of the existing ones. A few months ago, there was the complaint about a drug shortage, so critical that one was led to believe that crucial pharmaceuticals were absent.
It turned out that people in the system were stealing the drugs as fast as supplies were dispatched. That has slowed. The system is so much better to the point that the health index keeps rising.
We must have a proper public health care in order to have a healthy and productive population.
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