Lessons from COVID-19


Lessons from COVID-19


Sunday, May 17, 2020

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Since the onset of the 2019 coronavirus pandemic we have heard repeated reference to that dictum: “A crisis is a terrible thing to waste.” It is clearly a perspective which should inform the way in which individuals engage such experiences to lead to proactive outcomes. COVID-19 is making it clear that it is not only appropriate and applicable to individuals, but to governments also.

As we look across the globe and see the way in which diverse nations have been responding to the pandemic by way of the leadership offered by governments and their health authorities, we can be proud of the way things have been handled by our governing authorities. Nothing is ever perfect, and in a context of this nature every citizen and interest group has a different perspective as to the path to perfection in handling our current challenge.

At the same time, by its very nature, in a crisis things are going to happen which are unpredictable and have the potential for deepening an already anxiety-laden situation and throwing people off balance. As well, by its very nature, crisis situations have a way of exposing the weaknesses and points of vulnerability even in the most organised and best planned system. It is of the nature of a crisis to be the vortex for generating blame towards supposed villains in a non-productive manner. The question which arises in such a context is whether those who are in positions of authority and control can grasp the opportunity which the situation offers for learning, growth, and positive action.

A number of such weaknesses have been exposed in this crisis and the challenge is whether the Government will take the high road and employ constructive and decisive actions that will leave us in a better place in post-COVID-19 Jamaica. I would like to draw attention first of all to an issue which has been discussed ad infinitum with no positive response from Government, but which has not only shown up as an issue of frustration for the majority of citizens of this country, but has been an obstacle to the smooth disbursement of government compassionate benefits and the conduct of business within the constraints imposed by the pandemic. I speak of the vast number of Jamaicans who are not able to operate a bank account in this country and the digital online business facility which it makes possible.

Minister of Finance and the Public Service Dr Nigel Clarke, in recent pronouncements, has pointed to the difficulty involved in transacting business with government departments, in particular the Tax Administration Department, citing the long lines at the tax offices, and pointing out how easy it would be if citizens were in possession of a national identification and a bank account to do their transactions online.

Putting aside the fact that there is still a significant section of the population without access to the digital technology, we have long known that countless citizens of this country are not in possession of a bank account and will never be able to possess one under the current regime administered by this and the previous Government.

People present themselves at banks and other financial institutions armed with their passport, driver's licence, or national voter registration card to open an account and are dismissed because they need to bring along with them a utility bill addressed to them at their place of residence, a job letter, and a letter of recommendation from a justice of the peace. If a piece of national identification has no value for authentication of identity, then it is of no value to us as citizens and we are operating under a system by which we are deluding ourselves as a nation. Our government must decide if it will continue to exclude more than 50 per cent of our citizens from having a bank account and access to the digital banking by simply repeating the shibboleth of “money laundering prevention”.

The requirements for having a bank account, as I have written on other occasions, is at base a discriminatory act perpetuated by our governments and which make a significant part of our population ineligible to exercise a right, which is a prerequisite for functioning in a developing nation. The argument about money laundering protection cannot continue to hold so many of our citizens to ransom, and we need not use our imagination as to the social strata of the society which constitute the primary victims. I need not mention the young people who, on leaving school, would like to open an account and can only get a runaround.

I grew up in an era when children were encouraged to save in the penny bank system — a most laudable system if citizens are to learn from early the value of saving. Many of us grew up knowing the value of our Government Savings Bank account, when the Government was embracing and encouraging this approach to teaching thrift to its people. How have times have changed! Thankfully, Senator Don Wehby, in a recent presentation in the Senate, has seen the light. A way must be found to stop this unjust unbanking of our citizens. If this COVID-19 pandemic could lead our Government to act decisively in this matter it would be one more sign that it has not wasted the crisis we now face.

There have been many tragic occurrences since the onset of this pandemic, but perhaps none has touched the hearts of Jamaicans as the untimely death of Jodian Fearon under circumstances which have raised many unanswered questions. Our hearts go out to her family who have been plunged into grief, while many call for justice and try to establish where culpability resides. It is a time when raw emotions are given free expression. Beyond all this, we must ask: What are we learning from this? And, how do we turn this tragedy to good effect? Already there are voices calling for amendments to certain laws related to doctor-patient confidentiality to be named in honour of Jodian, and which it is believed has played a significant role surrounding the handling of her death and the subsequent investigation by her family.

Jodian's death also raised a number of questions concerning the protocols which exist between private hospitals and public hospitals regarding the transfer of patients from one to the other. This led to a recent newspaper investigation and expose regarding the status of private hospitals in the nation's health care system. It has revealed that the majority of private hospitals in Jamaica are not in compliance with the relevant legislation. This has turned out to be a classic case of how a crisis can bring to the fore deficiencies in any system. The explanations offered by the health authorities are sad, if not laughable, and demonstrate a system that has long outlived its usefulness and makes little sense to the modern mind.

The expose made public that, “Local private hospitals are governed under the Nursing Homes Registration Act (NHRA) of 1934, which is separate from the National Health Services Act, which regulates public hospitals.” Private hospitals have been a part of the landscape in Jamaica for just about a century. The Nuttall Hospital, for example, was opened in 1923 as a hospital offering general medical care and the training of nurses for the island of Jamaica. Yet, nearly 100 years later it is to be registered under a Nursing Home Act. No wonder the other private hospital have had an issue with such a designation, finding the idea ludicrous. While, I subscribe to the fact that there must be a legitimate system of registration for all medical institutions serving the public, what has been revealed about the status of the registrations of these private institutions is a manifestation of anachronism in a 21st century world.

One historian, in writing about the emergence of private hospitals at the beginning of the 20th century in Jamaica, writes: “At the beginning of the twentieth century the only hospital facilities in Jamaica were those established for the benefit of people too poor to pay for medical treatment. It often happened that an employer could send his employee to a properly equipped hospital, while he himself had to depend on makeshift care at home or go abroad to be treated…” In short, what this was highlighting is the fact that the Kingston Public Hospital was built primarily for the poor and offered free medical care. It was a different situation where other sectors of the society were concerned.

Since that time, private hospitals have complemented the service offered by public hospitals and, in many instances, have offered superior medical care. It is interesting to see that the Tony Thwaites Wing has been identified as one private medical facility that is not registered with its nursing home honoured status as it offers quality medical care, and to which leaders in various spheres of our nation are admitted when overseas travel is not an option. It is no overstatement to say that the private hospitals have usually been offering better and more comprehensive care than many of the public hospitals across the land which have teetered between hospital status and that of an upgraded clinic.

Following the publication of the expose, Minister of Health and Wellness Dr Christopher Tufton was referenced in the press: “Tufton has put the blame on years of inaction across political administrations in failing to revise outdated legislation and has shouldered some personal responsibility for not operationalising a new framework.” It is further noted that he ordered that the necessary inspection be undertaken and is pointing in a direction toward a positive resolution of the issues involved. If we can get updated legislation governing private hospitals, clear recognition of their role within the system of health care delivery in this nation, and their registration consistent with these regulations, we would have converted another aspect of this COVID-19 pandemic into a positive outcome for our nation.

The positive outcome to this crisis is not just what happens sometime in the future which still remains elusive, but how we set right the manifest vulnerabilities and inadequacies of our systems, even while the pandemic persists. Truly, a crisis is a terrible opportunity to waste.

Howard Gregory is archbishop of the Province of the West Indies, primate and metropolitan, as well as bishop of Jamaica and the Cayman Islands.

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