The Tribune

By NEIL HARTNELL

Tribune Business Editor

nhartnell@tribunemedia.net

A CABINET paper on the proposed 'breadbasket list' reforms could be ready within three to four weeks, as part of long-term moves to prevent a healthcare budget "explosion".

Dr Duane Sands, minister of health, told Tribune Business that his ministry had agreed with the Ministry of Labour, Price Control and "other stakeholders" how they would approach public education and the roll-out of an initiative designed to improve public wellness via economic incentives.

Suggesting that the benefits from encouraging a healthier diet may take "a generation" to materialise, Dr Sands said the demand for healthcare services was "astounding" and placing ever increasing pressure on the Government's Budget and system. He warned that "the Budget is going to explode", as in Canada and other countries, unless the Bahamas adopted a 'preventative medicine' strategy to tackle the high level of chronic non-communicable diseases (NCDs) plaguing its society.

"Health will prepare the Cabinet paper with recommendations for final consideration, so that what we have discussed on this journey can be debated by that body that makes the final decisions," Dr Sands told Tribune Business.

"It's being drafted right now. Realistically, given that it should be completed for my review this week, and then has to be vetted by the permanent secretary here before going to the Cabinet Secretary for review, then on to the Prime Minister for consideration and to be placed on the Cabinet agenda, we could be looking at three-four weeks" before it is discussed.

The bid to completely alter the Government's 'breadbasket' food line-up aims to align tax and economic policies with the Bahamas' dietary health needs for the first time since the 1970s. It plans to switch-out many existing foods in favour of products that will encourage healthy eating, replacing the likes of corn beef and sugar.

Dr Sands said a legal opinion from the Attorney General's Office suggested the 'breadbasket' reforms did not require legislative change, only an amendment to the schedule accompanying the existing Price Control Act.

Given the "fairly dramatic implications" for health, and a cultural shift in the eating habits of many Bahamians, the Minister said the revised schedule was likely to be laid in Parliament and accompanied by a ministerial communication.

"We have targeted the Budget as the mark, the benchmark," Dr Sands said of when the change will likely be introduced. "This has such significant implications that whenever it's done will be worthwhile. We are shooting for that target, and not necessarily suggesting we will miss it, but it should proceed anyway and we will make whatever adjustments we need to make."

Dr Sands acknowledged that "continuous public education" would be required on the reforms, as altered prices would not necessarily lead to an immediate change in dietary habits that many Bahamians have learned over decades.

He added, though, that a preventative approach that focused on wellness would more than pay for itself in the long run as a result of Budget savings as well as improved quality of life, productivity and healthy living.

Describing the cost of, and demand for, healthcare as "astounding", Dr Sands told Tribune Business: "We recognise we have to pay more than lip service to a preventative approach to health and investing in wellness. If we don't, the Budget is going to explode.

"If you look at Canada's budget for healthcare, it's 51 per cent, I'm informed, of their spending per year; 51 per cent of their budget. If we look at that we realise this an insatiable appetite for healthcare expenditure will not stop. We've got to apply a drastic force in the other direction.

"I'm hoping this initiative finally starts to change behaviour, and we go in that other direction. This is going to be part of a generation before we see the impact."