HEALTH Minister Dr Duane Sands.
By NEIL HARTNELL
Tribune Business Editor
nhartnell@tribunemedia.net
The Bahamas can only turn to private-public partnerships (PPP) to help finance its “$500m or more” public healthcare infrastructure needs if there is “a sustainable way” to pay for them.
Dr Duane Sands, minister of health, revealing that unfunded renovation/new build commitments alone totalled around $80m, said the new Fiscal Responsibility Act together with the government’s financial realities meant the era of “spending money blindly” is over.
He added that The Bahamas needed to also “change the balance of trade in health” by repatriating a large portion of the $300m-$400m that Bahamians currently spend annually with south Florida healthcare facilities, arguing: “It’s not a position that can remain forever”.
Dr Sands said Bahamian healthcare providers, both private and public, could ill-afford to “roll over and simply not compete for our people” with Florida-based medical facilities now appointing in-country representatives in this nation to seek out local clients.
Acknowledging that his vision was “audacious and bold”, the minister added that The Bahamas could emulate its tourism and financial services industries to become a market leader in healthcare with “some effort, attention to detail and strategic planning”.
Confirming that the public healthcare system’s physical plant/infrastructure needs alone total hundreds of millions of dollars, Dr Sands said The Bahamas had little choice but to seek out PPPs to meet these capital needs provided they made sense.
“We know the level of unbudgeted or unfunded existing commitments for renovations or new buildings around the Bahamas, that number is around $80m. That’s in the Family Islands primarily,” Dr Sands told Tribune Business.
“Then we know of millions in terms of the emergency room, and the new maternal/childcare unit at PMH. That’s anticipated to be another $160m-$180m. Then, with the demolition of the Royal Victoria structure, there is the requirement for a new HIV Secretariat and referral lab. We have to replace those facilities, and that’s probably another $10-plus million.
“We’ve talked about a National Blood Bank and medical examiner’s facility. Whether that is in the same structure or not, you put that altogether and we’re just around $300-$400m. That doesn’t speak to the infrastructure upgrades required in Grand Bahama, so we’re still looking at the better part of half-a-billion dollars or more.”
With the already-strained Public Treasury unable to generate the necessary financing as required, Dr Sands added: “We have to recognise the value of PPPs as long as we can create a sustainable way to pay for it. That’s where we are.
“There has to be a way to pay for these things because otherwise we will be spending money blindly, and we have to move away from that with our fiscal responsibility legislation; that kind of hand waving economic forecasting.”
Besides finding private sector partners and arrangements that made sense, Dr Sands said Bahamian healthcare services, outcomes and the quality of care needed to be improved to attract millions of dollars in annual spending back to this nation.
“We have to strengthen local healthcare services in order to repatriate - we’ve talked about this over and over - $300m-$400m spent in south Florida annually,” Dr Sands told Tribune Business.
“We have Bahamians spending more on healthcare in south Florida than they do at home, and we recognise if we can be a world leader in tourism and financial services then, with some effort, attention to detail and strategic planning, we could drastically improve our healthcare product and people recognise one of the best places for teaching medicine is home.
“That’s an audacious, bold view but a view I hold. It makes absolutely no sense, when we have south Florida facilities with a country representative to siphon off patients from us, to roll over and simply not compete for our patients, our people,” he continued.
“It’s a matter of building local capacity, self-sufficiency and changing that balance of trade in health to a more favourable position. We’re not going to reverse it in a year, but it needs to be reversed. It’s not a position that can remain forever.”
Dr Sands confirmed that ongoing talks with John Hopkins Medicine over a potential partnership had been “fruitful but in the conceptual stage at this point”. He said the Government’s key objectives were improvements in safety, patient care quality and improved healthcare standards.
The minister said joint accreditation for Bahamian healthcare facilities, and improved education for local doctors, nurses and allied professionals were among the areas where this nation could benefit from “the world-leading approaches and ideas that have caused John Hopkins to continually be among the top three hospitals in the US.
Confirming that any partnership would be built on local talent, Dr Sands said it would “go a long way” if both sides can “compress the timeline to execution” of any agreement. “What the model should be we’ve not yet agreed,” he said. “Right now we’re going back and forth to determine what would be most appropriate for The Bahamas, and that comes with implications and costs.
“I’m excited at the potential. Let’s see what comes to fruition, bearing in mind the previous administration walked this road with the University of Miami. That started with the stem cell initiative and was intended to be a whole lot more, but it faltered.
“We have a relationship with Yale for 30 years on ophthalmology that continues to this day. This is nothing new. The devil is in the details.”
Comments
ohdrap4 5 years, 8 months ago
Translation: payroll tax (the only tax they want to charge, as doctors and lawyers are not on payroll) or extra vat.
M goose is cooked. :-((
birdiestrachan 5 years, 8 months ago
doc a whole lot of talk. Getting an ambulance to a young man who has collapsed should be a simple matter. See if you can do that a simple matter.
Economist 5 years, 8 months ago
Let's see. Min of Health Audit shows Min of Health can't account for $100 million each year.
Clean up this loss and you can pay for the $500 million in just 5 years.
Dawes 5 years, 8 months ago
You won't get the $400-500 million spent in south florida over here if the services are the same. I ahve heard too many stories of people going in for routine surgeries only to have to be sent out of the country due to gross negligence. And then nothing happens. I along with most people who can afford it will continue going overseas until that stops.
bogart 5 years, 8 months ago
WHY DOES DA NATION ...BE PAYING FER DA ......VICTIMS OF CONSUMERS WHO HAVE ILLNESSES POPULATING DA PMH CLINICS ....RELATED...FROM SUGGARY DRINKS.....MANUFACTURED ...IN CHARGE OF.......BY A HANDFUL OF BUSINESS PEOPLES MAKING PROFITS....??????....nation mussey aint knows dat these top illnesses of PMH...CLINICS....GOVT SERVICES...paid fer nation for dese victims of suggary drinks even odder foods related along wid dese foods...!!!!!!!!!.....taxed da suggary drinks an get da nation healthiest...!!!!!!.....empty beds in PMH...!!!!!.....oops dey gan likely have to lay off doctors an nurses if hospital gets empty...!!!!!!!!
Well_mudda_take_sic 5 years, 8 months ago
This man's head is lost in the weeds. The big picture is that each of the 175,000 working Bahamians today owes about $68,500 that successive incompetent and corrupt governments have borrowed on their behalf. The math is all too simple:
National debt $8,000,000,000 (Eight Billion Dollars)
Off-balance debt and unfunded entitlements (National insurance, civil servant pensions, etc.) $4,000,000,000 (Four Billion Dollars)
Total debt $12,000,000,000 (Twelve Billion Dollars)
Total debt per working Bahamian ($12 Billion divided by 175,000 workers) $68,500
Now keep in mind that most Bahamian families are over worked, under paid and over taxed and, as a result, are living a miserable existence, from pay day to pay day. Ask yourself, who on earth is going to pay the $68,500 debt that the successive reckless and corrupt governments have heaved on to each of their backs?
And here we have this looney tune Sands talking about PPPs and the borrowing of hundreds of millions of dollars more!
Remember: Whenever a politician mentions PPP it's code for projects where the Bahamian people take on even more unsustainable debt to finance the PPP while a select few greedy others, who have no downside risk, walk away with the profits, if any, not to mention all of the hefty consultancy and other fees they take along the way.
Chucky 5 years, 8 months ago
we are not a world leader in tourism or finance.
what we are is a country who is host to large hotels owned and run by foreigners who are world leaders in tourism. And we are host to foreign owned financial institutions, be it large public or small private banks that are themselves world leaders in finance.
Note the difference!
We are less likely to become a leader in healthcare as not only are we a nation with some of the lowest educational stadards talking about an industry that relies on the highest levels of education; but also an industry that demands the best of the best when it comes to ethics, progressiveness, facilty and facility maintenance etc. There is not one attribute required in healthcare that would or could be considered a Bahamian strength. Not to say we dont have some good doctors or nurses.
With unlimited reasources and 50 years, we will not be able to match what the USA can offer in healthcare.
We can hardly keep the doors open in our hospitals. We cant pay the nurses.
How on earth would we ever get to the level of teaching doctora, having training hospitals etc.
As a nation, our strengths are not aligned with being healthcare providers.
We need to find our strengths, and build off of those. We need to stop talking foolish and move forward in realistic paths that will truely benefit bahamains.
Adding "for profit" to our healthcare will just make any improvements more expensive and further from the reach of our average people.
The obvious, its cheaper to buy most things imdividually from amazon and pay individual freight charges, than it is to buy from our local capitalist vendors who import in quantity and pay duty on cost.
it willl forver be cheaper And better to "pickup" your healthcare in Florida.
Well_mudda_take_sic 5 years, 8 months ago
Very well said.
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