Kapavore urged to act firmly

Letters

THE Health Minister Elias Kapavore needs to act firmly to stop the infighting in the Health sector between secretary Pascoe Kase and Dr Sam Yockopua from the National Doctors Association.
The war of words played out so publicly in the media is the best example of why health services have deteriorated over the years. There is too much infighting and too many people claiming to know the answers to the problems but nobody is doing anything to solve them.
The Health department is dominated by two key professional groups – clinicians such as doctors, nurses and aid post orderlies who treat the sick, and health administrators who are procumbent officers, accountants, lawyers taking care of housekeeping matters such as ensuring health facilities are maintained, fully stocked and equipped as well as to administer health regulations and laws.
The public spat between Kase and Yockopua is nothing more than professional rivalry between the two groups – doctors who think they know better and health administrators who think it is their job to worry about the housekeeping matters within the health sector.
It’s interesting that this debate should once again come to the fore at a time when secretary Kase is nearing his term in office.
Two years ago when former health minister Sir Puka Temu arrived in the job, he put a stop to these nonsense among the doctors and health administrators.
Instead he announced an open door policy and invited all those who cared about the health system to come to his office and offer advice on how to improve the health care system.
If Yockopua and his association accepted the invitation, they might have had their grievances heard and acted on. In the last two years, the health sector enjoyed the biggest budget allocations, procedures for the purchase and tendering of medical supplies were reviewed and improved, the outbreak of polio was dealt with successfully, immunisation programmes were given more attention and specific funding was allocated to fix a number of health facilities across the country.
I’ve looked at Yockopua’s suggestions and I’m not convinced it will lead to major improvements.
Sure you might get cheaper medicine but building your own distribution system will come at a cost.
For this to happen you will need to recruit many more people, resource them and then pay for the medicine and the cost of distributing them.
It will be an administrator’s nightmare to get the Department of Personnel Management to restructure the department, then go to Treasury to seek funding for the new positions at a time when the Treasury cannot even consistently pay the medical supplies bill on time.
Then it will require political approval at the NEC level from a prime minister who is opposed to big government with a big public sector bill.
Yockopua’s proposal is similar to what we inherited at independence when government departments did everything from owning and maintaining their own institutional houses, transport fleets and delivering government services all at the same time. They might have been efficient but that was when we had a much smaller population of three million people.
Times have changed, we now have eight million people.
Government departments nowadays focus mainly on policy while the aspect of delivering services has long been outsourced to the private sector.
You can see it at the Department of Education through the delivery of school supplies, at the Department of Works in the funding and maintenance of public roads, at Health in the way we now distribute medicines and many more.
Sometimes I don’t understand this obsession with the shortage of medical supplies.
We read daily about stories of health facilities without medicines here and there but we don’t have the follow up story or pictures of ten or twenty people dying daily in Port Moresby, Popondetta , Madang or anywhere attributed to the lack of medicines in those hospitals.
Just because one or two facilities are out of medicine every now and then, does not mean the health system is not delivering.
I’m not saying we don’t have problems but this debate is superficial and boring because there is a real gap between what the so called medical expects are telling us and what actually is happening on the ground.
It’s just a storm in the tea cup.

Former public servant