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Barbados Healthcare

The Government operates Queen Elizabeth Hospital (a large secondary and tertiary care facility), a network of four district hospitals for geriatric care, a main geriatric institution, a mental health hospital and a half-way house, two small rehabilitation institutions for the physically and mentally handicapped, an AIDS hostel, a development centre for disabled children and adolescents, and a nutrition centre.

A nationwide network of eight polyclinics provides a wide range of preventive and curative services, as well as limited rehabilitative services. These polyclinics and four satellite stations provide traditional public health services such as maternal and child health, family life development, communicable disease control, community mental health, chronic disease programs; dental health, nutrition, and general practice. These services also cover environmental health, which includes food hygiene, mosquito and rodent control, building development control, atmospheric and chemical pollution monitoring and control, monitoring and control of water quality, monitoring and control of sewage disposal, solid waste disposal, the maintenance of cemeteries, and the licensing and control of stray dogs.

The Government also operates the Barbados Drug Service, a WHO Collaborating Centre that controls the importation and distribution of essential drugs in the country, thus ensuring that Barbadians receive affordable quality drugs and pharmaceuticals.

The private sector is well developed, with about 100 general practitioners operating singly or in multiple practice; consultants (senior doctors working in government hospitals or polyclinics) also have private practices. There is only one small private hospital in the country – Bayview Hospital – with fewer than 30 beds, representing under 4 % of the country’s total acute bed capacity. Private sector health services and facilities also include 18 homes for long-term care, as well as pharmaceutical, laboratory, diagnostic, dental, psychiatric, and physical therapy services.

Staff at all levels are well trained and receive regular updates. All of the polyclinics are supplied with the necessary equipment for the delivery of quality healthcare. There is a referral system between clinic, hospital, and other support services.

The Ministry maintains autonomy over the health services. The decision on how money is to be spent lies within the Ministry, but the Ministry of Finance appropriates the overall budgetary allocation.

Health service delivery falls into the following seven program areas: primary health care; 24-hour acute, secondary, tertiary and emergency care; mental healthcare; care for the elderly including rehabilitation services; drug service; assessment services and rehabilitative care; and health promotion. Primary healthcare services encompass maternal and child health; family life development, including family planning and ophthalmic and dental care for schoolchildren; care for the disabled, pregnant women, and the elderly; general medical care with clinics for hypertension, diabetes, and sexually transmitted diseases; nutrition; pharmaceutical services; and community mental health and environmental healthcare.

The Chief Medical Officer is responsible for all matters affecting public health and medical services, advising the Minister of Health and Environment on these matters; the Chief Medical Officer also plays an integral role in health planning and health infrastructure development. Two Senior Medical Officers support the work of the Chief Medical Officer, and a team approach is applied for each program area.

Each polyclinic is managed by a Medical Officer, who functions as a clinician and an administrator, heads a team of clinical medical officers and public health nurses, and works closely with the Public Health Inspectorate. Additional staff comprises pharmacists, community nutrition officers, dental officers, and other ancillary personnel. An administrator, a clinician, support medical staff, and other ancillary staff similarly run other institutions.

The major problem at the primary healthcare level is the shortage of staff resources, especially at the clinical level.

At the secondary care level, the Government operates the Queen Elizabeth Hospital, a 547-bed facility that offers 24-hour acute, secondary, tertiary and emergency care. The hospital houses more than 90% of the country’s acute care beds; clinical services include accident emergency and outpatient and inpatient care in surgery, medicine, paediatrics, obstetrics and gynaecology, pathology, radiology, radiotherapy, rehabilitation therapy, ophthalmology, and ear, nose, and throat. The hospital’s diagnostic equipment includes a CAT scan and ultrasound and modern radiotherapy equipment. A cardiac catherisation unit was established in 1993, and by the end of 1996 had performed 50 open-heart surgeries and 242 cardiac catherisations.

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