MISUNDERSTANDINGS, misrepresentations and confusion often follow changes to wellknown policies, even when efforts are made to inform end-users about the adjustments.
This is why the shift in the new rules governing the use of the Barbados Drug Service (BDS), along with the introduction of a new drug formulary, was expected to be perplexing and unclear for some.
The fact is that the BDS has moved from a programme where almost all people bearing Barbados national identification cards got their hypertensive, diabetic, asthmatic and epileptic medication from any pharmacy free on presentation of a valid prescription.
Also over-65s and under-16s had that benefit. And the drugs they had access to were most often the leading brands.
Now, free access to the BDS is being enforced to the Barbadian-born and those who became citizens and permanent residents through the immigration process.
So simply holding a Barbados ID card is not enough.
Another change is that if someone sees their doctor in a private office and takes the prescription to a private pharmacy, a handling fee, called a dispensing fee, will be charged for having that prescription filled, and the amount to be paid would depend on the cost of the drug itself.
What’s more, the brand name drug that the patient has become accustomed to may no longer be available since several have been deleted from the drug formulary. The individual would then have to accept a generic brand which has similar properties.
But these new costs could be avoided if patients attended doctors at the polyclinics or at the Queen Elizabeth Hospital (QEH), and have prescriptions from private physicians filled at a BDS pharmacy in those institutions.
What is fuelling the confusion is that most people have become accustomed to attending their doctors in the private sector and using a pharmacy close by, so they find making a change to the public – or less expensive option – a real challenge.
Also, many people have become used to a particular brand name drug and have no or little side effects from using it, therefore they would be unhappy switching to a generic substitute.
Then, there is the non-nationals issue where these people are now responsible for their medical care and can only get free treatment in cases of emergency or if their illness can be a threat to public health.
But as Minister of Health Donville Inniss pointed out a bell was needed for the health system cat.
“Health care in Barbados is not free as some people put it. It may be the best in the Caribbean, but currently it is costing taxpayers more than $400 million a year, and I have been asked to review the system and I am doing just that – for the benefit of everyone – now and in the future,” Inniss said last month.
In that interview, the minister stressed that “too much of the taxpayers’ money is at stake,” and there would not be any “reverse of policy” with regard to health care reforms – even if it costs him votes at the next general election.
While we commend the minister’s straight talking, no-nonsense resolve to tackling this multi-faceted challenge which has to be wrestled and controlled to ensure the longevity and high quality of Barbados’ health care system, we feel every effort should be made to understand, and wherever possible, accommodate the sensitivities of people.
Put another way, though we agree with the need for efficiency in the health care system, we feel vigilant monitoring on how it is functioning should be ongoing in these early days in order to fine-tune the system, in particular the BDS, so that it caters to the needs of its users.
If this is done, then Barbadians would have a less expensive, more efficient health care system which caters to the genuine needs of its core population. And Inniss would be saluted as the one who tamed this multi-headed beast.
