“Prevention is better than cure.”

“Simply, it is better to stop something bad from happening than it is to deal with it after it has happened. It is cheaper to prevent future illnesses and preventing complications from existing conditions, are vital to the future sustainability of health systems.”

How relevant are these sayings to our personal health, the health service with its vast resource requirements, who is footing the bills, who is educating us to embrace prevention vs curative healthcare. I am taking liberty to invoke Group Health Insurance and the conflict with prevention better than cure. It therefore begs to question what does insurance pay for?

If the coronavirus disease – COViD-19 has not taught us anything, then we will never learn. This one disease is the intersection between health and wellness acute and chronic diseases. New terminologies have emerged – long COVID, post COVID, long haulers among others.

Healthcare is at the crossroads. Those of us who can recall the advent of Primary Health Care (Alma Ata Declaration – September 1978) and the declaration of Health For All by the year 2000, and the excitement for Jamaica’s presentation at the forefront. Countries agreed to address the main health problems in the community, providing health promotion, preventive, curative and rehabilitative services.

The subject of financing health care was topical then, as it is today, giving meaning to “the more things change, the more they remain the same”.

COVID-19 has placed health systems squarely at the crossroads. Health promotion – kudos to the Hon Minister with his insistence on a health and wellness message and acting it out personally. He went as far as naming the Ministry from Ministry of Health and the Environment to Ministry of Health and Wellness, all in order to maintain focus on his initiative to change minds and hearts for better health outcomes, thereby giving effect to prevention better than cure. Prevention – COVID vaccines – be damned – poor uptake; Cure – to hospital emergency room rather than a health centre, so emergency rooms become another ward with patients with mixed diagnosis wanting cure and no beds are available on the respective wards.

If triage refers one to a health centre – talk about “drunk and disorderly”.

Security to the rescue. Emergency rooms are like fortress. The need for staff, equipment, repairs and maintenance and suppliers send financing rearing its ugly head. So, commission a study, yes, another one? Check the archives – studies and recommendations gathering dust. Trust me, you can ask me, I have been there, done that research paper for an Economics of Health Course on financing. A Committee member – of the group on financing healthcare, from which came – the National Health Fund.

I was like a midwife at its birth; Primary Healthcare Community Health, I have a BA degree in it, Hospital Administration – check me – management of all sizes and specialisations; Consultant – hate the word, but done that too and yes, as the Health Development Officer for then 17-member Caribbean Community (CARICOM). I can write the proverbial original book on health for all.

Healthcare being at the crossroads is not new, just ask WHO, PAHO, CARICOM, Commonwealth and the respective health ministries and agencies in developed and developing countries. I am always puzzled how tourism and hospitality can be managed but not healthcare with so many similarities – people, process, products and services.

Managing healthcare is complex but so is the tourism and hospitality sector – hotels to be specific. However, healthcare has specialisations of all stripes, name a health condition, there is a specialist for that. Even the layman minister of health will soon convert to a new health specialisation. Some converted by doctors, some at recognised and international force, others go off on a canter their own, and soon after all, special interest trumps common sense healthcare policies. Sickness and death are not choosy, COVID-19 has made this clear.

Crossroads have signs, the question is where you are going, any road won’t lead you there. You must know which one to take that will get you there, that destination, “that there” is healthcare outcomes.

Health professionals are learned and smart. Training and experience generalists, specialists, even charlatans together aim to prevent illness and treat sickness. Not a day goes by without seeing or hearing about health in the media, health workers vs policy makers, patients and their relatives shouting in cameras on the news. The crossroads is a good meeting place after all. We have been here before, but separately, so we keep coming back to talk some more. We even generate a report, yes communique too, we take them home to waiting shelves. Health is the most studied entity, a consultant’s dream world, opinion makers galore, talk shops a plenty, developed countries in the name of aid introduced by consultants and grants; disconnected from the country’s capacity, infrastructure and budget. Aid is trade so you are now tied into purchasing the newly introduced technology from the source of the aid of equipment, pharmaceuticals, systems and not to be left out, the diaspora will donate goodies – old and new, while training to use this new technology is an afterthought.’

Let’s make a deal to address healthcare. Meet me at the crossroads. Representative of all the health disciplines, licensed and certified. Bring all the Government policies, laws (even outdated ones), reports – international, regional – consultants training institutions too, and yes, patients past and present, and relatives of some dear departed. Health Insurers, you will be placed centrestage as you hold the bag (of money), yes, it takes cash to care. Health is bigger than any of us or any one entity or discipline, hence the representatives of the disciplines coming together at the crossroads can best choose the road on which everyone will tread towards a health system that meets the needs of the populace and is both affordable and sustainable, subject to the provision of resources. which will be identified, quantified and provided in support of health for all.

“Health for all, through us all” (my words).

• Audrey Hinchcliffe is CEO and founder, Manpower and Maintenance Services Ltd Group