As the island celebrates the opening of a new session of Parliament and the overwhelming dominance of the Barbados Labour Party with another clean sweep of the polls, there are groups of Barbadians who are reminding us that the bread-and-butter issues are still on the table.
The recent intervention by the Congress of Trade Unions and Staff Associations of Barbados’ (CTUSAB), General Secretary Dennis Depeiza was not a routine intervention by a labour leader. It was a necessary reality check for those who will take over the management of public health on the island that the issues are real and they have not gone away.
At the centre of Depeiza’s concerns is the Queen Elizabeth Hospital (QEH), the island’s primary acute care institution and a representative of the social contract between the State and ordinary Barbadians.
As Prime Minister Mia Mottley rightly reminded her Cabinet at the recent ceremony ushering them into public office, the work that they are about to undertake is not about lofty speeches but the actual work that helps poor people to elevate themselves from the poverty that encircles them.
Persistent complaints about long waiting times, delayed diagnoses, overcrowding, and staff fatigue have eroded public confidence in the hospital. What does Mr Depeiza want? He is calling for urgent reforms to the country’s public health system, and has warned that public frustration over services, particularly at the QEH, cannot be ignored any longer.
What makes CTUSAB’s intervention significant is that it reflects the collective voice of frontline professionals, including the Barbados Nurses Association and the Barbados Association of Medical Practitioners, rather than disgruntled observers on the outside.
Depeiza’s main argument is that the quality healthcare does not emerge from stately buildings alone. He asserts that though there is a promise of a new, multi-million-dollar hospital, the day-to-day operational failures within the existing system are killing morale and compromising care.
In addition to staffing shortages, questionable management systems and other structures cannot be solved by ribbon-cutting ceremonies, he says bluntly. We support his call for immediate and what can sometimes be uncomfortable reforms to be undertaken.
Perhaps the most pointed of CTUSAB’s proposals concerns consultants’ working arrangements at the QEH. When consultants are absent or inaccessible, junior doctors are left to carry the burden, leading to delays that patients may experience. We know that junior doctors have for decades undertaken the heavy lifting in the hospital.
However, they require the guidance of the consultants, who must of necessity be available, to ensure patient safety and for young doctors to build their confidence.
Equally urgent is the call to reform the ambulance service and decentralise emergency care. Expanding emergency capacity at polyclinics would not only relieve pressure on the QEH but also bring care closer to communities they were established to serve.
CTUSAB’s head reminded us that if patients feel as though they are not being heard or that there is no empathy for what poor people are going through as they seek access to this public service during their most vulnerable moments of sickness, then the system fails regardless of clinical or medical outcomes.
The new administration is going to face several areas demanding their attention.
International trade is still in flux as global trade giants try to manoeuvre around shifting tariffs and political pressures.
Barbados and the region is also under great pressure to align themselves with the United States at the expense of other longstanding partnerships, while the Caribbean Community bloc is confronting fractures that threaten the grouping’s very existence.
Yes, the Mottley administration is facing many competing priorities, which are expected to be outlined in the coming Estimates and Budget debates. Government should, however, see CTUSAB’s warnings as an opportunity rather than a threat.
Public health reform cannot be postponed until new buildings emerge from expensive blueprints. It must begin now, with an honest assessment, decisive management, and respect for those many professionals who carry the system on their backs.
Barbadians deserve a healthcare system that functions efficiently, displays compassion, and has accountability built into its operations. The question is no longer whether reform is needed, but whether there is the political will to act before public confidence in the system is dismantled.
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