Groundbreaking Ceremony UHWI Modernization Project
Keynote Address
By
The Most Honourable Andrew Holness ON, PC, MP
Prime Minister of Jamaica
At the
Groundbreaking Ceremony UHWI Modernization Project
On
February 20, 2024
________________________________________
Thank you very much, Carl, for your skilful mastery of this ceremony. I will follow the doctor’s orders and just simply say good morning, nice and decent people. Good to be in your company. You will forgive my raspy voice. I’m sure you understand why that is the case.
Minister Tufton from all I’ve seen, you deserve to continue to be the Minister of Health.
This morning marks a pivotal moment as we gather to celebrate the contract signing and groundbreaking ceremony for the redevelopment of the University Hospital of the West Indies and this is only phase one. This project stands as a testament to your government’s commitment to advancing healthcare infrastructure and meeting the evolving needs of the Jamaican people. I had a little bit of history here on the hospital, but to save time when we come to open this building, then I will preserve that part of the script.
The hospital, which was opened in September 1952, I believe, received its first patient at that time. Started with an initial capacity of 200 beds and it consisted of medical, surgical, and pediatric wards and a main operating theater, casualty and outpatient department and it was officially opened in 1953.
In 1967, the University College of the West Indies, UC as it was called then, obtained its charter and was granted full university status. The name of the hospital was changed to the University Hospital of the West Indies. From its inception, the UHWI has been recognized as a center of excellence, and its primary objective is to meet the needs of having a teaching facility for medical students, residents, and allied healthcare workers, whilst providing the highest level of medical care to the Jamaican people and persons who come for its services from other parts of the Caribbean.
Since then, the hospital has played a pivotal role in medical education, research, and health delivery. Over the years, the UHWI stayed true to its commitment to excellence, despite facing challenges stemming from aging infrastructure. Today, we acknowledge the pressing need for modernization and expansion to align contemporary healthcare standards and to address the growing demands of our population.
The current hospital infrastructure with its ageing buildings and inefficient layout, and I stress that- ageing buildings and inefficient layout, I’ll come back to that, poses numerous challenges from maintenance issues to overcrowded departments. The need for comprehensive redevelopment is evident. The proposed redevelopment aims to address these challenges by modernizing facilities, enhancing departmental synergy, and expanding critical care services. The incorporation of modern technologies and the provision of state-of-the-art facilities will further elevate the hospital’s status and capabilities, ensuring that the UHWI remains a centre of excellence in the region.
Today, this contract signing and groundbreaking ceremony marks the beginning of a transformative chapter in the history of the University Hospital of the West Indies so as we gather here to celebrate this important moment, you will allow me to take this opportunity to just remind the audience, but of course when I speak, I always speak to a bigger audience so I thank you for being the platform for which the message is delivered, right Minister? It’s necessary.
So in 2023 Minister, I’m just taking 2023, we improved the Moneague Health Center. We’re doing this, but in case people believe that we are only focused here, we did the Moneague Health Center, 26 million dollars; it will benefit 32,000 patients, improve that health center.
Ground was broken for the construction of a new administrative building for the St Ann’s Health Department at a cost of 400 million Jamaican dollars.
The Mandeville Comprehensive Health Center in Manchester was upgraded to offer improved services and retrofitted with additional safety features to be more resilient to natural disasters.
The Cambridge Health Centre was renovated by the NHF at a cost of more than 60 million Jamaican dollars. It will benefit some 4,000 residents of Cambridge and its environs.
A new 29-million-dollar energy-efficient broiler system was installed at the Savanna la Mar Public Hospital in Westmoreland.
A US 5 million dollar contract was signed for the implementation of the electronic health record system in the public sector; Minister Tufton spoke about that.
The St Elizabeth-based Black River Hospital was equipped with a 37 million dollars digital retrofit, that means they changed out all their computer systems there.
A mammogram machine was installed at the University Hospital of the West Indies at a cost of 47 million Jamaican dollars.
The renal units of the Kingston Public Hospital got 10 new hemodialysis machines valued at over 30 million dolllars.
The UHWI received 18 patient monitors, valued at 25 million. The Bustamante Children’s Hospital got a new C-Arm. I don’t know what that is, but I guess it’s a kind of X-ray, we’ll look at it later. And laparoscopy machines valued at 46 million.
Two ambulances and a panel van were acquired at a cost of over 33 million to serve the parishes of St Ann, St Mary and Portland.
The Southern Regional Health Authority received four retrofitted ambulances, a passenger bus and a van at a cost of 62 million dollars.
And the Linstead Public Hospital in St Catharine and the Princess Margaret Hospital in St Thomas got two new ambulances valued at 33 million dollars.
I went into this detail which I would normally go into because it is important that the public gets a sense of what the government is doing. You know, perspectives are important. The glass can be half empty or it can be half full. Now, if you were quarter of the glass and each year you continue to add to that amount in the glass, then your perspective has to be more that you’re getting to the filling point rather than at the bottom and every year our government is adding to the capacity of the healthcare system. So I’ve given you the small things that we’re doing.
And we know that much more needs to be done. We still have this segment of the glass, which is still empty, but we’re getting there. We’re doing it. It’s not going to be filled all in one pour and we recognize that. And we recognize as well that patients are suffering in our healthcare system. We are not oblivious to that. We know this, but it didn’t start in 2016. And in fact, we have done more to alleviate and ameliorate the conditions of healthcare in Jamaica than any other administration before and I can say that without fear of contradiction.
We acknowledge that for three decades, before my time, and it’s my time now, we haven’t built a new hospital. We acknowledge that but who is it building the hospitals now? We acknowledge 70 per cent of our current hospital infrastructure and equipment are deemed to be end of life, or nearing end of life. That didn’t just happen since 2016. It happened because previous administrations did not invest in healthcare and now they have the – I’m trying to find the right word, but audacity seems to come to mind to speak on healthcare. It galls me the level of hypocrisy but more on that my administration is making sizable and tangible investments to reverse this long period of underinvestment and neglect.
In fact, I can, without fear of contradiction, say that my administration has embarked on the most significant program of expansion and improvement in our national healthcare infrastructure since independence. Under the Health System Strengthening Program, we are making a substantial investment of one hundred and forty-eight million US dollars, and this initiative will lead to the development of three hospitals, St Ann’s Bay, May Pen and Spanish Town, where we broke ground a few weeks ago. And it will also include ten health facilities, the Greater Portmore, Old Harbour, St Jago, St Ann’s Bay, Brownstown, Ocho Rios, May Pen East, May Pen West, Mocho and Chapleton and some of these will be type five health facilities, meaning that they are just one level below a full hospital capability. And the program goes beyond physical improvement to facilities.
We’re also moving to improve our information systems and technology that are critical elements of a modern healthcare system. We will introduce advanced information health systems, remote patient monitoring, e-prescription and electronic health records.
You know, a certain person who is now a prominent medical person who is also in the political field, a few years ago sent me some pictures of some hospitals including the Docket Room, that’s what it’s called? And that was like 2015, thereabouts and files were just thrown all over the place. If a patient were to come, it would be hell to find that record ut they had records there for 20, 30 years of patients probably who have passed which they still need to keep the record, but it is competing with the space for current patients.
The investment in the electronic healthcare system is absolutely important in improving the quality and speed of healthcare delivery cannot be undervalued or underestimated. You won’t see it like how you would see this lovely building going up, but you will experience it in your waiting time, in the right diagnosis being made so that should not be undervalued. I want to put that up there as well with all these hospitals, which you will see the physical representation of.
Now, you mentioned our problems in Jamaica, particularly for our males with prostate cancer and under our National Health Fund, we have now- and Minister Tufton, I don’t know if you have announced it yet, but the NHF instituted the prostate-specific antigen test benefit to encourage more men to get tested with a provision of a 1,600 subsidy for one PSA test per year.
Now this is big. I can’t emphasize it more than I am doing now; it affects all men. King Charles was recently diagnosed with prostate cancer and we do send out our sympathies and hope for his recovery and treatment but a lot of Jamaican men don’t take their healthcare seriously in this regard and the last statistics that I’ve seen continue to say that we have very high incidence in the region of men reporting either enlarged prostate or being diagnosed with prostate cancer and that is why your caring government isn’t just talking about healthcare, but we are providing you now with a subsidy. I know there are other issues, but if cost was the issue, then we are providing you with a subsidy that will help to reduce the cost to you so please go and get tested. There’s a specific test, the PSA test, I’m encouraging all our men, as you say, after you pass 50, you don’t pass certain things. You don’t pass bathrooms, and you don’t pass the PSA test. You make sure you take your PSA test.
We have put in place some new conditions which we have added to the NHF card representing over four hundred and fifty million dollars in additional benefits, which will see some 47,000 Jamaicans benefiting. As Prime Minister, I instructed the Minister of Health to put on… I was out doing my routine campaigning and a young lady came up to me and she really gave me her life story and her struggle with lupus and I went back to office, consulted with the Minister and his team to see what was the extent of this, and whether or not we could accommodate it and we expanded it. And since then, we have expanded significantly.
Today, we can report an additional four hundred and fifty million dollars per year in new subsidies for new conditions and services. There are sixty-one contracts valued at twenty-seven billion dollars, which were signed recently for the procurement of essential drugs under the 2023-2026 pharmaceutical awards program. I say all of this to say that if we’re talking honestly about perspectives, yes, the glass is not filled, but it is not half empty. We’re filling up that glass day by day, budget by budget; we are making real impacts on the healthcare system.
And now today, we signed a contract for 278 million dollars for phase one which will be to realign the ring road, to demolish some old buildings here- I believe the doctors used to live in them (for the emergency specialists), to make way for a green field meaning a clear area in which we can construct this wonderful six-story building which will have important services, operating and surgery and ward spaces and specialist services that will improve the healthcare that Jamaicans have access to.
Now, when the colonial government in 1949 established the commission to determine how we can improve tertiary education and particularly medical education, their concept, my view, did not foresee Jamaica today. They laid a good foundation. They laid a solid foundation of quality. Quality in training in particular but in terms of the infrastructure, you can see that the mindset of the layout was you do this ring road and you expand in terms of space with small buildings all around and it is the colonial style of tropical medicine in terms of how tropical hospitals were developed certainly for ventilation and those kinds of things.
And for expense as well, it was the most affordable way of building out the facilities but with the population that we have in this growing urban area and the strong concentration of the population and the contest for space, the contest for land, there is no land in Kingston for us to do sprawling developments like this. Some of the land next door is contested and we will have to look at that at another point. Whenever we go to treat with the contest of space and physical development it is not just to take down the existing infrastructure; people have developed sentimental attachment. There are persons who like things the way they are and if you go with a proposition, hey, will you give up what you have to get this, some people are going to say, it might make everybody else better off, but it might make me worse off. Governments have to deal with this.
We can’t just go and knock down and don’t take into consideration the valid sentiments and attachments and feelings and indeed prescriptive rights that people would have developed over time on the existing layout. So as your Prime Minister, I’m very seized of these issues and whenever we go to restructure, we have to have consultation. And if the consultations are not just sitting down in a room, it’s a dialogue that has to go on for a long period of time to get everyone on the same page about change. This one is relatively simple. I’m certain you’re going to call in the doctors and explain to them and show them how they’re going to be accommodated in alternatives.
You’ve mentioned that you have approached the NHT. I’m sure the NHT will come back to me on this about how we will find homes or build new homes and facilities for our medical emergency professionals to be housed because they have to be close to site. So even here, you still have to do it, but it’s a matter of showing what the alternative is and for across the road and for other areas, it is going to be a longer process and a much bigger budget but I want to use the opportunity to say to Jamaica, not just the audience here, that the way in which our country has developed from a physical built environmental point of view, it is not sustainable.
As I travel the country on the campaign trail, you can see that we have chosen to live in areas that are going to be under threat from climate change. We have chosen to live in areas where you’re going to have landslides, the nature of the soil is changing because we have cut down trees and we haven’t taken all the environmental protection precautions and so, in the next 50 years of our development as a nation, we’re going to have to be looking very carefully at our spatial development.
In a microcosm of this, the University Hospital of the West Indies has now been forced into doing this. As they look to the next 50 years of their development and the land space that they have, they’re going to have to figure out how all these dispersed buildings that they have all over the place connected by open corridors, that is not going to work. So, you’re going to have to go knock down some of those buildings and consolidate in more modern structures which is what this is, but it is good that you’re doing it because it becomes an example.
In development parlance, it’s called a demonstration effect; to get people to agree to change sometimes you have to physically show them what the change is going to be like. I’m saying this because I need this project to be done efficiently. It must be done on time and it must satisfy all the stakeholders because we need to hold it up to say see, here is what we have done. And if we did it here, we can take this model and carry it elsewhere to get people to buy into the change, to give up their sentiments or even their prescriptive rights and attachment to things as they are, to embrace what could be, which they will have their own benefits and welfare and well-being maintained in change.
So ladies and gentlemen, you have been such a good audience. I have 10 more pages to go. So, I noticed that those who used to claim that ‘nuttn nah gwaan’ have changed their tune. Now they see ’nuff tings a gwaan’ like never before and they are now falling over themselves to say, but it was my idea. You know, my job as prime minister is to improve the lives of Jamaicans and I will implement any good idea or good project that does that. I do not care whether it originated with the PNP, the JLP or no P or PIP. The fact is Jamaica has never been short of great ideas. The projects that are being implemented now, many of them have been spoken of for decades. There are many plans that are in files and gathering dust, good plans.
I have the opportunity to look at a few of them sometimes and say why didn’t they do this? My administration, however, is doing it. We are getting the job done. We are taking the plans and implementing them. You know, there is a saying, the brain isn’t all in one head so if somebody has a good idea, if you keep it to yourself, it’s not going to help. And if you have a good idea and you can’t implement it, it’s not going to help so we welcome the contest of ideas. It is important but governments cannot be only about ideas; that’s universities.
Governments have to be about ideas and execution which is why there has to be this symbiosis between institutions like universities, academic institutions that do the research, generate the ideas, and you have your school of management, which helps us to convert ideas into projects, and then you have the political bureaucracy that gets the stakeholders behind the project, and then you have the technocrats- I don’t like to use that word, but they use technocrats sometimes almost as a pejorative but yes, the technocrats who then take the plan and implement it. And the government oversees everything from the research and development through partnerships with our universities, through to the development of the plans, through to the development of the implementation phase and that’s what we have been doing.
We do another important thing, we manage the economy so that plans can be funded. So if you ask, what is the difference between this government and other governments, the big difference is that we have been able to run the economy in such a way that we are not borrowing more to do this, we are not taxing you more to do this, but yet we can put over 200 billion dollars more on the wage bill to pay everybody in the public sector a little bit more and we’re not collapsing the economy; that’s the difference.
So with the greatest of ideas and the greatest will, Patrick will tell you, if you don’t have the budget, you cannot execute. As was said by our former Prime Minister, Edward Seaga, “it does take cash to care” and there are two ways of thinking in Jamaica. One is it takes cash to care, the other one is we put people first. I think both have value, but we must bring those two things together right now. We must have an economy that has the wherewithal to deliver, and we must make sure that the economy cares about the needs of the people. So that’s what we’re doing now with this caring economy in spending on healthcare.
So as I’m at that point, I’m gonna close with a challenge to the University of the West Indies. Once I was asked, what do I do as Prime Minister? What is the value of government? And I could have given all kinds of answers but when I reflected on it, what politicians do, what you hire them to do is to ensure that there is equity in the society, that is what it really comes down to. Every decision that we make to spend, I examine what is the equity meaning how is it going to be fair to all stakeholders. Will this decision make everybody better off and not one person worse off? And if some people are going to be made worse off, how do we compensate them? That is what you hire your politicians to do, to maintain equity in the society. Sometimes politicians come out and they will say some things promising the moon and star and it sounds good, particularly to a particular sector and for that sector, yes, not recognizing how they destroy equity.
I was in a rural area of Jamaica, up Penlyne Castle and it’s a coffee producing area and you know, and the question was asked about a factory. The factory was there and the factory was closed and they wanted the factory to be reopened. And when I came down on the planes, the same thing, they were asking me in Duckensfield about their sugar factory and their banana factory. And the thinking is that the government should reopen the factories and it sounds like a noble thing that yes, maybe the government should open the factories but if you step back a little bit and think, if the government opened the factories that the private sector found unprofitable and closed it, then what would the government be doing?
The government would be taking public resources and subsidize factories that are not profitable. Who pays for that? Who pays for it? You! But the problem is who benefits from it? And what you would hear is well, it’s the workers that benefit from it. No! Who benefit from it are the people who are gonna sell the machines, the management that is going to operate. The workers get a little bit.
I’m saying to you that for too often we have been tricked. We can’t continue this. We’re a country that is growing. Our electorate, our population must look more deeply so I make that bigger point to make the more pointed proposal now to the University Hospital of the West Indies. What is the equity of this expenditure, 278 million dollars to build the facility here and billions to build this, and this is a paid institution? Why not spend it on KPH?
See that question, what’s the equity of spending it here versus spending it on KPH? I’m saying this to you, you may not have considered it. On the surface of it, you won’t think of that, but every public expenditure decision, I look at it. Every one of them, because we have an unequal society and that inequality, yes, it had its roots in slavery and it had its roots in colonialism. It had its roots now in modern times in poor government. A government that made decisions about public expenditure that did not consider equity and fairness and everybody’s going to be asking for their equity and fairness but as a government, you have to look at the bigger picture.
What is the bigger picture in healthcare? If we’re going to expand the physical infrastructure of our hospitals, and I’ve shown you how we’re doing that with 10 healthcare facilities and three hospitals and more to come, where are the 1,000 new medical personnel going to come from? They come from right here so the equity is balanced by the strategy. So the strategy is we need to increase the capabilities here to drive healthcare delivery right across the country in all the other facilities that we’re developing. I just thought I would give you some insight into why it is that our government gets results and others didn’t.
I didn’t come into politics for aggrandizement. I just came into politics because I just saw people being misled even people who should know better and I decided that when I’m there, I’m not going to mislead the people. I’m the only politician to have told you how it is and I pay the price. I pay the price and I haven’t changed my ways. I’m going to tell you how it is. If you like it, you like it. If you don’t like it, well, it’s just the reality. So the reality is that we acknowledge that under normal circumstances, it would be better to have spent the resources on KPH but because we have strategic reasons, we’re spending here.
I’m going to ask Minister Tufton at another time to outline the plans for KPH, which is also in dire need. We have made one massive public investment already, which is the Cornwall Regional, which is almost finished. As soon as Cornwall Regional is finished, then we will shift our focus to doing the same at KPH but you hire the government to think about these deeper things, things that you are not going to see, and to synchronize and curate our public expenditure to deliver the results that will yield equity and fairness in the society. And that is what we’re doing.
So, ladies and gentlemen, you have been a wonderful audience and a great platform on which to explain to the people of Jamaica what their government is doing.
Thank you so much.