[Blog] The state of the health service in Mauritius

This is a brief outline of the health service in Mauritius, what is available and what is lacking or wrong, followed by some pointers on what generally needs to be done in problem areas. A more comprehensive plan is urgently required as the health service in Mauritius generally needs major surgery.

A lot of money is being spent on health services, but is it value for money? All the citizens of Mauritius are entitled to a health service that is modern and dependable, one that provides high-quality care that is free at the point of delivery. In order to achieve these goals, the focus needs to be on the following:

1. An easily accessible and responsive service to meet the patients’ needs.
2. A high-quality service that is cost-effective and makes the best use of available resources so that patients can receive maximum benefits from the system.
3. Encouraging the active participation of users in the planning of services at the local level.
4. Ensuring that all staff members are fully accountable for any care that they provide.
5. Clear and comprehensive information providing full details of the different services that are readily available and how to access them.

Currently, there are regional variations in performance and practices in the provision of care. These variations are unacceptable and do not always meet patients’ expectations. The reasons can be attributed to two main factors:

• There are no clear national standards to which the various regional services are expected to adhere and which they should strive to achieve.
• The managers of the health services are not sufficiently accountable for the quality of service provided to the public at large.

There are five key areas that need to be addressed as a matter of priority

1. The reorganisation of each of the five regional hospital authorities. Each authority needs to be run by a structured management unit headed by a regional director with the appropriate qualifications and the required qualities. They should be appointed on a rolling contract with performance-related terms.
2. There is at present an untapped and vast resource of knowledge and experience that can be secured from personnel employed in the health services. There is an urgent and immediate need to establish a human resource department in each regional hospital to appraise and rationalise the workforce so that the health services can make the best use of their employees and service users can maximise their benefits.
3. An audit of all current health services provided to the public needs to be conducted in order to establish a baseline. Subsequently, a framework for total quality management (TQM) should be instituted throughout the regions.
4. The establishment of a practice development unit to address the personal development and education of all personnel, especially nurses, who form the largest workforce in the health services and serve as the first point of contact with users.
5. The implementation of a comprehensive complaints policy and procedure so that users do not feel that they are being ignored each time they make a complaint. It is crucial to ensure that the policy is widely available and that all staff members are fully conversant with it. Conversely, the establishment of a disciplinary mechanism should ensure that any staff member who fails in their duty of care faces appropriate consequences, rather than merely receiving a punitive transfer, which neither benefits the individual nor improves the service.

The public places its trust in health professionals. They need to know that the treatment they receive is up to date and effective. They also need assurance that the care provided by health professionals is aligned with new thinking and new techniques. Furthermore, they must be confident that when individual health professionals fail to meet established standards, the matter will be openly and thoroughly investigated and, where appropriate, action will be taken against the transgressor to ensure that there is no recurrence of similar problems.

There are a number of challenges facing health service, stemming from changes in family structures, changes in work systems, and, most of all, from an ever-increasing ageing population.

I humbly suggest that there should be an island-wide consultation with all stakeholders and a master plan devised and acted upon. Regular reviews of the plan should be conducted, with necessary adjustments made accordingly.

Having had a lifetime of experience in the National Health Service in the United Kingdom at a managerial level, I am willing to be part of any working party set up to start the process.

Claude Canabady
General Secretary
Consumers’ Eye Association