The Public Health Committee held their monthly meeting on Wednesday, 2 May 2018. Below is a summary of the main items discussed:

The Chairman opened the meeting with a brief remark about what the Committee wanted to achieve at the meeting and throughout this financial year. These would be to consolidate gains over the past year and acknowledge successes made by the team and to thank them for their hard work. The Chairman also highlighted that there are challenges ahead including ensuring that the ever-increasing demand on the health budget can be tackled effectively.

Issues arising from the previous meetings, not on the agenda, were considered and updates received by the Committee. These included:

  • The challenge to fill healthcare specialist posts and the fact that most posts are now filled and recruitment ongoing for current vacant ones
  • The proposed used of Sundale as a Primary Care Centre and the fact that final decision by the relevant Committee and ExCo is awaited. The Chairman resolved to discuss this at the next ExCo meeting to clarify implications of delayed decision on this matter
  • The proposal to introduce a National Health Insurance Scheme was revisited and the Committee noted that the next meeting of the working group is scheduled soon
  • The implementation of the revised fees & charges including for the Dental Service was discussed and the Committee agreed that the new fees were fully discussed and agreed previously before the Public Notice was issued

The Director of Health highlighted the significant progress made during the last year and the challenges ahead in the new financial year. Noteworthy achievements are the:

  • Introduction of a systematic approach to prevention and health promotion including the new social marketing campaign to be launched on Monday,  21 May 2018
  • Ongoing work in schools and the community at large to tackle obesity and children’s wellbeing
  • Improved access to better diagnostic equipment in the Lab, the X-ray Unit and the Dental Service
  • Maintained access to outpatient and inpatient services despite the staffing challenges
  • Complete clearing of the overseas referral waiting list
  • Support obtained from DFID to commence joint replacement surgeries on the Island

The Committee also noted the progress made in upskilling local staff across the various service areas and the nurses in particular. The ongoing work to install a new clinical information system was welcomed. The Committee remain interested in the work being done to improve engagement with the community and use feedback to improve services. It was resolved that more work should be done to train frontline staff about how to handle difficult conversations and improve customer service.

The Director highlighted, among many, the key challenges ahead. These included:

  • The fact that half of young men and women on the Island continue to smoke regularly with the consequent risk of heart disease, stroke, cancers and premature deaths
  • The high levels of preventable chronic diseases,  particularly diabetes and high blood pressure, with the risks of complications related to these including blindness, risk of limb amputation, heart disease, stroke and early death
  • The increasing risk of kidney disease and end-stage kidney failure in a context where it is difficult to offer kidney replacement treatment on the Island
  • The high levels of risk from excess body weight resulting in diseases such as diabetes, cancers and joint problems
  • The limited resources available to expand services because of limited budget, specialist staff or space to deliver new services
  • The additional cost to transfer patients referred overseas from Johannesburg to Cape Town when equally effective services are available in Johannesburg, this currently costs £870 extra per person or at least £100,000 per year
  • The perceived low level of confidence among the public about the local health service despite significant improvements, new service developments and improving outcomes

The Committee discussed and resolved to work with the health service to:

  • Champion the new health promotion and social marketing campaign
  • Support the new approach to Chronic Disease Management and the ongoing communication drive to familiarise the community with this approach
  • Support the revision of the tobacco legislation to ensure compliance with the WHO Framework Convention for Tobacco Control and introduce elements to ensure plain packaging, sell tobacco in only registered shops, reduce advertisement and limit access to flavoured (e.g. menthol) cigarettes and purchase of single sticks and for young people to show proof of age to buy tobacco

The Committee agreed to the use of medical facilities in Johannesburg for overseas referrals and the Chairman of the Committee and the Director will revisit the shortlisted hospital and accommodation facility in June. The new arrangement will then be introduced. All efforts will be made and arrangements in place to support patients transferred overseas during this transition period. Safety, access to effective treatment and efficient use of available resources are key criteria which were considered before this decision was reached.

The Committee noted the successful commencement of knee and hip surgery and noted the intervention and support by all Elected Members and DFID to obtain this funding. The Committee thanked the health service teams who have worked hard to make this happen and the significant levels of savings expected to accrue from this initiative.

#StHelena #PublicHealth #Summary


11 May 2018

St Helena Government Communications Hub

Telephone: 22470