Health spending follows doctors

Caption:  Dr David Mills

By MATTHEW VARI

Sunday, November 16, 2014 (Sunday Chronicle, PNG)

The trend was highlighted, among other factors affecting rural health, by the President of the PNG Society for Rural and Remote Health, Dr David mills, in his report launch by the National Research Institute last week in Port Moresby.

The report, ‘Doctors for rural Papua New Guinea. Too hard? Or have we just stopped caring,’ was presented in the issue of the chronic shortage of doctors in rural PNG and the reasons behind this.

He highlighted the tendency for health spending to follow the doctors as a key point in the delivery of health service.

Dr Mills used a case of a province he did not name as an example of the development.

“When doctors make a lot of noise- it is that noise that matters- it gets results,” Dr Mills said.

“I’ve chosen a random province to explain- in a particular provincial hospital, it has a yearly budget of K13 million, and the provincial hospital is where all the doctors are based.”

“The entirety of rural health spending for the rest of that province is K3 million- so one hospital in the town gets K13 million and the entire health centers and aid posts in the province get K3 million.”

“In the provincial hospital there were 13 doctors, and the number of doctors working in the rural areas was 3.”

He said that despite the coincidence, the figures are largely representative of what happens around the country.

“That is that big hospitals consume a lot of resources but they see a relatively small number of patients, and the rural sector, which is seeing the vast majority of the burden of illness gets a very significantly decreased amount of funding,” Dr Mills said.

“The reasons of that are of course complicated but there is no doubt that a part of the reason is that doctors know how to make noise.”

“When a doctor asks for resources to carry out their work eventually gets what they need, whereas, if a nurse officer in a health center or HEO (Health Extension Officer) does not have that same ability to make that noise where the funds will come to them.”

He added that the doctor that is based in a rural area will be able to agitate or advocate.

“So part of my job today as a doctor in rural PNG is to try and bring the funds and attention back to rural health.”

“I am not trying to say that is a good thing, I’m just saying that is a reality and that is the way it works,” he added.