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6. The lesson for Jamaica in preparing for health reform in the new Millenium is to understand that Jamaica’s primary health care programme was developed essentially and primarily from the rigour of local expertise which formulated, determined and implemented policies that were in tune with the Jamaican people in their communities and most importantly, set the context within which the needs of the programme could best be implemented. It took into consideration, the serious resource constraints of the Jamaican economy and used such technologies which were appropriate to these realities.
7. There are disturbing trends in the global domain. Trends which either inadvertently or deliberately seem to suggest that what works in the Metropole (in both form and substance, of their systems and sub-systems) will work in developing countries such as ours. This trend is further strengthened by an ideology of globalization manifested even by the attempted export of a high cost managed care systems by the USA to Latin America and the Caribbean.
8. The role of funding agencies and other multi-lateral organizations such as the Inter-Development Bank (IDB) in facilitating such an ideology must be carefully examined.
9. The role of our local government operatives and the mechanisms for initiating far reaching international policy decisions affecting the lives of the Jamaican people for years to come need to be the subject of very urgent and careful evaluation.
10. The lack of openness, secrecy and lack of communication between the non-government health domain and especially the bureaucracy in the Ministry of Health go counter to the present government policies or even the policies of participation enunciated and implemented by all governments since the 1970’s. (Please see copy of letter to Health Minister).
11. The changes in health care delivery process are taking place at an accelerated rate. These changes in the main are technology driven. Any analysis of the health situation which does not take into consideration these changes is doomed to failure.
12. The four Waves of technological epochal changes are instructive in any analysis of health reform and the essence of the KPMG Report is not only riddled with incorrect data and falsehoods, but fails to take into consideration the primary determining role of technological advances in shaping both the form, substance and process of Jamaica’s health delivery systems. [more]
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