• Networking
• Knowledge resources
• Credibility
• A foot in the grapevine of the profession
• A soundboard for your ideas
• Current issues
• Developments
• Benefiting from the wisdom and experience of your elders
• Keeping you connected to the younger persons in your fields, if you are in the older age group
• Volunteering and receiving positive karma coming back to you

There are no disadvantages to joining the MAJ!

We want your wisdom, your ideas, your leadership, your intellect, your integrity and your experience. We see you giving these qualities to your individual practices, hospitals, churches, schools and service clubs. We are inviting you to join us, to give us your energies and so make this organisation one that you can be proud of. Come to our events, socialize with us, get to know us. Let us hear your criticisms and suggestions.

We will be

• Providing leadership
• Encouraging leadership development
• Supporting and broadening our membership
• Broadening our policy and research bodies
• Communicating our achievements more effectively to you and
• Implementing structures to ensure your satisfaction.

With this in mind,

\We will be doing the following:

1. Organising an aggressive membership drive
2. Organising a straight line to the executive through a dedicated email address and telephone line
3. Be consultative by inviting your comments on all MAJ’s position statements and topical concerns in the media
4. Work closely with all branches of the MAJ
5. Work closely with all sub-umbrella organisations of the MAJ
6. Have our voices and opinions heard by lobbying for positions on the boards of the regional health authorities, hospitals and health-related boards.

Ladies and gentlemen, I invite you to look at my manifesto and to add your comments for the way forward for the MAJ. I want you to hold this executive to its ideas for this term and in the end to evaluate our performance.

MISSION STATEMENT

Let us talk

our mission statement reminds us that as an organisation we are here to enhance the professional and personal development of our members, thereby enabling

them to contribute optimally to the health and well being of the society

Let us talk about professional development.

My manifesto speaks to

The promotion and advancement of high ethical standards in the medical profession

Ladies and gentlemen and colleagues, we had the dubious distinction of making the editorial of the gleaner of September 9, 2007. It was entitled “a question of ethics” and it spoke to the chief justice Zaila McCall’s warning to doctors about the issuing of false medical certificates. Dr Bailey, our Immediate Past President, addressed this matter already.

This is just one of the many articles which appear to be exposing dubious practices of some of our colleagues which threatens the respect our profession receives in this country.

We will nip this in the bud. We propose to:
Make available to all, not only a core of fundamental guiding principles in medicine such as “standards of care” but also:

• To include ethical topics such as these in our annual conferences
• To hold workshops on subjects such as these in all our regions
• To work closely with the Medical Association of Jamaica Insurance Fund (MAJIF). In their seminar. In October 2007, for instance, they will be exploring the pharmacy act so this will touch on prescription writing and dispensing from the office, for instance.

We propose to work closely with the medical council of Jamaica to legislate sanctions against our colleagues who breach the law.

We propose to reward all our good physicians by celebrating who we are and what we do during a medical doctors’ week when we will highlight to this society the essential role we play. During this week we will award one of us who exemplifies the good physicians that many of us are. Nominations will be taken from the membership.

Volunteerism
In this profession it is the norm for us to volunteer our services. We do so regularly in our professional lives selflessly and without praise or notice. Every day the MAJ gets requests for us to donate our services. We would like to thank all of you who at very short notice have responded to our appeals. We propose to harness this volunteerism, to refine it even further; to add to the work of the MAJ with the red cross, food for the poor, Office of Disaster Preparedness & Emergency Management, (ODPEM), Drug Rehabilitation Centres, the Special Olympics, FISH, The Skill Training Centre, St John’s Ambulance and our adolescent outreach programmes; to add to the work of the Medical Association of Jamaica Trust which was registered in 1994 as our charitable arm.

I would like us to further promote philanthropy in the profession by also adopting as another of our major charity the refurbishing of the Sir Golding Rehabilitation Centre (Mona Rehabilitation Centre). The centre is in disrepair, lacks much necessary equipment at a time when there is great need for such a facility. Where do we think the victims who survive 13,182 motor vehicle accidents, the 2,997 stab wounds and the 1,512 gunshots that occurred in 2006 end up? Many of them have lost limbs, are paralyzed and need rehabilitation. Where do we think they go for this rehabilitation? I have already spoken to the relevant persons at the centre and their needs are critical. We propose to join forces with them and lobby for their acute needs to be met.

My manifesto speaks to the
Protection of the Academic, Professional and Economic Independence of Medical practitioners

We will be having regular workshops on best practices in running a private practice

We will implement benefit packages on investments, life insurance, pension plans and retirement homes for medical practitioners

Specialist Services
It is opportune at this time that I offer my sincerest congratulations to the new government and particularly the new minister of health, the Hon Rudyard Spencer. We welcome their expressed desire to improve the Health Services in Jamaica and look forward to having meaningful dialogue with them.

This government has pledged to upgrade specialist services at the Spanish Town, St Ann’s Bay and Mandeville Hospital; to upgrade the Parish Hospitals to Type B Hospitals to offer the 4 basic specialties of Surgery, Obstetrics and Gynaecology, Medicine and Paediatrics and to upgrade the specialist services at the Bustamante Children’s Hospital.

Primary Health Clinics
Primary health care delivery will also be improved at the Health Care Centres. Ambulatory care at the Government Health Centres during 2006 numbered some 1,140 139 visits whilst inpatient hospital discharges were 174,218 and visits to casualties and accident and emergencies were 715,707. Traditionally, the government health clinics have poor infrastructure, ageing equipment, inadequate supplies and a paucity of medical supplies. The pharmacies are poorly stocked with a limited number of drugs, which are usually not readily available. Staffing of these pharmacies, themselves have been poor. There are long waits to see the doctor. We expect that the primary care clinics will no longer be treated like Cinderella but will be adequately staffed and will be given adequate supplies and drugs given the emphasis of this new government on prevention.

Physicians Posts
New Physicians’ posts will have to be created at these institutions.

But we have heard reports of 1-year contracts for some persons versus 3-year contracts for others. We have heard of the summary dismissal of some of our colleagues. We have heard of colleagues whose contracts have not been renewed. We have heard of colleagues who have their specialist degrees, who are working in the capacity as specialists but who have not, after 3 – 4 years been promoted to a grade 4 posts. We feel this is untenable. There is no transparency or equity. This leads to disillusionment, apathy and migration from the public sector to the private sector or even from Jamaica.

We pledge to work closely with the association of government consultants, the Jamaica medical doctors association and the primary care medical officers association to address the terms and conditions of the work of doctors currently employed and the new ones who will be entering the system. We wish to ensure transparency, uniformity of benefits and security of tenure.

Postgraduate Education
We encourage our colleagues to fulfill their potential to the best of their ability. We recognize that there may be limitations to postgraduate education in Jamaica and the region. We encourage experience in the larger countries of the world. The United States and Canada by dint of their proximity are favourite places for postgraduate education. Post graduate education in the United Kingdom, can now be a challenge, given the ruling of the European commission.

For our colleagues who wish to access further education in the USA, for instance, we propose to offer courses on the United States Medical Licensing Examination (USMLE).

For our colleagues who have provisional medical registration in Jamaica, I am aware that the College of Family Physician is doing yeoman’s work in preparing them for their licensing examinations and we commend them for this.

Patient- physician communication
Colleagues, i am very protective of the reputation of our profession so media reports that speak to misconduct by some of our members are cause for concern.

In a recent newspaper article there was a discussion on poor customer service from a few physicians here in Jamaica. I wish to emphasize the word “few”. This speaks not to the quality of the clinical services offered but to poor patient-physician communication and to demonstration or lack thereof of warmth and empathy.

We propose to engender a closer working relationship with the faculty of medical sciences at the UWI, Mona so that we may influence the professional standards and practice of our future graduates.

Student’s Loans and Funding
We propose to interact more closely with the medical students and to articulate and address some of their concerns, some of which includes access to students’ loans and other funding and the terms, conditions and payment plans of these loans.

Faculty of Medical Sciences, University of the West Indies 60th anniversary in 2008
Next year, the faculty of medical sciences will be celebrating its 60th anniversary. It was the very first established faculty of the then new University and today, the medical students of that first class continue to contribute to the well being of medicine in Jamaica. Ladies and gentlemen, I speak of Dr Don Christian, a Past President of the MAJ and Immediate Past President of the Association of Consultant Physicians of Jamaica and Drs Muriel Lowe and Keith McKenzie, whose achievements are well-known to you.

Medical Students
And they continue to shine. The Jamaica Medical Students’ Association is a member of the International Federation of Medical Students Associations that is the largest student organisation in the world. There are 92 national member organisations, representing 88 countries and 2 million students. Recognized in the world health organisation as the forum for medical students and by the United Nations as a non-governmental organisation it has a yearly general assembly that lasts at least seven days and can be attended by up to 1400 medical students. In 2007, this took place in England at the University of Kent. I am happy to inform you that our students out bad Canada, Greece, Taiwan and Bulgaria and that the 57th General Assembly of the International Federation of Medical Students’ Association will be held in Jamaica at the Mona Campus and on the North Coast. On your behalf I would like to congratulate these future leaders of the Caribbean. I exhort you to visit their website at http://www.jamaicaam08.org/new/downloads.htm

The Medical Association of Jamaica pledges to aid our young members in this venture.

Interns Posts
There have been occasions when our interns have found it difficult to find posts. We propose to promote a closer working relationship with interns and to lobby to provide more internship posts, for instance

We propose to:
Protect and preserve the political, legal and industrial interests of the medical profession

By making the MAJ the premier lobby group for decision makers in government so that the MAJ will be able to keep a close eye on health care issues and development in Jamaica, react rapidly in times of crises in the medical field and defend the interests of the medical practitioners and patients in the media and other fora.

The Caribbean Commission on Health and Development
Ladies and gentlemen, the Caribbean commission on health and development has just released their report to the heads of government in Trinidad and Tobago. In 2001, the Heads of Government in the Nassau declaration noted that the “Health of the Region is the Wealth of the Region”; that health is a critical input in the human capital; that expenditure in health is an investment in human capital and that health is linked to wealth.

The report notes that 51% of deaths in the region is due to cardiovascular disease and cancer, and that risk factors for the former are obesity, hypertension, hypercholesterolaemia and tobacco use. The report notes the high cost of depression and schizophrenia in Jamaica which amounts to USD 600m; that there are half a million persons living with HIV in the Caribbean, one of the highest prevalence in the Americas; that homicide and motor vehicle accidents have resulted in 9.3% of the years of productive life lost and that in Jamaica the lost to injury and violence for 2002 came to 0.7% of GDP. The report points to the deficiency in public health teaching and public health function, the poverty of quality assurance and public health research in the region.

MAJ’s 2006 position statement on health policies
It concurs with the MAJ’s 2006 position statement on health policies that

1. The health system infrastructure needs to be strengthened
2. That the health system needs to be better organized for effective planning, effective decentralization and quality assurance
3. That investment in health information systems and the institutions which establishes and maintains these is important
4. That there needs to be increased financing of the health sector
5. And that health expenditure should be 6% of GDP.

Colleagues, we pledge to work with the ministry of health and environment and other regional bodies to make these recommendations possible and thus to improve the health of our nation and of our patients.

The Declaration of Port-of-Spain on Chronic Non-Communicable Disease (NCD)
The Declaration of Port–Of-Spain entitled “united to stop the epidemic of chronic non-communicable disease (NCD)” (and I must thank Mr. Xuerub, for this document) speaks to:

1. Cigarette smoking and the need to reduce this

I propose that the MAJ, through regular seminars regionally and nationally, sensitize our physicians on the need for screening for this lifestyle choice and arm them with the skills to treat what is an addiction in some persons.

I further propose that through the MAJ’s disease management guidelines we prepare and disseminate a document on screening and the treatment of this addiction. I propose that we partner with an international organisation to start a media campaign on the hazards of smoking.

2. The declaration speaks to NCD’s and promises that by the year 2012, 80% of people with NCDs should receive quality care and have access to preventive education based on regional guidelines

Type 2 Diabetes Guidelines
The MAJ has already disseminated to 300 medical practitioners a type 2 diabetes guideline, which speaks to screening, treatment and therapeutic goals. Our physicians were also empowered as to the pharmacological treatment of diabetes as there was a flow chart, which spoke to this

Guidelines on Hypertension
The MAJ is now ready to disseminate our guidelines on hypertension. These guidelines again address screening, treatment, treatment goals and the pharmacological and non-pharmacological measures to reach these goals. We have expanded our numbers now to target 1,000 physicians. We emphasize that only 20 percent of hypertensive patients have attained the target blood pressure. I would like to thank the pharmaceutical companies who partnered with us in these ventures

I propose during my tenure to develop guidelines on hyperlipidaemia and on obesity.

Obesity
A word on obesity
The Declaration of Port-of-Spain spoke to

1. Mandating physical education in schools
2. Promoting healthy school meals
3. Promoting healthy eating
4. Enhancing food security
5. Eliminating transfat
6. Promoting the use of indigenous foods
7. Promoting increased physical activity across all age groups

Through the availability of parks, recreational spaces etc
We stand ready to lobby with the relevant authorities for this.

Public education programme on obesity
I propose that we start a public education programme on obesity. At the end of which all adult Jamaicans will know what is the normal BMI similar to their knowledge of the normal blood pressure. We can be guided by the phenomenal results that some countries in the developed world have seen with public education on hyperlipidaemia, for instance. Scotland, Finland and the United States have seen a dramatic decrease in ischaemic heart disease that was the result of public education, screening and intervention.

Ladies and gentlemen…. My last comment is on the Caribbean and international stature of our august body. We were…

1. The first overseas branch of the British Medical Association
2. 1992 health promotion workshop anti-smoking campaign in collaboration with the Pan American Health Organisation (PAHO)
3. Representation on the government delegation to the United Nations fourth world conference on women held in Beijing, china, September 1995. (UNFPA funded).
4. Caribbean consultation on the need for legislation pertaining to reproductive health and the family.

We will strengthen our ties with Regional and International Medical Associations and Organisations such as the Pan American Health Organisation.

I wish at this point to thank my many supporters for the encouragement and importantly the confidence displayed in my ability to lead this association.

Thanks also to the members of the media with us here today, your coverage is appreciated

Colleagues, ladies and gentlemen, thank you.