“One of the great mis-truths of the PNC government is the claim that they have introduced a new free health care policy. We know that is not true. A recent World Bank report confirms it is not true.
“Indeed, the report states in terms of the so-called new policy that ‘The free health policy came into effect on February 24, 2014 …. Despite the name of the new policy, primary health care services have officially been free in PNG since 1975. Nevertheless, due to a lack of reliable financing, health facilities do, in practice, charge user fees as these are often the only source of operational revenue.’ So we have confirmation of a fake ‘new’ policy from the PNC government” said the Shadow Treasurer, Mr Ling-Stuckey.
“The World Bank report then expresses concerns about how the PNC health policy is actually being implemented: ‘there are concerns about implementation of the policy in terms of its efficacy, implementation schedule, and lack of indicators to determine both the extent of financial protection through the policy and the coverage of health care services. (p1 of report)’.
“In the official and cautious language of the World Bank, this is a pretty damning criticism. Of course, for those members that spend time out with their constituents, we know the reality of this government’s appalling record on health services. In recent years, we know that there have been massive cuts in health care funding. After allowing for inflation and population growth, spending has declined from K217 in 2015 to K148 per person, in 2017.
“The 2018 Budget claimed that it was going to reduce some of these cuts with an increase health funding to K167 per person. This would still represent a massive cut of over one-quarter in only 4 years. But as I said at the time, the fake revenue in the budget means the promised levels of health expenditure will not be delivered! The recent mid-year budget update called MYEFO, hidden in the detail, confirms that this is happening. For example, the government’s own report shows that of the promised K20m for the so-called “new free health care policy” that no warrants had been authorised and nothing was spent.
“Even more extraordinarily, of the K646.5 million spent on the capital works in the first six months of the year, only 1.5% was spent on the health sector. Of the K50 million allocated to District/Rural Hospital Redevelopment, nothing has been spent. Of the K30 million allocated for the ANGAU – Lae Cancer Unit, only K1 million has been released and nothing has been spent. Things are a bit better for the Port Moresby General Hospitals Cancer and Heart Institute where expenditure is only K4m of the K28.5 million allocation or less than 15%. The K15m Nursing College Infrastructure Rehabilitation has only had K3.5m spent, and the Wewak School of Nursing has had nothing spent from its K15m 2018 fake budget. Likewise, this appalling implementation record flows into the planned K10m for the PNG Church Partnership Program which is already massively underfunded given its important health and education roles and where no warrants have been released, as is also the case for the planned K10m to the Medical University where nothing has been spent.
“Come on Treasurer – if the revenues were actually flowing in as you claim in the MYEFO and keep publishing in the newspapers, why aren’t such trumpeted health activities being funded?” asked the Shadow Treasurer.
“What does this mean in practice? It means that when our people turn up to our run-down rural health services that they may not find a trained health worker or any medicines – so fewer of our rural people are even bothering to attend underfunded rural health clinics. This lack of investment then has national implications such as the return of the scourge of polio to our country. The lack of funding for basic water and sanitation facilities just adds to these problems. There is a need to move away from the fake and failing health policies of the PNC and towards an Alternative Government” said Mr Ling-Stuckey.
Shadow Minister for Treasury & Finance
28 August 2018
Further concerning information from the World Bank report released on 11 June 2018 (available here – http://documents.worldbank.org/curated/en/493091528779467386/Papua-New-Guinea-Health-financing-system-assessment ) includes:
- Health spending, as a share of general government spending, decreased from over 9 percent in 2010 to 6.8 percent in 2014. P3
- Malnutrition rates are high and persistent: almost one half of children under five years of age are stunted and 28 percent are underweight.p8
- The existing health workforce is rapidly aging, compounding the health worker shortage issue. The workforce is inequitably distributed between rural and urban areas, with a substantial predisposition toward urban areas. Another compounding factor is PNG’s lack of significant progress in medicine and health-training capacity, which has resulted in a shortage of qualified staff to replenish the aging workforce.p ix
- Overall, PNG has experienced a decline in the utilization of outpatient services between 2010 and 2014. There are significant disparities in access to, and utilization of, health services. Furthermore, rural outreach has continued to decrease.p3.
Figures from 2018 MYEFO pp 64 and 65
MEDREL -PNG’s FAKE FREE HEALTH CARE POLICY.280818