Minister of Health and Social Development Hon. Dancia Penn, OBE, QC Ministerial Press Conference

October 28, 2008

I am delighted to welcome each of you here today. I am very conscious that we have not, for a long time, met in this setting.

I think you all know that I have the highest regard for the media as an institution and as part of a free society, and I certainly look forward to meeting more regularly with you.

I intend, this morning, to make a fairly extensive and wide-ranging statement and I very much look forward to your questions after I have made my statement.

I will begin with what I know is of very special interest to each of you, and what of course is of very special importance to all of the people of this country: the New Peebles Hospital.

The New Peebles Hospital

Ladies and gentlemen of the press: many of you are very familiar with the New Peebles Hospital project. Some of you were in fact present when the former Government officially signed the 63-million-dollar contract with Mirsand-Carimex-Quantum on January 22, 2007. Many of you have also attended several media tours that have been arranged by the Ministry since ground was broken for the project in March of 2007.

Those of you who attended the contract signing ceremony probably recall that the project was scheduled to be completed in September 2008. That has of course not happened.

The Ministry has already produced two video documentaries on the status of work on the project, and as some of you will recall that the most recent update was issued just last month (in September).

Since that programme was aired, there have been new developments with regard to the New Peebles Hospital Project.

Work continues to progress, albeit at a slower pace than we had anticipated.

The good news, however, is that the contractor has already passed the half-way mark towards completing this significant development project. Indications are that the contractor is now moving towards the completing latter 40% of the project, and I am advised the work would be completed in mid-2009.

In another week or two the public will begin to see color being applied to the roof of the new hospital. The roof is going to be red in keeping with the colors already on that site.

In the second video documentary on the project, I mentioned that the building was to be enclosed within the next three months; I am happy to confirm that we remain on schedule with achieving that target.

Over the next two-to-three weeks the plastering works will commence on the exterior walls of the building. As a consequence the general structure will begin to take even more of a form of the end product.

Although I remain grateful for the progress that has been achieved on this important project, I must reiterate the fact that the overall pace of work continues to be slower than was promised.

The Ministry continues to work towards resolving that matter through its Project Management Office, under the able leadership of Mr. Bennett Smith and we look forward to an early and satisfactory completion of our new hospital. We will of course, ladies and gentlemen of the media, continue to provide regular updates to the public as we progress with this project.

I am happy to say that plans are already being made for the transition to the new hospital. Obviously we have to have continuity in our services; there can be no break whatever in the services that are provided now at the present Peebles Hospital and the services that would be provided when the new hospital is occupied. At the moment we are assembling a team that will be responsible for dealing with all of the arrangements for the transition to the new hospital.

As you will also know, recently a new Health Services Authority board was appointed – it is a very strong Board and I am very grateful to the men and women of this country who are rendering very important public service by serving on our Health Services Authority board. One of the important things that we are doing with the new Board is to ensure that the service level agreement is concluded between the Ministry and the Board so that there will be clarity and certainty on the expectations of the Ministry on the one hand and the responsibilities of the Board, on the other. We have had – and I myself participated in it - a very good orientation programme with the Board and they are enthusiastic.

Mini-hospital for Virgin Gorda

Our programmes and projects related to health call for the improving not only of the physical infrastructure in health facilities, but in our services generally.

So besides completing the Peebles Hospital we have pledged to construct a mini-hospital on Virgin Gorda as well as a polyclinic in the East End-Long Look area. These are necessary projects that the Ministry is keen to commence, because we recognise that the health of our people is among our most valuable assets.

The trend worldwide is towards greater emphasis on primary care – that is healthcare delivered in clinics and in communities, and a strong part of our focus and our emphasis will be on primary healthcare.

As you probably know that the issue of a mini-hospital for the people of Virgin Gorda has been a widely debated issue in recent years. Concerns remain over the inconvenience faced by persons on Virgin Gorda – as indeed on some of our other sister islands - as well as the challenges associated with achieving emergency medical attention, especially late at nights where issues with quick access to transportation, and the costs of such transportation etc.

These concerns continue to resonate with us; they resonate very strongly, and I am very pleased to say to you today that preliminary steps are underway towards constructing a new mini-hospital on the island of Virgin Gorda.

Tender documents for the project have already been submitted to the Public Tenders Committee. May I say here that despite reports to the contrary early last year, payment for the property on Virgin Gorda is only now being made.

I expect that tendering will be done within the next two weeks, when the Public Tenders Committee will have completed its revision and adjustments as necessary. We expect that shortly thereafter the usual advertisements will be issued inviting bids.

As soon as an architect has been contracted he/she will work closely with the Ministry to design a suitable mini-hospital for the people of Virgin Gorda. Once the architects are retained it will be safe to say that formal work has begun on developing a mini-hospital for Virgin Gorda. I am very optimistic that the formal groundbreaking for that health facility will take place early next year.

It is important for me to state, and to state clearly, that the residents of Virgin Gorda will be fully and properly consulted so that they have an opportunity for their views to be included in shaping of this important facility. I also must say that the Ministry would work very closely with our Premier Honourable Ralph T. O’Neal, who is the representative for Virgin Gorda, in getting feedback and input as we seek to move the project forward.

Polyclinic at East End-Long Look

The Ministry is at the moment appointing a Search Committee, which will seek to find the most appropriate location for the proposed East End-Long Look polyclinic. I have myself, as the representative for the 8th District, been in touch with individuals in the community seeking to obtain a suitable site. And I would like to confirm that the idea is to build a single facility to serve the communities of East End/Long Look as well as the neighbouring communities.

For years there have been two separate clinics in the community: one in Long Look, one in East End; each is small, each is inadequate. We believe that the best thing to do in the long term interest of the country is to build a single facility and of course the East End/Long Look area is the largest centre of population outside of Road Town. I promise that more information will be forthcoming in the very near future on this very important project.

Senior Citizens

As I announced several months ago, a new site is being sought to construct a senior citizens home, and a Search Committee is in the process of being appointed to identify and advise on a site.

We believe that it is important that our seniors who need to live in a public facility are housed within the community, not away in the mountains far away from the community. We also believe that it is important for their family members and other members of the community are able to visit them regularly and to have full access to them, and the residents of the home should equally have full access.

So we are working very assiduously to make sure that we soon have a site for the construction of a home for our senior citizens. We also have arrangements in place to purchase a specially designed vehicle to facilitate the movement of our seniors, many of whom continue to participate actively in the senior citizens’ programmes and in other activities.

The Ministry of Health and Social Development is strongly committed in ensuring that the staff and each resident of the Adina Donovan Home is provided with safe, comfortable, and positive surroundings and we will spare no effort in reaching that goal. Our senior citizens programme continue to do well and next year plans are afoot for the celebration of the 20th anniversary of the senior citizens programme.

Clinics in General

We remain, as we have promised, to providing improved facilities in all or our clinics.
The Ministry is at present working with the BVI Health Services Authority to review the status of all of the clinics. Some months ago we commissioned a study and a firm of structural engineers is in the process of looking at and evaluating each of our clinics and we have already received a preliminary report from the structural engineers. We know that there is work to be done and we are not just sitting and waiting for the report. In fact we have taken the step of already having funds allocated to deal with improvements to the clinics.

We continue to be part of the OECS Pharmaceutical Procurement Service and we get good value for money through our participation in that programme. In addition we continue to work very hard to make sure that there are adequate supplies of all major prescription drugs available in our pharmacy at the hospital, and we also committed to making sure that there are adequate supplies of the normally prescribed drugs in our clinics.

In terms of tertiary care, earlier this year we have already stated that I led a team to hospitals in Florida – primarily Baptist Hospital and Jackson Memorial Hospital – to seek to update the agreements which we have with those major facilities under which our people may receive tertiary care as needed. We also are reviewing our agreements with Pavia Hospital. The Government clearly has an obligation to make sure that there are proper facilities for people with major illnesses as well as people who suffer major trauma, whether it be through accidents or other injuries.

In that regard we continue to be committed to constructing helipads wherever needed and our major focus at present is on constructing a helipad on the island of Jost Van Dyke. I have personally been very concerned about that – the entire Government is – and we continue to hope that we can soon find an appropriate site on the island of Jost Van Dyke on which a helipad can be constructed; this is very important in the event that there were a major incident or in the event of a person falling seriously ill.

National Health Insurance

Responsibility for that National Health Insurance was recently assigned to my Ministry by the Honourable Premier. In our Ministry we have already began work on the National Health Insurance Programme, and the consultants who did quite a lot of work in the recent past will be returning in a few weeks to work with the Ministry.

Community Centres

The Ministry of Health and Social Development is currently in the final phase of reviewing proposals for the various community centres throughout the Territory. This is being done to determine the best ways in which most centres can be made more functional and more attractive.

Some of the very regular events at all of our community centres are the senior citizens programmes, which are very successful and mean a great deal to our seniors.

Some of the expected enhancements include painting, and possible minor repairs such as the replacement of broken windows and doors etc. We are very keen – and I have made it part of my personal quest – to ensure that there is proper wheelchair and other access at all of those senior citizens centres.

So ramps are going to be installed where there are no ramps. We continue to look forward to the official hand-over of the Cane Garden Bay community centre and I trust that we will have the keys to that very important facility, for Cane Garden Bay and surrounding communities, before this year ends.

Cabinet, a few weeks ago, agreed to purchase a property in Jost Van Dyke, on which a community centre will be constructed. So very soon we will be working with architects and other relevant persons to begin the very important work of having a community centre on the island of Jost Van Dyke.

I am also pleased to announce today that our plans are advanced for the construction of a community centre in the Purcell community. In Hope Estate, which is part of my own constituency of the 8th District, funds have been included in the 2008 budget for the acquisition of land and for the design of a community centre in Hope Estate.

Social Development

As we all know, the last several years have seen marked changes in every respect in these islands. There is no doubt that expectations have changed, the population has grown, the nature of the population has become more diversified etc. We have therefore found it necessary to assess where we are in terms of our social services, our whole social sector, and the delivery of services and the provision of facilities in our social services sector.

For that reason several months ago we commissioned a Social Sector Analysis; the consultants have been here and know they have met with some of you ladies and gentlemen of the media; they have also met with several other members of our community, organizations and related persons.

We have also appointed a team which works with the consultants and which will also advise me at the Minister and the Government as a whole on the implementation of the report of the consultants once that report is completed. I expect, and the contract provides, that by the end of December I should have that report in hand. I have said to the consultants, and have said very clearly, that we do not want a report that would be put on a shelf. We want a report that is practical and can be used because we are serious about addressing whatever the social sector needs of are of this country.

One of the things that we know we will have to do is to embark on a programme of social sector legislation. I recently had a meeting with senior staff within the Ministry where we discussed the social sector legislation that I know we must enact.

Tomorrow Wednesday and also on Thursday our Social Development Department in collaboration with the United Nations Children Fund (UNICEF) Office for Barbados and the Eastern Caribbean will host a two-day workshop towards the creation of a “National Protocol for the Prevention, Reporting, Investigating, and Management of Child Abuse and Neglect in the BVI.”

This is coming at an important time when we seek to develop a national protocol on the reporting and management of child abuse cases, as well as to develop a multi-disciplinary committee on child abuse.

We are all disturbed by the increasing number of reports of child abuse and it is important for us to have proper systems and mechanisms in place to deal with that very serious problem.

The Ministry and wider Government are very committed to safeguarding and protecting our children and to ensure that their rights are protected. We hope this workshop will assist in achieving this very important goal.

Tomorrow morning I will be signing an agreement with UNICEF, with authorization from Cabinet, committing to measures to improve life and conditions (legal and otherwise) for children in these islands. We will continue to work with UNICEF to rely on and to use their technical expertise while of course ensuring that we cater as we see best fitting to our needs.

As you know we have a very small children’s home in Road Town, called the Rainbow Children’s Home. We continue to take measures to improve all the facilities and services at the Rainbow Children’s Home, and in fact we are in the process of acquiring land to make sure that the Rainbow Children’s Home can continue to be adequate to meet the demands of our children who after all – it’s no cliché to say - are our future.

Substance Abuse

This is a troubling matter and we all know that; answers to it are not easy. We have had in this country for some years the Sandy Lane Centre, which has come a long way and the time is now ripe to look at the Sandy Lane Centre and to review what happens there in order to make sure that we have proper arrangements and protocols in place for admission, for treatment, and so on.

Any day now, we should be signing an agreement for a consultant to undertake a much needed review of that facility. BVI Services is another facility that was established several years ago to deal with persons with disability and we regret the BVI Services continues to be housed in facilities which are not the most appropriate but my clear advice is that by the end of the year we should be able to move BVI Services and its clients into a more appropriate setting but fantastically good work goes on at BVI Services and I pay tribute to all who work there and indeed all who work in all of our facilities.

The Disabled and Persons with Special Needs

My aim as Minister and the aim of the Government is to integrate services and care for persons with disabilities and special needs into our general population and into our general services. We are pledged to doing whatever is necessary and whatever is possible to make sure that such persons are adequately taken care of; that any stigma and discrimination is minimized and driven away. That is why we have been very careful to appoint a person (who was appointed in August) Ms. Lenette Mactavious as a special disability coordinator. She works with the Ministry and in the short time that she has been in post I have received her preliminary report. Ladies and gentlemen of the media I can give you the assurance that we are well underway to seeking to meet and address the needs of those who are disabled and who have special needs.

It’s not an easy thing; and it’s not a matter of getting up and saying that we will do A, B, C. And although there is a view that one does not need more study, and I myself think that there are often too many studies, it is very important that we have the right focus and that the proper policy is in place before we do things like embark on legislation and so on. However, the matter of physical access to bathroom facilities, to public places, and to buildings is very high on the agenda on our disability coordinator. The entire Government is entirely supportive of this.

Legal Aid

Legal Aid is one of those matters which fall under the remit of the Ministry of Health and Social Development, and the Ministry is meant to work closely with the courts on the matter of Legal Aid. As a lawyer myself, I am well aware of the pros and cons of Legal Aid but obviously it is consistent with democracy and a developed society that Legal Aid is provided. One of the matters that we intend to pay closer attention to in the coming months within the Ministry is our Legal Aid system. I commend the members of the Bar on the very fine work they have been doing in this area, in which they have a very keen interest.

Public Assistance

We have a very old law, which I think dates back to the 1930s that deals with public assistance. Since becoming Minister I have appointed a new Public Assistance Committee. It’s under the chairmanship of one of our very fine citizens Mrs. Claudia Lettsome; she is a retired school principal and a lay preacher in the Methodist Church. That group meets under the auspices of the Social Development Department, and one of the things that they do is make assessments of and decide on persons who qualify for public assistance. Regrettably, the sum that is currently being paid by way of a monthly grant to persons on public assistance is as low as $100; that is obviously too low and I have in preparation a paper on its way to Cabinet for that grant to be increased. I have already addressed that subject with the Premier; he supports it 100% and we think it is critical. We were waiting for more reports from the relevant stakeholders, but we thought that given the current state of the economy with the increased cost of living that it is important to expedite this process. There obviously needs to be principles, standards and guidelines by which these sums are paid but we do hope to increase - and increase very soon - the monthly grant which is paid to persons who qualify for public assistance.

Mediation and Conciliation

I think we’ve all been struck by the increase in crime in our society. It’s an inescapable reality of the days in which we now live. And it is clear that despite whatever material progress we may have made, we have lost something at the core of our society and of our people. And part of what I believe, as Minister of Health and Social Development, is necessary is for us to look at ways of resolving conflicts; ways of resolving disputes. I sit as a member of the National Security Council and we look regularly at reports from the police. It is so very clear that a lot of the incidents which occur, which reach the police, which reach our courts, which sometimes result in death – they are instances which have arisen because people have failed somewhere in resolving a dispute. Sometimes it’s a big one, sometimes not such a big one between them. So part of what we will be embarking on in the Ministry of Health and Social Development is a programme to seek to promote resolution of disputes and to institutionalize more reconciling of differences. That has been done in some societies; I think it is important that we try to do it here, and that is one of the things that we in the Ministry would be embarking on. But let me be clear, this is not a matter at all for the Government of the day or for the Minister of the day: it affects and impacts the whole society, and the whole society has to come together in seeking to address the issue. We need the churches, we need the non-governmental organizations, we need the business community, we need civil society in its entirety – we need every single one of us. But we are pledged – in the Ministry – to seek to lead on that very important matter of trying to do more to institutionalize conflict resolution.

In that regard, I was happy to learn in the last few days that a march and rally against crime and violence is being planned for 4 p.m. this coming Saturday, 1 November. I understand that it is going to be held at the Bandstand in Road Town and that it is being organised by a multi-sectoral group. I welcome that. I think that’s a good start. The Christian Council is involved, the BVI Teachers Union, the Rotary Club, the Rotoract Club, the Lions Club and several other organizations. And I myself will be in that march - God’s willing - at 4 p.m. this Saturday.

I believe it is a very important event, and a very important step that we should all commit ourselves to.

Gender

This Government is pledged to promote a community that values, supports and promotes the rights of women, men, and children. We know that this is a key to our society. The subject of Gender was fairly recently assigned to me as Minister. And in our Ministry we continue the important work that has been done over the years on the subject of Gender in the Premier’s Office. The Office of Gender Affairs has done a great deal of work on a Gender Policy, and I am currently embarked on taking that Policy forward. May I stress that the matter of Gender and the work of the Office of Gender Affairs is not only about women: it’s about men, it’s about women, it’s about families, and it’s about everyone.

Just a few months ago the Office of Gender Affairs organised a very successful week on men’s health, and I know that part of the ongoing programme of that Office is to focus on men even as it focuses on women. But the realities are that historically their has been a lot of discrimination against women and a lot of blockages to women, and one of them has been cited as women in public life – women in public policymaking. And I believe that that’s a very important thing, I obviously believe that is important for any developing society.

Incinerator

A lot has been in the news recently about our incinerator, and I think we all know that the new incinerator will, in the next few days, be shipped from Virginia to us here. There is a great deal of work to be done once the incinerator plant arrives on the island and for it to be assembled. But we really look forward to commissioning that plant very early in the New Year. You will know that a team led by the Acting Permanent Secretary in the Ministry of Health and Social Development Ms. Petrona Smith visited the premises in Virginia where the incinerator was built, and the team has advised that it was fit for purpose and fit to be shipped. There are a number of things to be done once the incinerator arrives here and we will keep the public fully advised and updated on developments with that incinerator. It’s desperately needed. We are all concerned about the very unsatisfactory arrangements that exist for the disposal of garbage and the open burning at Pockwood Pond. That is not what we want to continue and as soon as the news incinerator can be commissioned it certainly will be. More information will be provided as we go along.

Solid Waste

Solid Waste falls within the remit of the Ministry of Health and Social Development. Very soon, we will be proceeding in the House of Assembly with amendments to the existing litter laws that will strengthen the powers of litter wardens and do a lot more to make it easier for those who work in solid waste disposal to function more adequately. I am making an appeal for all of us to look at our personal habits and commit ourselves to having a cleaner, healthier, better looking, and more beautiful Virgin Islands than we have allowed ourselves to get in the last few years.

Cemeteries

Recently I met in this room with the burial ground managers. We have approximately 11 public cemeteries in this Territory and of course there are some church cemeteries as well. It was a very useful meeting and the cemetery managers were all very open and very forthcoming.

They had a number of good suggestions as well as some concerns. As Minister, I am actively following up on the various suggestions that were made by the different managers. We in the Ministry as well have some thoughts and plans of our own for dealing with cemeteries, and it is another area where we need to update and modernize our legislation as our Cemeteries Act is quite old.

Breast Cancer

We are a member of CAREC – that is the Caribbean Epidemiology Centre – and CAREC has confirmed that chronic non-communicable diseases like high blood pressure, heart disease, diabetes and cancer are among the leading causes of illnesses and deaths in the Caribbean. In 2006, a health systems profile was done here in this Territory and that confirmed CAREC’S findings. So in other words what CAREC found to be the case in the region is also the case in the British Virgin Islands. This is one of my main concerns as Minister of Health, and I can tell you that with great sincerity. And that is one of the reasons why over a year ago now I instituted a monthly Heart Healthy Walk. We started off just walking for healthy hearts, but it has evolved and we now walk for several different groups and for several different causes.

This coming Saturday, 1 November, we are dedicating our walk to breast cancer and breast cancer awareness. Of course men develop breast cancer as well as women, so it’s not a woman’s problem. And men as fathers, husbands, boyfriends and brothers sometimes have to be caregivers for whatever illness it is including breast cancer. So I invite all of you to come and join us this Saturday morning. The very special features will include a brief ceremony in the Breezeway after the walk, where cancer survivors will speak about their own experiences. So I invite all of you to be there since the media has a strong and powerful role to play in getting that message out about the non-communicable chronic diseases which are very real.

In this very small Territory, we have approximately 30 people who every week receive dialysis treatment at Peebles Hospital. It is very expensive for Government; it is very expensive; it is very hard on an individual; it is very difficult for the families of these patients; and our economy loses a lot. We spend out of our public purse, I am advised, about $2,000,000 per year purely on dialysis. And our ratio for persons on dialysis, looking at the international norms and standards, our ratio way exceeds what it should be. A lot of it can be linked to our lifestyles such as our exercise habits and the way we eat.

Before I end I want to thank several people. I must thank the people of the 8th electoral district for electing me to membership in the House of Assembly. That is how I have been placed in what I believe is this very great and privileged position, which a very humbling position of being the Minister charged with the responsibility for Health and Social Development.

I would also like to than the Premier for his confidence in appointing me not only to this very important and challenging Ministry but also to be the Deputy Premier of this Territory. I must also thank those who I work with everyday in the Ministry itself, Joe Daley, Ms. Petrona Smith, Mrs. Ritzia Turnbull-Smith, Mrs. Beverly Hodge-Smith, Betty Chalwell-Bailey and many others including the staff of all of the different departments that operate under the Ministry of Health and Social Development. My daily life is made by them and their efforts and I want to go on public record in thanking each of them. Thank you members of the media for your attendance and for being so patient as I made this fairly lengthy presentation. I will now be delighted to receive you questions. Thank you.