THIS week the PIOJ launched its plan for growth, titled "A GROWTH-INDUCEMENT STRATEGY FOR JAMAICA IN THE SHORT AND MEDIUM TERM". This is welcome, as a stimulus package from the government has been long overdue as a result of the strictures imposed on us by the IMF programme. We also see that the PIOJ in September 2010 stated that the IMF programme was contractionary, which is consistent with a belief held by others for a while.
While I welcome the strategy outlined by the PIOJ, I have a few concerns, the first of which is my hope that the bureaucracy does not prevent us from maximising the benefits from the programmes. We have in the past seen many such strategies developed, but we never derive the full benefits as our problem has always been in implementation, yet we are great conceptualisers.
The second concern comes from what is stated in the PIOJ document itself, where on page eight it says in bold type: "We were not called upon to construct a plan for long-term development of the economy". This is a big turn-off for me, as before even telling us about the programmes that are to be put in place to move the economy forward, the authors are putting forth a disclaimer about any link to long-term development. My own view is that the "Planning" Institute of Jamaica is supposed to be involved in long-term development planning, and so to produce a document where their primary role is denied seems contradictory.This is significant especially as they have a responsibility for Vision 2030.
On page 17 it then seeks to increase employment by growing the "labour-intensive industries", which to me is not necessarily the way to go as we should be trying to mechanise these industries for productivity improvement. What we should do is create employment by increasing the capacity in the areas where we have a comparative advantage, and that is one of the shortcomings of the document as it does not focus on international competitiveness to take advantage of exports or import substitution.
Overall, though, I agree that many of the projects included are necessary, particularly the infrastructure projects, and I want to support the government on establishing this initiative. I believe, however, that the limited resources could have been better utilised (greater ROI) by the PIOJ, and should undoubtedly be a part of the long-term development plans. The responsibility for this not happening I will have to place at the feet of the PIOJ, as they are the technical experts, and are the ones who propose this to the government, and not the other way around. While the government may say that they want to achieve growth in the economy, I expect that the technical implementation must rest with the body charged to drive the policy directive.
For example, I do not think that the document places enough emphasis on long-term productivity improvement (or even short-term), sustainable crime reduction, and what I like to call (as an accountant) "balance sheet improvement". The latter, of course, refers to the Balance of Payments.
I will not go into any further details on my analysis of the document, except to say that I hope that this is still a work in progress and can be adjusted to ensure that it is brought in line with the long-term development we need and not just focus on short-term growth. Having no doubt that the strategy will lead to short-term growth I applaud the efforts to provide this stimulus, but is this all we want from the PIOJ?
Public health strengths and weaknesses
Two weeks ago I had knee surgery done. It was a complicated procedure, as it involved meniscus repair, ACL reconstruction, drilling, and insertion of an implant.
When it was determined last year that the operation was necessary, I was advised to have it done overseas, at which point I started the investigations. After a few months of looking into it, I discussed the situation with Dr. Derrick McDowell, who was the head of the MAJ mission to Haiti and former head of the Orthopaedic Association, and apart from all of that his greatest attribute is that he is a Jamaica College Old Boy. He immediately explained to me that he does many of these surgeries and could easily do it.
He also advised me of the team he would be using (Jackie Minott - anaesthetist, Michelle Depass - physiotherapist), whom I also checked out, in keeping with my accounting training. I also checked with persons overseas to see what their experience with similar surgeries was, and they indicated that they experienced pain for a few days after the operation. I also did extensive reading on the procedure and anaesthesia methods.
After much reading and analysis of the information given to me by both Derrick and Jackie, in addition to my checks with persons overseas, I decided that there was no benefit to doing the surgery abroad. In fact I felt that one of the advantages of doing it in Jamaica was the ability to be in touch with the local team as needed.
I opted for spinal anaesthesia, and was enjoying watching the surgery being done while listening to my iPod. The next thing I remember is the bandage being put on and being wheeled back to the hospital room. On seeing Derrick later I asked why they had put me to sleep knowing that I wanted to see the operation, to which he responded that I was fully conscious but that the sedative I got causes amnesia, so I wouldn't remember what happened. That I found amazing. In addition, by the next day I had no pain at all, in contradiction to the experience of the persons overseas.
I say all that to point out our tendency not to recognise the competence of our local experts, and this is why we seem to always prefer to go for external consultants, who in many cases mess up a project and leave the Jamaicans to clean it up. One of the reasons for this choice is because we fail to do proper analysis up front. The result is that much of our talent (e.g. Bob Marley) is recognised abroad long before it is recognised in Jamaica.
It seems to me that the real problem with public health in Jamaica is a lack of good administration rather than the capacity of the workers, and I hope that the work being done by the Ministry of Health will soon resolve this long outstanding problem. The recent Observer story that shows specimens being stored in unsatisfactory conditions at the KPH illustrates the poor administration and controls.
Recently I was having a conversation with the manager of a strata plan who was telling me that some of the owners still owed significant amounts for maintenance. When I enquired as to why she didn't go to the Strata Board and seek to enforce payment she indicated that she had, but before any action could be taken she would have to pay a fee of $5,000 per unit. I would have preferred to hear that action was taken and then the offending parties (owners in arrears) were asked to pay the $5,000, but not that the victim (strata), who has had to suffer because of the non-payment of what is due, is being asked to pay to access something to which they are entitled. This gives the impression that the main concern of the Strata Board is to raise funds rather than to improve compliance, as many strata properties still continue to suffer from what the Strata Board was set up to fix.