Belfast Telegraph

Monday 21 April 2014

Northern Ireland politicians to visit Cuba to study the island’s health system

Havana's crumbling colonial facades and classic American cars make it visually unique.

A Stormont committee is aiming to find a new way to improve efficiency in the health service — by flying a team of MLAs and an official across the Atlantic.

The group will travel to the Caribbean in December on a fact-finding mission to observe Cuba’s healthcare system — at a cost of £6,000.

Originally the committee had discussed sending all 11 members, or a member from each party, but has now decided against it.

Among those travelling to the four-day conference in Havana will be the chair of the Assembly’s health committee Sue Ramsey and deputy chair Jim Wells.

A committee clerk will also travel on the visit.

The taxpayer-funded trip is being promoted as an opportunity to observe Cuba’s renowned health system.

Mr Wells said the priority was to ensure that money was used “effectively” and to provide “the best outcomes for people”.

However, a leading lobby group has questioned the need to travel more than 4,000 miles when video-conference facilities can connect people across the world.

Jonathan Isaby, political director of the TaxPayers’ Alliance, said politicians must always consider whether a trip is strictly necessary in the first place.

“After all, video-conferencing facilities are now able to connect MLAs with other politicians or experts around the world at very little cost,” he told the Belfast Telegraph.

“And if the trip is deemed necessary, they should be flying standard class and staying in modest hotels.

“Politicians must be able to demonstrate that the overseas excursion is absolutely essential and delivering taxpayers value for money before they start racking up the air miles.”

Although regarded as a Third World country, with many people living on a salary of around £10 a month, Cuba’s health system is highly-rated.

Politicians and doctors say they hope to learn from the Cuban model, which produces one of the highest life expectancy rates in the world.

Cuba’s average life expectancy is 77, compared to 71 in Belfast.

The communist system has also produced world leaders in eyecare.

A cataract operation in Cuba costs about £40 — a fraction of the price for similar surgery in Northern Ireland.

The island has more doctors and surgeons, but fewer hospitals, relying more on health centres and clinics.

Mr Wells said the visit would allow the group to see at first-hand how the system works and whether it could be applied in Northern Ireland.

“Cuba is also known for being able to deliver excellent health outcomes despite spending considerably less than most European countries, including Northern Ireland,” he said.

“We need to ensure that the monies we have available to spend on health are used effectively and provide for the best outcomes for people.

“We need to learn from systems which have been proven to produce good outcomes that are equitable and cost -effective.”

They decided to go after consulting with health visitor Una Lynch, who spent nearly five months studying Cuba’s healthcare system in 2005.

“The World Health Organisation in 2008 in their world health report highlight Cuba as a model of excellent practice,” she said.

“Needs assessment is very much at the heart of the service and within each neighbourhood they have GPs attached to approximately 300 families, depending on the density of the population.”

According to Ms Lynch, a system is then created to ensure the services available to a community are responsive to its needs.

Ms Ramsey said Cuba is well-known across the world for its success in terms of improving public health.

“Lessons can be learned from Cuba which can be applied to how we take forward our new public health strategy,” she added.

“The visit will allow us to see health projects at first-hand, talk to health professionals on the ground and also meet experts in this field who will be attending the conference.”

However, Alliance MLA Kieran McCarthy, who also sits on the health committee, said the trip was not the best use of public money.

Mr McCarthy said an option to send the whole committee to Cuba was pulled after he raised objections.

“While I acknowledge that Cuba has a very good health system and I am sure that we could learn some things from them, I believe that this trip is not justified when video-conferencing facilities are available to us,” he said.

“I am sure that we could have learned the same amount as Sue Ramsey and Jim Wells will if we organised to make a video-conference call involving the whole committee, instead of sending them.”

Mr McCarthy also questioned how much can really be learned from the Cuban health system.

“The Cuba model may not be transferable to Northern Ireland considering that they are a communist country and being in the Caribbean, they obviously have a different climate,” he added.

“I understand that their salaries are different to ours, and pay is obviously a big part of our health budget, so I do not know how much we can copy them.”

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By Adrian Rutherford

The planned fact-finding mission to Cuba is not the first time that a costly overseas trip has caused controversy.

Earlier this year MLAs abandoned plans to visit California following a public backlash.

An outcry was sparked after it emerged the employment and learning committee was considering a trip to San Diego despite the deepening impact of public spending cuts.

Initially, it was suggested that the 11-strong committee would set off on the five-day tour at a potential cost of £12,000.

The all-expenses paid visit was aimed at uncovering how research work in universities and other institutions can help create jobs.

Committee members Jim Allister and Michelle Gildernew said they were unhappy with the trip.

The committee later unanimously voted against the proposal.

Concerns about overseas travel were also raised following a Belfast Telegraph investigation earlier this year.

This newspaper revealed how Stormont ministers, MLAs and senior civil servants had enjoyed five-star hospitality during costly trips around the world.

Former Employment Minister Sir Reg Empey visited the United States and Canada six times in 18 months.

During one visit, Mr Empey stayed at the prestigious Four Seasons Hotel in Washington. Meanwhile, DUP MLA Nelson McCausland made three expensive overseas trips in six months as Culture Minister.

On a visit to India for the 2010 Commonwealth Games, he stayed at the five-star Le Meridien.

Another 10-day trip to America by Mr McCausland and two advisers, intended to enhance links between Northern Ireland and the US, cost some £30,000.

Two other former ministers stayed in five-star comfort while on overseas business, according to documents released after Freedom of Information requests.

Former Social Development Minister Margaret Ritchie stopped at the luxury Fitzpatrick Manhattan and Willard Intercontinental while in the US for the 2010 St Patrick’s celebrations.

And ex-Agriculture Minister Ms Gildernew stayed at the five-star Hotel Sofitel in Brussels while attending a meeting of the Agriculture and Fisheries Council in May 2009.

The hotel’s website states it is “a truly elegant and luxury five-star hotel”.

Other ministers and officials travelled to cities across Europe.

Former Environment Minister Edwin Poots and eight colleagues attended a major climate change conference in Copenhagen in December 2009 at a cost of £8,766.

Ex-Regional Development Minister Conor Murphy and a special adviser also travelled to Valencia in Spain, staying at the four-star Vincci Lys hotel. Its website describes how rooms are “completely equipped with the most modern services to satisfy the most demanding traveller”.

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