Based on the findings from his research on “Health Reforms in the Cook Islands 1995-2015” for his Doctor of Philosophy (PhD) studies, Glassie described health services in this country as better than other nations in the Pacific.
He said that was despite a consistent decline in government spending on health over the past six years.
“Overall, the Cook Islands health system has improved a great deal,” said Glassie, who served as health minister from 2010 to June this year.
“Anywhere around the world, health reform is not perfect. You really have to understand things like the structure of the organisation, the staffing of the organisation, whether they have the capacity and competence to do their work properly and as far as I’m concerned, the medical staff here are doing an excellent job.
“For a lot of the islands like ourselves - Tahiti and so forth, health (services) have improved compared to others within the Pacific.”
Glassie said health reforms were one segment of broader public sector reforms and a “devolution” agenda in the Cook Islands.
He said his research aimed to critically evaluate health reforms and outcomes and assess the extent to which they had affected the quality of health service delivery.
The research focuses on the relationship between health reforms policies, their implementation and their effects on health provisions for Cook Islanders. Its preliminary findings show 38 per cent of the 50 respondents interviewed were satisfied with the health service, while 36 per cent were not.
Transport issues were their major concern, followed by insufficient medical equipment, under-resourced staff and lack of medical/specialist services.
The findings on the impact of the public sector on health reform show staff redundancies and downsizing on top at 33 per cent, followed by outmigration on 17 per cent and salary reductions on 10 per cent.
The research also shows that before 1995, the health service had happier staff, doctors were well respected, transport was provided (for staff) and there was an excellent patient care.
Improved Information and Communications Technology (ICT) systems, quality and efficient patient care systems and new and renovated heath infrastructures were the highlights of health service improvements between 2001 and 2015.
In the outer islands, 10 per cent of the respondents who took part in the research said improved healthcare system had resulted from the health reforms.
“People are saying that the health system before was good (and) there were doctors in the outer islands, but then there is a different landscape of diseases in the Cook Islands (than what) we are dealing with now,” Glassie said.
“Before we had communicable disease like typhoid, elephantiasis and TB and they were external diseases so we needed to have doctors there. The landscape of diseases has changed into non-communicable diseases.
“There is also a decline in our population in the outer islands and there are not as many Cook Islands trained doctors as before. The doctors (in the outer islands) are replaced by nurse practitioners and they are doing an excellent job.
“In other words, the level of training for our medical staff has increased in a professional manner, and we are becoming quite technological these days. If there is any illness in the outer islands, we can talk to the nurses through email, video conferencing and telehealth, which means we are faster in the way we deal with patients.”
Glassie also noted the increase in the referral budget which had helped the ministry provide better health care to the people of the outer islands.