Montserrat Survey of Living Conditions (MSLC) Executive Summary

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Montserrat Survey of Living ConditionsExecutive SummaryHealth costs are rising due to better, but more expensive treatments, people are living longer thusrequiring more treatment and costs associated with chronic diseases are disproportionately high 18 . At thesame time, the impact of sudden health expenditure on family incomes can be severe for those who are onlow incomes. It is anticipated that the new Health Strategy will address these issues with options beingconsidered including a National Health Insurance System, increased user charges, possibly allied toexemptions for some groups being subject to greater means testing.There are also issues related to the quality of health care in terms of the availability of trained nurses anddoctors and access to less frequently needed health services. This is largely attributable to the small size ofthe population, which offers few opportunities for medical staff to gain a breadth of experience; thismakes the posts relatively unattractive. It also makes it harder to provide treatment for specialist problems,e.g. mental health.4.3 EducationPrimary and secondary education is compulsory up to age 16.government to all residents. Attendance is therefore almost 100%.Services are provided free by theGOM developed an Education in the Country Policy Plan for 1998-2002 in conjunction with DfID.Under this plan, the government is supporting initiatives in the areas of curriculum development, studentassessment and evaluation, professional development for teachers, post-secondary education expansion,and educational infrastructure and information technology. Considerable progress has been made in thelast few years. One new day care centre opened and another was expanded in 2002, which made it possiblefor more children to access early childhood education at minimal cost. Access to primary education alsoincreased in 2002 with the addition of a fourth grade in one primary school; in 2005, two additional gradeswere included. The Government constructed Montserrat Community College (MCC) in 2004 where boththe secondary school and high school are located.With the construction and expansion of facilities, the Ministry is now turning its attention to issues relatingto the quality of education and services to disadvantaged pupils. The Ministry states that a number ofchildren are underachieving; the truancy rate (over 50+ students every day) is also high. GOM alsoconsider that the behaviour of children is a key issue which adversely affects the educational attainment ofother pupils and have introduced a red and yellow card system to caution students. Despite improvements,significant proportions of primary school students have below average reading levels. Some lessons aretoo academic for some students. Some parents 19 find it difficult to come to school to discuss the issues.Children arriving from non-English speaking countries have trouble integrating as do sometimes thosewho started their education in UK. To address these concerns, the government has introduced severalprogrammes (see Box ES1).18 Drugs for diabetics and hypertensives (c. 13% of the population) account for over half the cost of drugs providedfree.19 E.g. low income and non-nationals who find access harder due to lack of transport. These tend to be thehouseholds with problem kids.Montserrat Country Poverty Assessment, Final ReportHalcrow Group Limited, July 2012.ES18
Montserrat Survey of Living ConditionsExecutive SummaryBox ES1: Targeted Educational Programmes• The Every Child Matters (ECM) agenda, under which the government wants every child to be healthy,safe, contribute positively to society, achieve - and enjoy achieving - economic well being.• School lunches for all students at a nominal fee.• The Pupil Support Unit (PSU) was formed less than a year ago to address disciplinary concerns in thesecondary school. The PSU is intended to provide counselling programmes and act as a resource unitproviding basic child guidance and a place to pacify children in a managed environment. However thePSU has yet to be fully established and engaging parents with ‘problem’ children is not straightforward.• A Change Manager has been employed to provide guidance on the changes needed in schools and howto bring these about to improve the quality of education and pastoral care in the secondary school.• The Low Achievers Education Programme is designed to provide extra lessons/ tuition to improve thebasic skills of some first year secondary school students in order that they can fully participate insecondary school classes.Overall however, the education system in Montserrat is generally working well. Reconstruction of facilitieshas largely been completed, although space is still limited and there are insufficient spaces for sports andrecreation. Attention is now turning to issues relating to the quality of education and support for thosewith educational needs and social problems, which have been exacerbated by the tight economic situationand the fragmentation of families.4.4 Social ServicesGovernment social welfare services are provided by the Social Welfare Department (SWD) andCommunity Services Department (CSD) within the Ministry of Health and Welfare. Together thesedepartments offer a number of services to the poor and vulnerable including: regular and one off socialassistance in cash or kind; counseling; fostering and adoption services.The Social Welfare System (SWS) provides regular financial assistance to very needy elderly, mentallychallenged and physically disabled Montserratians. Criteria are tight and. essentially only those with noother means of support receive SWS. Since 2001 GOM has also provided a rental subsidy for vulnerablegovernment housing tenants; again most of the recipients are elderly or disabled. In 2009, there were 270beneficiaries of SWS and just under 100 for the rental assistance scheme. SWS benefits (EC$600 permonth) are significantly higher than the indigence line but are well below the poverty line. One off grantsfor emergency relief (food baskets, housing supplies, school uniforms) or medical care also provided (toaround 350 beneficiaries in 2008); criteria are very strict.Due to resource constraints, little assistance is available to poor family households who have been badlyaffected by falling incomes and rising prices. A recent review recommended that benefit levels should beraised and that eligibility should be more closely based on the needs of the applicant with less regard takenof other income sources of other household members. It was however recognised that the additionalfinance might prove difficult for this to be implemented. No recommendations were made to widen thecriteria to enable more non-elderly households to benefit.Montserrat Country Poverty Assessment, Final ReportHalcrow Group Limited, July 2012.ES19
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