Montserrat Survey of Living Conditions (MSLC) Executive Summary

Montserrat Survey of Living ConditionsExecutive SummaryTable ES9: Health: Summary RecommendationsRecommendationsProduce a booklet and publicity campaign based oneating according to the MCFB.Enhance system of home visits for those who find itdifficult to attending clinics.Ensure that the ‘doctor on call’ system is wellpublicised.Improve the supply of drugs for the chronically ill tothe govt. pharmacy.Health care finance:Assess feasibility of introducing NHIS.Review exemptions and current user charges tomake them more means-tested and increase costrecovery.Investigate the feasibility of establishing a rota ofvisiting specialists to provide services which are notcurrently available – especially for mentally ill.Eliminate disparity in medical costs for NNATsRationaleThe MCFB provides the cheapest way of achievinga healthy diet. If this is actively promoted, peoplecould reduce their food expenditure and achieve ahealthier diet.Many elderly and disabled persons find it hard toget to clinics yet do not have the means toorganise their own transport.These patients are often on low incomes andunavailability of drugs at the pharmacy means theymust pay more privately.Reduce insecurity and loss of income arising fromhealth care costs.Target exemptions to those most in need.Reduce pressure on health finances.Reduce the need for overseas medical treatmentand the impact that this can have on householdincomes.Improving the treatment of the mentally ill willbenefit patients and health personnel alike.Will eliminate an important source of NNATdiscontent.6.6 Social Assistance/ PensionsSocial assistance will always be important in the Montserrat context due to the number of elderly who areliving alone and receive no, or inadequate, pensions, the disabled who cannot work, and one parent andlow income households with children. The living standards of these groups are exacerbated by diminishedfamily support networks. Current social assistance benefits are generally accepted to be below thosenecessary to purchase the Minimum Cost Food Basket and other necessities. Furthermore, by and large,the current system is only available to the elderly and the disabled and does not cover very poor (let alonepoor) family households. Notwithstanding budgetary constraints, these are serious shortcomings.Accordingly, the reform of the Social Welfare System (SWS) is a strategic action of the MSDP. Some waysin which this could be achieved are shown in Table ES10.As a major increase in finance for social assistance is unlikely, the crucial decision is whether availablefinance should be used to increase benefits to those already receiving payments or to widen the eligibilitycriteria to include those not currently eligible, e.g. very poor families.Table ES10: Social Welfare: Summary RecommendationsRecommendationIncrease benefits to current recipientsWiden eligibility criteria to provide assistance tounemployed and working poor households.Increasing SS pensionsProvide a discretionary stipend to SWSRationaleCurrent benefits are below minimum living costs.Needy households without elderly persons arecurrently largely precluded from receiving socialassistance.Current SS pensions are well below basic livingcosts AND below SWS benefits.Will reduce their sense of dependence.Montserrat Country Poverty Assessment, Final ReportHalcrow Group Limited, July 2012.ES27