 Thank you very much, Mr. Speaker. Mr. Speaker, I thank you and thank you honourable members. Mr. Speaker, the member of parliament for Kastri's East and Prime Minister of St. Lucia presented the appropriation bill 2023-24 to honourable members to our country on Tuesday, 25th 2023. He presented truth not manufactured on truths. He gave evidence not wishful thinking. He handed the evidence of growth to the parliament and laid out for all to hear and see a clear path for continued prosperity, a clear path for shared prosperity, a clear path for inclusion and also a clear path for shared responsibility. The member of parliament for Kastri's East, Mr. Speaker, the leader of the St. Lucia Labour Party on Robert Philip J. Pierre, is the Minister of Finance and the leader for this time, Mr. Speaker. He is the leader for the times. I will heartily support the report and proposals which were presented by the Prime Minister in the appropriations bill 2023-2024 under the theme health and security pillars of sustainability. I am indeed pleased, Mr. Speaker, that my constituents of V4North will benefit from the vision and programs of the government wherever they are. Fishers of Sabans Bay and V4T who will get the rebate of a dollar per gallon of gas, repairs to the facilities, training for fishers, safety equipment. Students from V4North who will get the laptops and parents who will save thousands of dollars. Those visiting health facilities with improvements to be done. The elderly who will benefit from improved health care and the golden program. The youth from V4North, the youth economy, the small enterprise sector. The tax amnesty, the support to honey producers, for example, the arising brothers of V4North, the young honey producers and others. People like Josh Os from Grace will be smiling, Mr. Speaker. Value added in cassava and coconuts, the St. Jude reconstruction project, the Iwanora airport reconstruction project, the blue economy project, the removal of vat, unbuilding materials. Indeed, Mr. Speaker, this is the prime minister for the times, Mr. Speaker. He is the prime minister for the times. A while ago, Mr. Speaker, the member of Oshwazel asked whether I should respond or whether I can respond to the fact he noted, well I don't know if it's a fact, but he noted that many young people from his constituency and in other places are suddenly dying. And he believes clearly that there is a problem. I will say clearly, Mr. Speaker, that what we are seeing in terms of the medical records, it shows a clear pattern of increased mortality, a clear pattern of increased challenges in health care with people who have non-communicable diseases. It is also important to say that our health professionals continue to do the research and continue to ensure that we gather the data so that if there are any clear trends, these will be reported. I also wish to say to the member for Oshwazel, Mr. Speaker, that not only in Senusha but around the world, there is a growing trend of what you call long COVID, where it is being described that people who have recovered from the COVID-19 disease seem to be coming up and presenting new challenges. He spoke about pharmaceuticals and this has been an issue for a long time. In fact, Mr. Speaker, the supply chain issues stemming out of the COVID-19 pandemic and the enormous debt which we incurred to suppliers were negotiating payments on these debts. And again, Mr. Speaker, he was in the last government and he should know about the bills which they left to pay to pharmaceutical companies. We are certainly paying down those debts and I can say to him, Mr. Speaker, that from time to time we do have shortage of some pharmaceuticals but these matters have been addressed and they have been addressed. Mr. Speaker, the leadership of our ministry, anchored by the permanent secretary, Ms. Janie Daniel, has been guided by the strategic policies of our government in the implementation of projects in our ministry. It is very clear, Mr. Speaker, that we have to guide this health care system and the economy from the devastation of the COVID-19 pandemic. As we know, the health care sector is one of the key engines and drivers of economic growth. We saw what happened with the COVID-19 pandemic and as the COVID-19 pandemic wins, we realized that the strengthening of primary health care is a major priority. We are also not, Mr. Speaker, that risk factors such as sedentary lifestyles, smoking, alcohol abuse, body mass index and so on have not reflected any signs of improvement over the years. And therefore, Mr. Speaker, it continues to be a major concern to all of us in the ministry, especially the team led by Dr. Sharna Sir. It is, Mr. Speaker, a strategy to tackle the risk factors which will involve an approach which incorporates the entire population. Mr. Speaker, on page 66 of the Prime Minister's address, a levy of 2.5% on goods and services except food, medicines, medical and security equipment. It will be placed for health care and security investments. I am pleased that some of the revenues which will come out of this levy will go directly into health care investment. Mr. Speaker, here is what we face. When we are sick, when our family is sick, when we have an unfortunate accident, we take them to the St. Jude Hospital to the team led by Dr. Natrum. Or we take them to the OKEU, to the team led by Dr. Lisa Charles, or to the January Hospital, to the team led by Nurse Yolanda Alsindo, or to the Sufray Hospital, to the team led by Nurse Sadhu Alexander. What happened? We want to ensure when we take our relatives to these hospitals and to the health centers that we get the best medical professionals available. We are expecting to get the best care and we are hoping that the hospitals will have the supplies and trained staff. It is the responsibility of the government to do its very best to keep focus on disparity and allocate resources to our hospitals as best as it can. We are responsible government, Mr. Speaker. We put people first and providing financial resources to our public hospitals is our priority. Therefore revenues from the 2.5% levy for health and security will assist us. Mr. Speaker, let me give you an idea of what we face. Two hospitals struggling for years to meet operational costs and served of capital investment for innovation and modernization. What do we do as a government? Continue to fight and battle and say we don't have money? No. Let us look at what happened at St. Jude, Mr. Speaker. Let us look at what happened at St. Jude. The fire and conditions at the stadium have made the situation worse. But when Ms. Lydia Adkins, the CEO at St. Jude Hospital and Mr. Elevik who is head in the board, look at the situation. You have to call for more resources to the St. Jude Hospital. Last year they served over 44,000 people before COVID-19 St. Jude Hospital served over 50,000 people. An average of 16,500 people accessing specialty clinic every year. And 33% increasing admissions between 2015 and 2019. If you look at the average cost per patient between 2019 and 2020, it jumped from $585 per patient to $719 if it's not subsidized. Now, Mr. Speaker, the cost per patient at St. Jude Hospital, it moved from $949 around 2020 to $1,173 now on subsidized. You have 400 staff members posting negative cash balances in 2021, 1.8 million, 1.3 million in 2022. The collection rates have gone down. Prior to COVID-19, they were collecting 53% of revenues from services. Right now, they are only collecting 23%. Critical equipment needs of $3 million. 20 nurses needed. Bed capacity over 100% at the stadium. And the cost of operation is over $33 million annually. And over the years, last year, before, a subvention of $21 million. What are we supposed to do? What are we going to do if we want proper healthcare? The 2.5% levy will assist the healthcare sector. And you will see in a while what we are doing directly to assist the St. Jude Hospital. If you look at the Millennium Heights Medical Complex, turning point, the mental wellness center and so on. Dr. James, Dr. Dexter James, the CEO and Dr. Lisa Charles. When they look at the responsibilities, and Ms. Reynolds was the head of the board. When they look at the responsibilities, they realize that over 50,000 people were served in 2022. Surgeries, admissions, accident and emergency, 95 people in dialysis. The cost of operation of the Millennium Heights Medical Complex, conservatively Mr. Speaker, is at $95 million and counting. $8 million in capital costs, in capital expenses they are budgeting for this year. The current recurrent budget, last year they got $52.2 million and $48 million of that is absorbed in salaries. And what do they collect? $5 million in services every month at the OKU, Millennium Heights Medical Complex. But they only collect $400,000 per month, so they are providing $5 million in services. But they only collecting from user fees, people who pay the hospital and so on, only $400,000. So you could well imagine the challenge with the Owen King EU Hospital and the Millennium Heights Medical Complex. So what do you do? What do you do? You just stay and keep scratching your head. This government has a clear path, step by step, phase by phase, to ensure that the hospitals, the public hospitals and facilities get adequately financed. I heard the member for Mikusav many times talking about health insurance or how we are going to finance health care. We started from health insurance. I want him to bring to the house the evidence with documents which showed that they had completed negotiations with any health insurance. And that they had a solid health insurance plan for St Lucia. He cannot do it, he cannot do it. So how did we address these challenges over the year? Our goal Mr Speaker is to advance universal health coverage and to make that goal part of all the workings of the ministry. So everywhere in the ministry we are talking about universal health coverage. While at the same time urgently improving conditions of work of our staff, urgently doing all that we can to improve patient care Mr Speaker. What did we do during last year to assist at St Jude? We know that we have started the refurbishment rehabilitation and we will complete the St Jude Hospital at OJ. But while we are at the stadium a lot of work was done. Reconstruction of the east wing, rehabilitation of the inventory warehouse, rehabilitation of the triage booths, rehabilitation of the emergency technicians office, works ongoing to redesign and rehabilitate the emergency room resuscitation bay, rehabilitation of outpatient clinic, redesign and rehabilitation of the eye clinic and bacteriology department, supply of furniture for departments and those kinds of things. Provide support through donation of major equipment including ventilators, lab equipment and other machines Mr Speaker. This is what we did last year. It is very important to note Mr Speaker that in November 2022 we started work on the St Jude Hospital at OJ and we are very confident that we are going to complete this hospital to remove the people and the staff from the stadium. Very very confident Mr Speaker. The 2.5% levy will contribute an investment to the government's efforts at providing quality healthcare under the universal healthcare program. The Owen King EU hospital, while we speak about all the challenges, what happened last year? I can spend a whole night telling you about what happened at Owen King EU hospital. We have lots of challenges there Mr Speaker and we have a lot of complaints about accident and emergency department. And so the hospital has adopted a new model of care with the board and Dr James and Dr Lisa Charles and the whole team. A new model of care and they are working on it consulting with St Lucia Diabetes and Hypertension, Appotensive Association, Blind Welfare Association, St Lucia Cancer Society, Alzheimer's and Dementia, St Lucia Renal Association. All of consultations to ensure that we take the views of all of them into consideration in our work. We are spoken about accreditation and the hospital is working towards that Mr Speaker. The hospital is also working on a new model of hospital financing and you will hear a lot about it. The hospital is establishing a trust so that it depends less on the government for direct support. The accident and emergency department improvements are happening there to shorten the waiting time. There are service enhancements and a move towards a 24 hour hospital. Mr Speaker, the challenges at our hospitals are strongly connected to the challenges and services at our health centers or at our wellness centers. Our teams in the region Mr Speaker all around have been hearing about universal health care, improving quality all around the ministry and throughout our various departments. So you can start from the respiratory hospital from Miss Nancy Francis and you can go to Nurse Julieta Cassius. You can also speak to Nurse Suraj, Kofni Suraj, the chief nursing officer and Nurse Tekle Jebatis, the immunization manager, all of them working together to ensure that we improve services. And what have we done Mr Speaker? We have engaged what we call public welfare assistance at the castries and view for wellness centers in addition to what we had at the respiratory hospital. And that is an idea coming straight from the prime minister and I want to thank him for that Mr Speaker. So public welfare assistance at the castries and view for wellness centers and we are going to spread these services so that these people can assist the nurses and the professionals to have some welfare service. Medical assistance Mr Speaker, $1.4 million last year in medical assistance. $1.2 million to services locally and a total of $144,985 overseas. And if you speak to Dr Glensford Joseph who handles the medical assistance, he can tell you the number of requests we have. Mr Speaker, we are working with our friends in Martinique and also in Guadeloupe and the discussions are preliminary. We have had a few meetings and we are going to work with the Department of External Affairs, the Ministry of External Affairs. Our permanent secretary, Miss Daniel, the Chief Medical Officer, Dr Shaan Belma George, in consultation with Council Alison Joseph and also the Department of External Affairs. We are going to finalize the memorandum of understanding between St Lucia and the French departments. In fact Mr Speaker in June, we are hoping to meet with them in Martinique and Guadeloupe to look at the possibilities to strengthen the relationship between Martinique and Guadeloupe. All of this Mr Speaker, in an effort to bolster service to our people, non-communicable diseases Mr Speaker. And if you talk to Dr Shaan Asir and her team, you will know Mr Speaker that they are working hard on know your numbers campaign. What about your blood pressure, what about your sugar and so on, they are working hard on that and I don't need to tell you about the St Lucia Moves initiative. You see it happening in different businesses now and it is just an effort to sensitize our people to move, that they need to move a little more Mr Speaker. We also are working on the performance best financing and Mr Neham Jabatis is their very strong assistant in this regard. Mr Speaker, in primary care, we wanted to ensure that we strengthen our weekly surveillance reports and the office of Dr Shaan Belma George, the CMO continues to strengthen the processes. If you say hi to Dr Michel Foswa, our epidemiologist Mr Speaker, working very hard to ensure that our processes are fine tuned so that we can get the correct research that the member for Schuuzel spoke about. And health promotion and Mrs Natasha Lloyd Felix and team working very hard and now Ms Nadezh Smith Lambert doing even additional work with our health promotion. And you can see an increase in our health promotion in the coming out of the ministry and when we speak about diet and nutrition, we've been working with the Ministry of Education and Mrs Lisa Hunt and her team together with the CMO's office on the schools nutrition policy, but of course with the Ministry of Education and we know what happened with the sugary beverages. It is something we are continuing to discuss and hope that our parents and we can work something out together. We believe we needed to have more consultation and the Ministry of Education is working very hard with us on that. Mrs Speaker, you can't speak about primary health care if you don't talk about substance abuse and we know the launch of our national drug strategy is coming Mrs Speaker and especially post pandemic. We are seeing a lot of issues and this is something we are working on and the program will be launched very soon. Mrs Speaker, primary health care although we are talking about universal health care Mrs Speaker, primary health care really is the foundation and the skeleton of universal health care. And I don't know if you know somebody by doctor if they quote Mrs Speaker on a team and here is what they did last year for the first time because of our focus on elderly affairs. They launched a wonderful program of mobile dental elderly programs at Comfort Bay in Viewfort, at Cornerstone, St. Lucy's home, Mary Ann home, Johnson's home, Adelaide home, Mother Teresa home and for the retirees. Two hundred and twenty-one elderly persons were provided care, two hundred and eighteen cleanings and a number of extractions Mrs Speaker. I am very proud of Doctor Ifrim and her team Mrs Speaker and the programs that they are providing for the first time to our elderly homes and that will continue Mrs Speaker. They will start a program for the great case and grade one students Mrs Speaker because Doctor Ifrim received a grant and Mrs Speaker she has been made a fellow of the International College of Dentists and they continue to work very hard. Recently Mrs Speaker we had the US military LAMAT mission and that was a huge success. Our team members put together a plan and we know it happened before but what we saw before we ensured that we would not see people on the tents waiting from three o'clock in the morning and so on. We had a system where people called in to make appointments and so forth and this was very very successful Mrs Speaker. The US professionals worked alongside our professionals and 230 patients were seen for surgeries, some of them major surgeries and they are praising this. So let me thank the US military LAMAT mission Mrs Speaker. Our infectious disease we piloted HIV self testing in collaboration with Caribbean Med Labs Foundation. That was a success and we hope to continue this Mrs Speaker. So Dr Gayle Kajada Mrs Speaker very quiet lady, soft spoken but very profound in her work Mrs Speaker. Providing further training in HIV and syphilis rapid testing with her team and we are looking at the commencement of fix those combination medications for tuberculosis management. So Mrs Speaker, when we speak about universal health care, the last time the members of microsoft and the leader of the opposition shouted across the room, what is universal health care? You need to talk about health insurance. When a former prime minister ask you what is universal health care, I just hope nobody from the international community heard that Mrs Speaker. A former prime minister say what is universal health care? It is very clear Mrs Speaker that he was lost as prime minister. He does not know the fundamentals of building a health care system and that is why they failed Mrs Speaker. That is why they failed miserably with the policies. And when we speak about universal health care, this time we know a lot of work was done before. I will demonstrate to you that this time we are not only just talking about universal health care. Lots of actions have been put in place. And if you speak Mrs Speaker for a little while maybe over coffee to Dr Alishon Eugene Ford who is the head and director of our universal health care program, you will understand what is happening. Tremendous amount of work has been done with the team. We established the universal health care unit as a project in August of last year. We were not just living it as a program in the ministry. We wanted to give it direction, we wanted to give it leadership and so we employed a director of universal health care with some limited support staff which we hopefully will increase later on. We employed a communication specialist to ensure that the universal health care had legs Mrs Speaker. The unit has done tremendous work with strong support from the universal health care working group. And many professionals in St Lucia who have worked alongside the team. Again I wish to say Mrs Speaker, everything is not starting from scratch. We are not reinventing all of the wheels. But what I can tell you is that we are on a path which will deliver universal health care to St Lucia all bit in a phased way. But we are on a path and I will tell you exactly what will happen. And to show you how the 2.5% levy for health and security will assist us in paying for some of these services. What have we done Mrs Speaker? The drafting of the white paper is ongoing and the white paper is a roadmap. We have had other papers before but this time with assistance from the world bank we are working hard on the health system strengthening project. We are working hard to deliver this. Also Mrs Speaker, we have looked again at the essential package of health services. Which health services should we include in a basket of services? Some work was done on it before. We have looked at the work, that work is completed and we have given it to an actuarial consultancy to make sure everything fits well and we should get the results soon. We are going to launch maternal and child health services as the first tangible result of our universal health care program. And in this budget Mrs Speaker, the Minister for Finance has allocated 1.8 million dollars to do this. And what does it mean? What does this mean Mrs Speaker? What does it mean? It means that we are going to provide additional services of labs, ultrasounds, investigations at the primary care level to improve St. Lucia's perinatal outcomes. It means Mrs Speaker that the ladies who get pregnant in St. Lucia when this program is launched will get the labs, will get the investigations and the necessary ultrasounds to ensure that we have safe delivery and healthy deliveries. Why did we choose this? We realize Mrs Speaker that over the last ten years we have been having challenges with our boths. Still boths, some parents unfortunately over the last three years have passed away and there are issues we are noticing over the years when we look at the data over the last ten years. We are noticing that a number of pregnant ladies, well, a number of pregnant women, they do not access health care because it is too expensive for them. They have to go for the labs, the blood tests, they have to pay for it. The ultrasounds and a number of these services have to be paid for. So we have selected this, it is direct, we have the data, we know what we are doing. There are a little over 2,100 ladies who get pregnant in St. Lucia every year over the last ten years. We have the data, we have costed the services. Mrs Speaker, we have had discussions with the providers of the services and the providers of the services are not only the public sector because you cannot have a successful university. We have a universal healthcare programme if you don't incorporate your private sector. So we are also talking to the private sector meaning the private labs and so forth. So a lot of work has been done, we have proposals, they are discussing with the labs and so on, proposals for the payments. So this is on track and we are going to deliver the maternal and childcare services as part of our universal healthcare delivery. Mrs Speaker, on the universal healthcare registration and issuance of health cards, we are working with the health system strengthening project to ensure that we register and provide health cards to the whole population. And I know some people have said, what's the sense of doing this? Why would you provide a health card to the population? It's very important because this health card, Mrs Speaker, will tie in to our health system, our information system on health and solution, SLUIS and it will assist us in providing the service. While all of the services for universal healthcare will not be available now, the services that will be available, we are going to issue the health cards and ensure that they are being used while we wait for the other services to come on board and then we are going to issue health cards. So we are not issuing thousands of health cards to just anybody as yet, we are doing it in a phased way. The experience in the other countries have told us that it is better if we are doing diabetes and hypertension as we will be doing with the performance-based financing project. Then you register those people who are in the diabetes and hypertension, give them the health card. We will be doing maternal and child healthcare services, we will register the pregnant mother so they have the health card, they can swipe it, they can use it in other facilities. Cancer screening and early detection. Mrs Speaker, we are hoping that by September of this year we will start work on this part of the universal healthcare project which is cancer screening for prostate, breast, colon and so on. A major deliverable for us is a cancer registry which has been elusive for a while. When I know Dr. Raimi, if she is listening, we will say I have been waiting for a long time and the Senusia Cancer Society faces cancer and they have been doing a lot of work in that area Mrs. Speaker. This year we are going to work on it. The communications aspect of the universal healthcare, you have seen a lot of it already. We are developing a communications plan, communications programs just for universal healthcare. There was a survey and we have a unit pushing the message of universal healthcare headed by Ms. Jade Brown and her team. So Mrs Speaker, we are moving ahead with universal healthcare purposefully but at the same time strengthening our health facilities and strengthening our services all around the world. What about elder care services? I have spoken about the elderly homes and the dental programs which we have started. We have worked with the government of Taiwan on kitchen gardens for the elderly. We have gone to Comfort Bay senior citizens home and provided equipment for the Comfort Bay senior citizens home. But we have a new initiative this year. The Prime Minister of Finance has agreed Mrs. Speaker that we are going to initiate a service which we will call the Golden Eighty Plus Health Package. The Golden Eighty Plus Health Package. Mrs. Speaker, we know that the value of pharmaceuticals which is provided to senior citizens who are 80 years or older is about $1.684 million, $1.684 million, $234 million. That is what we spend to provide medicines from our primary facilities, health centers, public hospitals and so on to individuals who are 80 years or older. We know that because we have the databases and so on. $1.684 million. Out of that we spend $250,000 for diabetes and hypertension medication which is free. So they don't pay for that. However, Mr. Speaker, our information suggests that $1.4 million, $1,433,763 is paid for out of pocket by individuals 80 years and over. So individuals, our residents who are 80 years and over pay to the primary care facilities $1,433,763 in medication. So it means if you are 80 years or older you have to pay although you will get diabetes and hypertension medication free. So you still have to pay for some medication. Starting this year Mr. Speaker and we are going to announce a date. All Saint Lucians who are 80 years or older will no longer pay for medication of pharmaceuticals at our primary care facilities as long as they are available. So you will not have to pay any money for pharmaceuticals. Mr. Speaker, we have a department for Guamoun. With the government of Saint Lucians who have paid for Guamoun with all the people who have paid for this. We know that the people who have been in the hospital for a long time will have to pay $1.6 million in medication. But with the government of Saint Lucians who have paid $254,000 in medication and diabetes and high blood pressure by the consul. But the people who have been in the hospital for a long time will have to pay $1.4 million in medication. So what is the governmentblockify. We want to announce the dates. With the government or other government who have paid expensive for medical treatment for patients ʻū qāi nī pū mene āi di kādu pū mūtʃwe ʻū kātwi ve lāne ʻpas lāni mūn ki kātwi ve lāne ʻek yō gā gādi āku e di yō sen kāt lāne ʻū nī pū kātwi ve lāne ʻso this is a new initiative Mr Speaker We continue on our policy for older persons and also on the creation of the elder care unit we are in discussions with the Ministry of Public Service and this based on the documents which I have seen will come soon we are increasing the capacity of the comfort bay older citizens home it has a capacity it has a capacity way above the number of individuals we have there now and so we are going to reorganize it to take more people we continue Mr Speaker to strengthen the supply of our health services we are creating Mr Speaker what we call centers of excellence and again the last time the Member of Parliament from Mikusaw and the leader of the opposition suggested that it didn't make much sense because it is better to have doctors go all around the country to all the health centers than to have centers of excellence and for people to travel well Mr Speaker my role in this job is very simple when the Prime Minister told me you are going to do this job I have a very simple way of assessing things you put plans in place you measure it against outcomes it's not about BAVA you shouldn't do this, you shouldn't do that it's not about BAVA you shouldn't do this, you shouldn't do that so Mr Speaker what is the center of excellence what we are saying is that we do not have the money to have specialist doctors to go all around St Lucia in all 33 health centers every month, every week and so on we don't have the money to do it and even though we have the money we may not have the professionals who are available to do it so what we are doing we are concentrating certain services in some of our wellness centers the regular services continue it's not as if you don't have the regular services anymore but we are concentrating some services and we have started with the Miku wellness center and the head of region for Dr. Shanda Haraksing I am sure can tell you a little more about that but let me just tell you something quickly about results and that is what I like, results verifiable results Mr Speaker when we converted the designated the Miku wellness center as a center of excellence we saw a much increase in the number of individuals who access specialist services in 2022 no one, we had no dental services there the whole of 2022 January and now of 2023 we have had 117 clients going to the Miku wellness center for dental services they never had dental services before well the regular medical services they are now seeing from 422 they are now seeing 633 casualty 437 it's around the same 477 internal medicine 15 in 2022 now they are seeing 155 and that is January to now okay we have others like antinatal, postnatal and so on from 61 to 92 men's health, mythology and others none in 2022 because we did not have that program but when we designated Miku as a center of excellence so far 63 men have access to services and they are coming back so Mr. Speaker very clearly this shows that we have increased access which is what universal healthcare is about increased access and increased quality of services dental services and so on the other wellness centers will come on board like the Ansleril wellness center Mr. Speaker we are going to focus on sexual and reproductive health and also awareness of the snake bite snake bite and so on snake bite education the viewport wellness center and others Mr. Speaker to expand our services we are going to establish the castries urban poly clinic and if you speak to nurse bernadette regis and a team you will know the kinds of issues they have in that region Mr. Speaker the present castries wellness center is no longer fit for purpose it has structural problems and it has situational constraints the hours of service need to be extended at least to midnight Mr. Speaker to include services on weekends and holidays we also Mr. Speaker need to cause non-emergency services to go to the urban poly clinic instead of the accident and emergency department of the Owen King EU hospital do you know Mr. Speaker it is estimated by the OK EU that 50% of the cases that come to A and E accident and emergency can be classified as non-emergency care somebody burst their toe somebody you can't blame them because they have nowhere else to go so if you burst your toe midnight and it's bleeding and so on you cannot go to the castries wellness center you go to accident and emergency so there is a backlog when we establish the castries urban poly clinic we are going to ensure that it goes at least up to midnight and in the future 24 hours so that those cases can go there and free up the accident and emergency area at Owen King EU hospital again Mr. Speaker while we are focusing on universal healthcare that's our goal you know remember that in the manifesto on page 20 you will see there a big goal of our government is to establish universal healthcare we are big on that but while we are doing that we are strengthening all the services everywhere as best as we can and we are going to establish the wellness center Mr. Speaker if you speak to this in the Antoine in that region we are going to health center by police service and we are spoken about and I'm sure Nussel Alexander at Souffre will be pleased to hear about the development Mr. Speaker another very important development in our strategy and in our work is to ensure that we centralize the processes of maintenance when I became minister Mr. Speaker all of the complaints and I went to the health centers I saw certain things Mr. Speaker some of them are heartbreaking certain things very simple things a door lock, a door knob and Mr. Minister we have been asking for that for so long a lock that costs $45 and so on it's not that they don't want to fix it but there is no proper system of maintenance regular maintenance Mr. Speaker and so our biomedical engineer Mr. Polin leads the team which we have put together and they are at the respiratory hospital and what they are doing Mr. Speaker we have technical staff to undertake maintenance work we have plumber, electrician heating ventilation and air conditioning technician so that they go around the health centers in a regular way a regular system to ensure that our systems are in place as a result of the new focus Mr. Speaker you know what happened last year members opposite criticize us I wonder what was happening whether they didn't know all of this let me tell you what happened last year Mr. Speaker just last year as a result of checking the equipment going all around the country and checking this government out of central government spent $1.2 million in the purchase of medical equipment in St. Lucia $1.2 million just last year St. Jude hospital $204,555 all kinds of analyzers anesthesia machine hematology analyzer nurses clinics all around St. Lucia we spent $911,500 the eye clinic purchase of equipment for eye clinic $89,541 Mr. Speaker $1.2 million spent to replace medical equipment now if we do not have a system of checking the equipment repairing them ensuring that they are in top shape we would not have the situations which we've had from time to time when surgeries cannot be performed when basic procedures cannot be performed and it's because the last government failed to look at the basic things in healthcare now I'm not saying we have done all we have a lot of work to do I get calls all the time from the health centers they are missing this they are missing that things like fatal heart monitors vital signs monitors Mr. Speaker urine analyzers we've placed those bits of equipment or pieces of equipment all around the health centers we have a lot to do so as a result of this focus Mr. Speaker we are able to alleviate a number of the problems so this is like Ms. Philippia Donnelly of Bellevue and Marilyn Laesom of Grace the supervisor for region 5 Ms. Jasmine Daniel Ms. Shulian Lamontine in region 6 Ms. Simone Solomon Ms. Yasmin Gabriel Ms. Beverly Joseph Samuel of Babuno Ms. Jamie Raphael Morgan Raphael all of these people are leading teams Mr. Speaker all around St. Lucia in the health centers to ensure that our work is done and to ensure that the people of St. Lucia are safe we continue to strengthen public health emergency preparedness and Mrs. Jeanette Hughes leads a wonderful team in the health system strengthening project of the World Bank Mr. Speaker and they have delivered so many positive things in the health sector they have helped to improve our database management they have helped to improve communication supply of personal protective equipment infrared thermometers universal transport kit viral transport kit supply of vehicles to the various departments and so forth the OECS regional health project of the World Bank similar they are the ones responsible for some of the smarting of our wellness centers and a number of wellness centers have been visited and Slerebin one of them and there are many others and also radio communication and so forth Mr. Speaker the Pan American Health Organization very critical to our work and the UNICEF technical cooperation team they are assisting us to strengthen our system post COVID-19 and they have assisted us Mr. Speaker with HIV, TB and hepatitis training they have assisted us with communicable diseases vector management and Mr. Raghunanan and the environmental health department is doing a wonderful work that department Mr. Speaker all throughout St. Lucia doing wonderful work and they are staffed of the kind of resources that they need and we are going to ensure we try to assist them health system and services Mr. Speaker vaccination card monitoring and strengthening the systems with vaccination vaccine safety and surveillance so all of these things Mr. Speaker are happening while these things are happening Mr. Speaker while we are trying to roll out the projective which is the delivery of universal health care universal health coverage Mr. Speaker Member for U-Fort North we have 10 minutes left Member for January North Mr. Speaker I move for the invocation of Stunning Order 32110 to allow the members of U-Fort North an additional 15 minutes within which to complete this presentation one of the members the question is that Stunning Order 32110 to allow the members of U-Fort North an additional 15 minutes in which to complete this presentation and I will put the question as many as of that opinion say aye as many as of country opinion say no as many as of country opinion say no I think the ayes have it the ayes have it proceed member thank you Mr. Speaker thank you honourable members colleagues Mr. Speaker we have the universal health care coverage here government we are in a position we have said that universal health coverage is important who are you talking about? we can develop a system we can contact them but we can start the delivery of the system we can start the delivery of the system we can start the delivery of the system we can気 compt can say with these problems with this dialysis the problems that will affect us we will start a government who is because of universal healthcare for the medical Turkey we have a health center and health rooms in the huge hospital in the clinic with different medical centers and we work with us to develop a solution So, as long as we are achieving these things, Mr. Speaker, we will move forward. Mr. Speaker, the overall objective, as I have said, is to pursue UHC, universal healthcare, and we continue to take action to work with our teams to strengthen the supply of health services, to refurbish key health facilities, centralize the maintenance programs, strengthen public health preparedness, strengthen policies for elderly care. In this year's budget, Mr. Speaker, provisions have been made for Cuban nationals to continue to assist us with our medical requirements in terms of health professionals being available. We want to take this opportunity, Mr. Speaker, in a special way to thank the governments and people of Cuba, Mr. Speaker. They have been at our side, they have been with us through thick and through thin, Mr. Speaker. I want to thank the Cuban ambassador and I want to thank the head of the medical brigade. Also, Mr. Speaker, so we are going to continue to employ Cuban professionals. As I said before, $1.8 million has been allocated for the universal healthcare project, and Mr. Speaker, the member of Parliament for Caster East and Prime Minister has put his money where his mouth is, so to speak. He said to us that healthcare is a major priority for the government, not only for this year, but for his administration on the whole. And what has he done? He has increased grants and contributions and also subventions to various organizations and hospitals in Senusia by 10%. In fact, grants, contributions and subventions increased by $7 million in this year's budget. By $7 million, Mr. Speaker, a $3 million increase in the subvention to the St. Jude Hospital. $3.6 million increase in the subvention to the Millennium Heights Complex, which includes the Owen King E-Hospital. A $10,000 increase in the subvention to the Diabetic and Hypotensive Association. A $20,000 increase to cater for the Childhood Development Center. $10,000 to the Autism Society. $20,000 to the Civil Policy Association. $300,000 increase to cater for medical assistance in this year's budget. And so, Mr. Speaker, the Prime Minister has demonstrated that he is putting people first and increasing assistance for our healthcare needs. In the capital, Mr. Speaker, $12.72 million for one, the establishment of the urban polyclinic. $1.3 million to assist St. Jude at the stadium to do some basic repair certain parts of the facility while we complete the hospital at OJ. $1.8 million for the upgrade of the deteriorated hot water system at the mental wellness center of the Millennium Heights Medical Complex. $500,000 for the reconstruction of the Law issues Wellness Center. Under the Health Systems Strengthening Project, $1.4 million and another $268,000 for the oxygen plants and also equipment. We are purchasing even more equipment under the OECS Regional Health Project of $1.7 million. So, Mr. Speaker, this year we intend to see significant improvement in the healthcare outcomes both in terms of training for our health professionals and a lot of training has been ongoing. I wish to take this opportunity to thank the hospitals, the CHAM hospitals in Martinick who agreed to train nurses from the St. Jude Hospital and the Owen King UU Hospital. These nurses were in Martinick and the training is over and more professionals will go to Martinick for training. Mr. Speaker, it is not difficult to understand why the members opposite will have problems with this budget. It's not difficult to understand Mr. Speaker because Mr. Speaker, the language is not one of growth. The language, it has been demonstrated, Mr. Speaker, that the members opposite, members of the opposition are not inclined to any debates. Not inclined to any debates. The history, Mr. Speaker, is laced with insults calling people jackasses at all terms whether it be on the conventional or whether it be when they are in opposition. That is the DNA, Mr. Speaker. They will not discuss the evidence in this budget. Mr. Speaker, it's not difficult to understand why the leader of the opposition will have falfwet. And you will see in his presentation, it's a lot of falfwet and accusations and shouting because what he cannot argue with Mr. Speaker is that real GDP growth under the Member of Parliament for Castries is and Prime Minister is 18.1% Mr. Speaker. No matter how high he jumps, no matter how much he shouts, Mr. Speaker, he cannot argue that parliament since 2010 has been achieved by the Member of Parliament for Castries is and the Prime Minister, Mr. Speaker. And what he says, he cannot argue that the overall deficit declined from 5.5% of GDP in 2021 to 1.5% of GDP in 2023. And no matter what he says, no matter what the poster in Mr. Speaker, he cannot argue that the current balance improved. He cannot argue with the increasing public assistance of 25.9 million dollars, the highest ever Mr. Speaker. So, while they say all what they say, the Member of Parliament for Castries is, it's the same one, they call him all kinds of names. They said he can't speak well. How will he manage a country? They said he's going to fail. All kinds of things they said about him, the derogatory things are not even say. All kinds of things. But today Mr. Speaker, today, today, the Member of Parliament for Castries is as demonstrated that he doesn't have to show both. Mr. Speaker, like they were show-boting. He doesn't have to do that. He is the leader of a cabinet with members and ministers. We put our shoulders to the wheel and we do the hard work for the people also Mr. Speaker. That's what it is. It's about jobs. I think the Prime Minister said it a while ago. When they said Jay, they were so flustered, they didn't realize his unemployment going on, so he jobs the Prime Minister creating. So, while they try to denigrate the Prime Minister and they say that Jay is for this, the people who are benefitting and working as a result of the policies of this Prime Minister, while they are show-boting on TV, they are just saying jobs, PJP jobs, jobs, jobs, PJP jobs, PJP jobs. They are going to deal with it Mr. Speaker. So, where is the lock box? Where is the lock box? When they try to challenge our performance and the performance of the Member for Castries is, where is the lock box? Where is the DSH? And why they talk about the 2.5% levy for health and security? You recall Mr. Speaker before the elections, they came with a host of hidden taxes, do you remember that? Tax on charcoal, do you remember that? Tax on if you are going to fish by the senior airport in view 4. They were proposing a tax on that. I slowly, all kinds of taxes Mr. Speaker. These people, they cannot argue with what the Prime Minister has done. They are shocked, they are shell shocked. So they are trying to hook on to the 2.5%. Oh, it's a vat, it's a vat. They call it environmental levy, all kind of thing they call it. But Mr. Speaker, the Prime Minister has demonstrated that he can manage this economy far better than the Member opposite did. Far better than him. The Prime Minister is a man for this time Mr. Speaker to take us out of the rut which we are left in by the Member of Parliament for Mikusov. And the Prime Minister has done it while assisting the poor, while giving social assistance to the needy and the vulnerable, while taking care of the elderly, look at our 80 plus golden program and so many other programs Mr. Speaker. You know what, they can't assist him, the Prime Minister is coming with a new economy. You are going to need a new one, we are going to have a new one, Limoa de Sen. We are going to have a new one in 2010. The Prime Minister has proven his economy, Mr. Speaker. So you can argue with this, you need to have a new quality. miss Jenny Daniel. the permanent secretary of very hard working women, Mr. Speaker. My secretary, Ms. Madeleine. Thanks to all the team of the ministry of health wellness and elderly affairs and I could not do it without the support of my family Mr. Speaker and the support of my team at my parliamentary office. Miss Kedu. Miss Shumian Pope. Mr. Lee Conferences, and all the teams on the local level. They understand Mr. Speaker that we have a lot of work to do in health and in the rest of the economy. I thank you Mr. Speaker and I support this bill wholeheartedly. Thank you Mr. Speaker.