 Thank you Mr. Speaker. Let me say good evening to colleagues and let me say good evening to Mr. Speaker. Mr. Speaker, I rise to support this bill which has been presented by the Minister for Finance and the Prime Minister on the health and security level 2.5% health and security level which will seek to ask the people of Saint-Boucher, all of us to contribute to the health reforms which are taking place and also to contribute to the very urgent and necessary security imperatives in the country. Mr. Speaker, before I continue, I wish to ask you for a few seconds of leave to say congratulations to all the students of the A4 North who sat their CPE exams and to specifically congratulate Nicola Nelson from the Piro Combined School, Shem Saviol from the Belle V Combined School, from the Vijay Primary School, Sir Jude Sabri, Grace Combined School, Zhaidi Shalri. All of these children were top students in the school Mr. Speaker and they gained some very high marks. I wish to congratulate also, although we have not received results, all the students from the A4 North who sat exams at secondary schools and also in other institutions Mr. Speaker. Mr. Speaker, just today a family in our constituency buried a very young man who lost his life in very tragic circumstances when he drowned a few, a couple weeks ago Mr. Speaker and I extend sympathy, my sympathies to the family. I'm sorry I was unable to make the funeral today and also Mr. Speaker, I wish to send sympathies to all the families in the A4 North. In the last few weeks we have had several individuals from my constituency who have passed away Mr. Speaker and I know the families are suffering. Mr. Speaker, this 2.5% contribution which the Prime Minister and Minister for Finance has asked the people of Senbusha, all of us in fact, to contribute to strengthen our security, indeed it's happening at a time when we have no doubt we cannot argue that we need to strategically place the security of the country, at the top of the heap of priorities that this government has to deal with. Mr. Speaker, the Prime Minister has indicated and other colleagues have explained to you Mr. Speaker into the House, have explained the various initiatives which this government has taken in relation to citizen security. These initiatives Mr. Speaker are expected to assist the police and other law enforcement agencies. We see Mr. Speaker, the brazen actions of those who want to settle scores among themselves and also innocent individuals, innocent solutions paying for some of this with their lives. Mr. Speaker, we see the brazen attempts by other individuals to enter the homes of Senbushans and to commit other acts of violence on the people of Senbusha. The Prime Minister and his government have placed citizen security as one of the important focal points for the during the last budget debate Mr. Speaker in the presentation of the Prime Minister health and security as you know were the two sub themes of the budget and this debate today gives life to the intentions of the Prime Minister. Mr. Speaker, the government through the Prime Minister and the Minister of Finance is asking the people of Senbusha to contribute a little to health and security. We have heard from the opposition Mr. Speaker although not in this House today but we have heard Mr. Speaker in other quarters the opposition criticising this attempt by the government to ask the people of Senbusha to ask all of us to contribute to health reform to contribute to the projects and the improvements in health care in this country and to also contribute to citizen security. All kinds of accusations have been leveled at this government but the question is Mr. Speaker whether the people of Senbusha truly believe that they must make a contribution to health and to security and we see it all the time, we see it Mr. Speaker, we hear the people of Senbusha and we know the people of Senbusha believe that this government is on the right track. The member of the country central demonstrated this a little while ago Mr. Speaker and the member of the country's north and others have spoken about it. The people of Senbusha understand that we too must make a contribution to our own health care reform and our own security situation in this country. Mr. Speaker, three months after the elections of July 26, 2021 a team from the World Bank visited Senbusha and in discussions they identified a few areas that the government should look into or a few areas based on the discussions in the government that they felt the government had some kind of focus that the government felt that they should focus their attention or our attention on some key issues. In the discussions Mr. Speaker, it was felt that to modernize and reform the health sector in Senbusha is central not only to boost Senbusha's capital and economic development but also to improve our population health outcomes. It was important, the World Bank said Mr. Speaker, that we accelerate progress towards universal health coverage. We know over the years and some of my colleagues have said it, that we have faced difficulties for decades and decades due to inadequate financing and also suboptimal management of noncommunicable diseases. We know that noncommunicable diseases are the major causes of sickness and death in this country. We also know Mr. Speaker that the COVID-19 pandemic caused the situation to worsen. We saw during the COVID-19 pandemic and now after the COVID-19 pandemic many individuals who did not have certain conditions or who did not present certain conditions are now presenting. We are seeing many challenges in the health sector especially among the older segment of our population, the older people in Senbusha. Mr. Speaker, we know the member for library indicated that over the decades public spending in health has been low traditionally. The World Bank and the World Health Organization and others suggest Mr. Speaker that we should be spending about 6% of our GDP on health. In Senbusha we sometimes over the years spend 3.4%, sometimes it goes up to 4% of our GDP on health. Clearly Mr. Speaker over the years the call has been for governments to pay more attention to healthcare financing but not just putting more money in healthcare but also causing there to be efficiencies. That is why Mr. Speaker commitments to universal health coverage can only be attained if we increase budgetary allocations to healthcare reform and to ensure that we strengthen the linkage between healthcare outputs, quality and efficiency. So Mr. Speaker this 2.5% levy will assist this government and it will assist the Ministry of Health and all of its partners to cause there to be the strengthening of linkages between health outputs and also to improve the quality and efficiency of healthcare delivery. Let me just remind you quickly Mr. Speaker that our NCDs is a big problem, non-communicable diseases. We say so all the time but it's not too much, it's not too burdensome to repeat it. We know the leading cause of death in Senbusha and we know that non-communicable diseases between the years of 30 and 69, between 30 and 69 years old. That is the age group where we have the non-communicable diseases really impacting sickness and death in Senbusha. We also know Mr. Speaker that we have an aging population, our population is aging and therefore the burden of disease can really be found in our older people and as the years go by with an aging population we need to prepare for the challenges ahead. What I'm going to do very briefly Mr. Speaker is again to give you an idea of the plan of this government. Are we working with a plan? Yes we are working with a plan. Why are we asking Senbushans to contribute 2.5% a 2.5% levy? What is the basis of this request by the Minister of Finance and have we demonstrated over the last two years that we are serious about healthcare reform? Has this government demonstrated that it's putting its money where its mouth is? And has the Ministry of Health, Wellness and Elderly Affairs demonstrated that some of the initiatives that are in the manifest of the Senbusha Labour Party coming into government and clearly the pronouncements in the manifest after you win an election become government policy. And how are these policies, how can we see is there evidence that these policies are in action? So Mr. Speaker what is the plan? The plan is to cause us to be on a solid and purposeful path towards universal health coverage. We want to ensure that we can clearly state to the people of Senbusha what the healthcare financing options are. We have said before that this has been the problem. The major problem has been how do we finance universal health coverage. And what are we doing about this? We continue consultations, we continue the development of a white people. We continue working with the World Bank, local consultants and other partners to ensure that very soon we can present to the Cabinet of Ministers and to the people of Senbusha the various financing options for the long term sustainability of universal health care. But while we are doing this Mr. Speaker, I have said over and over again and it is the wish of the Prime Minister and our Cabinet that we do not sit down and simply wait for an answer for the financing of universal health coverage. We need to present to the people of Senbusha some opportunities which will match us to the World's universal health coverage. The member for Kastri South and Deputy Prime Minister said it well. That the research has shown that countries like South Korea introduced universal health care over 30 years ago up to now are still refining, are still changing processes to ensure that everything is going well. So we will not achieve universal health coverage within one year or two years. However we cannot have our people just waiting for services without improving what we have now and doing what we can now to match towards the attainment of universal health coverage. So what are we doing? We introduce maternal and childcare services. We are working on services for kidney care. We are working on services for cancer diagnosis and early treatment. What else is in the plan? So number one universal health coverage, that's what we are marching towards. What else is in the plan for health reform? We are looking at our resources, our nurses, our medical professionals. We do the challenges, many of them are living to other pastures and what plans do we have to ensure that we sustain the level of human resource that we need. So that we are working on. What about infrastructure in health? And I will not go in detail through this. But Mr Speaker, the Prime Minister has explained that the St. Jude Hospital Rehabilitation Project is on stream. The St. Jude Hospital Rehabilitation Project is happening and we do not have the time to spend on rumour. We do not have the time to spend to debunk a few minutes that a contractor has removed his tractors and his back holes. This is not one of the lazy contractors. This contractor is in demand and he can move his equipment from here to our next project anytime he chooses. The one thing we can say to you is that this government is focused on delivering the St. Jude Hospital for the people of St. Jude. We have said it probably and I will say again, and I will say again Mr Speaker, Prime Minister has said it and I have said it many times that we are not hiding anything from the people of St. Jude. There are some of the buildings with DC approval, we are moving ahead with those buildings. There are a couple of buildings that we are working with the professionals, architects and so on to address some of the issues, some changes and some of these changes are not because a minister believes that he is an architect and he is a builder. Some of these changes are because the doctors and nurses at the St. Jude Hospital worked the facility with professionals and suggested that I think this can change That is what's happening and I can tell you last week Friday we had a professional from the Pan American Health Organization at the St. Jude Hospital meeting with the staff of the St. Jude Hospital to do a transition plan to move the patients and the staff from the stadium to the St. Jude Hospital. I can also tell you that we are in discussions with the supplier of equipment, the Prime Minister met them, I met them, the staff of the St. Jude Hospital met them and we are now working out which piece of equipment, which type of equipment we are going to change because of certain rooms that are going to come. The quality of equipment, the latest equipment that will change because we want the latest high-tech equipment so we are not sitting on our laurels debating about who will get this and who will get that from the project. We are working on the St. Jude Hospital reconstruction project and I am proud to say that I will follow what the Prime Minister has said and to say that I feel better today about the St. Jude Hospital project than I have felt. We are talking about the period that we have been talking about this. Because we know what is happening Mrs. Pigeon. The 2.5% levy is very important. The other part of the plan is to continue to strengthen our hospitals, both in terms of management, facilities and supplies. And very soon I will tell you how this 2.5% will assist with that.  veya  늬                                                             that the service which is being provided to the people of St. Lucia is of the highest quality, highest quality, and very soon we are going to make this public, introduce the quality manager to the people of St. Lucia, but now I'm proud to say that this is another part of the plan which has been implemented, another part of the plan is to see how we can engage professionals to use digital health, to use digital platforms, I'm very proud of the St. Lucia hospital and the other hospitals and in some way, some form they are already using certain aspects of digital health, some of the hospitals, some of our professionals are connecting with professionals from overseas using information communication technology to serve their patients, wherever we are tapping on hospital and the OKEU hospital at St. Lucia hospital, you'd be surprised to know that you can go to the St. Lucia hospital and use the digital health platform and they will actually produce for you based on the digital health platform your dentures and so on if you have issues with your dentures and so on, some of the consultants who came from overseas were shocked to see that so our professionals are moving them, we want to give them every support to move in the direction of digital health so we know what we are doing in this government, we know exactly what we are doing I will not tell you tonight that we are reinventing the wheel, of course there were processes that we found, of course decades ago there was research on universal health care and so on but what I can guarantee you Mr. Speaker is that this government has a clear plan for health care reform in this country and we can identify every step of the way what we are doing, why we are doing it and we can show you the results of it that is the difference, I am not in the business of arm and butts and when Prime Minister ask me a question or when the parliament ask me something arm I am not sure I don't know but decent that if I don't know at this moment I will get you the answer but I know that there is a clear plan, a clear policy universal health coverage, we have a clear plan and a clear policy we have the steps and we are moving forward but let me tell you Mr. Speaker the 2.5% living just in this year's budget what is going to do in addition to what the Prime Minister said we are going to spend 4.5 million dollars for the employment of Cuban nationals to augment the nation's pool of medical professionals, 4.5 million dollars Mr. Speaker we are going to spend 1.835 million dollars under a new project which is the universal health care project for maternal and childcare services that's the levy we are going to use money for that we are going to need 247,400 dollars to spend as part of the St. Jude reconstruction project in terms of consultancy services for certain services which we have spoken about and what are the architectural services and others we are going to spend 75,255 dollars to assist in the development of our policy and program for older persons in St. Lucia we are going to spend 150,000 dollars for the transition program for the St. Jude hospital so you see we know exactly what we are doing so when people tell you somebody take out a tractor from a site we are spending money for the transition we are already planning to get about 11 million we are already planning with the professionals at the St. Jude hospital and they have promised me that they are going to reach out to the doctors and the nurses and all the professionals who move Victoria hospital to the OKEU hospital during Covid because we have the experience here in St. Lucia and we will not pay 11 million dollars for it Mr. Speaker the 2.5% levy will assist us because the prime minister for finance has increased grants by 10% by 10% Mr. Speaker 3 million dollars in addition to what we are giving to St. Jude 3 million dollars in addition for the St. Jude hospital in Subvention to the Millennium Heights complex an additional 3.662 million dollars to the Millennium Heights medical complex 360,000 dollars for various associations and increase in the Subvention Mr. Speaker in the capital project a million dollars for the urban polyclinic and the prime minister explained to you that we must move the services from the Castries Health Centre to the Castries Urban Polyclinic where Victoria hospital was and we are going to have several facilities there the Millennium Heights medical complex OKEU hospital will operate a secondary care wing we are going to have urgent care up there we are also going to have 1.3 million dollars to assist at the stadium currently because there are several issues although we are moving to the OJ site there are several issues that are currently problematic for the hospital and we are going to spend 1.3 million dollars to do that we are going to spend 1.8 to million dollars in addition to what I just said at the Mental Wellness Centre to fix the hot water system Mr. Speaker we are going to spend 500,000 dollars for the reconstruction of the Larissus Wellness Centre in Denver North the 4.5% Mr. Speaker sorry the 2.5% so Mr. Speaker during the next few years under our universal health coverage we want to also focus I said before on kidney care preventative care we have a big problem with dialysis a very conservative estimate puts the numbers when you look at those who are under observation or those who have been treated at St. Jude OKEU and the private sector we have over 179 people and that's very conservative Mr. Speaker and if you look at sessions at $150 per session at the OKEU alone individuals would have to be paying approximately $2,246,000 for treatment for kidney treatment if you look at the St. Jude Hospital at the cost of $150 per session solutions who are under treatment for kidney problems would have to be paying over $1.1 million and we are not talking this is just very conservative Mr. Speaker and these are just two of the public facilities we are not talking about the private facilities and in the private sector you pay $500 per session for kidney treatment for dialysis so as part of our universal health coverage the 2.5% levy will assist us with that I have said about cancer screening and very importantly Mr. Speaker again I want to thank the World Bank for the performance-based financing pilot program we launched it a couple weeks ago and hypertensive and diabetic patients will be getting assistance but we will need to use some of our 2.5% the proceeds of the 2.5% to help us to sustain the performance-based financing program we want to ensure Mr. Speaker that our maintenance budget is up to par so out of the 2.5% levy we are going to purchase equipment for the various wellness centers Mr. Speaker and it's very very important to know that we will spend at least $1.5 million to purchase equipment for the various wellness centers this year so Mr. Speaker the proceeds of the 2.5% levy for health and security will assist us greatly let me just tell you very quickly before I go Mr. Speaker some of the other activities which will be funded by the proceeds of the 2.5% we want to strengthen our primary health care and as you know Mr. Speaker anybody who is working health care will tell you that that is the basis upon which you will form your health care system strengthening primary health care we are going to prioritize preventative and community-based care the implementation of health promotion and the prime minister is a prime example of health promotion when he told you how he changed his diet and he showed the ways fitting him and all that kind of thing he is now competing with the younger men in the cabinet but we are coming for him we are changing our diet and exercising also so we are coming we are coming we are taking his example but seriously Mr. Speaker he has already started but again Mr. Speaker the future entails some other very exciting things in the manifesto we spoke about a school health desk program and we are already working on the school health desk program and I know there is a doctor in the private sector Dr. Stan Lisian who is very passionate about the school health desk program every time she met me she would ask me about that that school health desk program she is very passionate about it and I know that we are formulating the modality the general aim is to ensure that the schools the children in the schools get access to medical care medical examinations in a form that will cause them to get regular access to health care regular access to health care and we are going to implement this in this financial year Mr. Speaker so the proceeds of the 2.5 levy for health and security will help us in that regard so this is another new initiative which I am just mentioning now it's in the manifesto but our professionals at the ministry are already working on it and we are going to launch it soon we have launched the program for dental care for all kindergarten and grade 1 students throughout St. Lucia and Dr. E. Freema and her team are going around all of the schools in St. Lucia another new initiative and we are going to need financing because Dr. E. Freema and her team are already telling me some of the exciting things they will need for dental care at all of our schools so Mr. Speaker it is quite it is a lot Mr. Speaker and I am very proud of the team and proud of my cabinet colleagues for supporting the establishment of a cancer registry very important Mr. Speaker and for this one I can say Dr. Rehmi is always after me for this one Dr. Tamara Rehmi the cancer registry the cancer registry and this year we are hoping to advance in terms of our work on it we have spoken about the castries polyclinic and the member for lab spoke about the golden 80 plus medical package the member for castries south once they age to go down and we will look at that Mr. Speaker I want to also say to you that we will be working at the Souffle district hospital the refurbishment of the Souffle district hospital and I want to thank the private sector for coming to the aid of the Souffle district hospital at another opportunity Mr. Speaker I will explain that a little more expansion of clinical services to ensure that we have internist care for child and adolescent health programs and also consultations on a number of pieces of legislation in healthcare but I want to say Mr. Speaker I want to say Mr. Speaker that there are some other things that are coming I know the member for Grozile is very passionate about the ambulance for the Grozile polyclinic and I don't want to make a definite I don't want to make a definite announcement now but I am very confident that the ambulance for the Grozile polyclinic will be delivered very soon very soon I have learned from my prime minister that unless I see it unless I see it unless I see it but I am very confident Mr. Speaker very confident that the ambulance or the Grozile polyclinic is on its way or it has arrived there are some adjustments to be made to the vehicle and so as soon as it is done we will get to you but just before I sit Mr. Speaker I really want to thank the team at the Ministry of Health Wellness and Elderly Affairs and especially the team being led by by Dr. Eugene Dr. Alicia Eugene Ford who leads the universal health coverage program together with all of the doctors and nurses and everybody else who are championing the universal health coverage I just want to say Mr. Speaker that we are very proud of the program so far we know there are 17 sites where lab services are available and they are spread throughout St. Lucia we know that ultrasound services are being offered at the private sector agencies the Rodney Bay Medical facility at Grozile this is a private sector the Helen Diagnostic Centre in Castries medical imaging in Castries Getwell Clinic in Castries Gablewood Clinic Tapio Hospital Castries Dr. C Fibel Jean Clinic Denry Village St. Anthony's Medical Centre Viewfort X-ray and ultrasound centre Viewfort so the policy of this government Mr. Speaker is to involve the private sector because without the private sector in terms of medical care solution it will be difficult to implement and achieve universal health coverage but as we roll out the various stages and phases of universal health coverage other privates, other labs and other private doctors who provide specialist services will come on board so we are not going to leave any organization out or anybody out we are doing it as we go along and we seek the council and guidance of all those who have had the experience and I want to thank all the nurses and doctors and the health aids and all those who are assisting us in this regard I want to say to you Mr. Speaker that as the Prime Minister said and the member of our castries and other colleagues I thank them for their support but we can show you results Mr. Speaker when we introduced the child and maternal care services for universal health coverage they said all kinds of things we want to send people and make children simply to dismiss the effort the results show Mr. Speaker that just between we launched on the 1st of June and when you compare the number of of expectant mothers who visited clinics in our facilities between May and the end of June Mr. Speaker or this period now not end of June but between May and this period now conservatively because we don't have all the figures yet 186 more expectant mothers attending the clinics because they are getting this benefit Mr. Speaker and the stories will come some of the stories already on Facebook the team is already some mothers are willing to tell the stories the stories are heartbreaking and comforting at the same time Mr. Speaker there are so many expectant mothers who say to you that they never saw a doctor they are in the third trimester Mr. Speaker in the third trimester and they never went to a doctor Mr. Speaker because many of them tell you they did not have the money to pay for the ultrasound and they did not have the money to pay for the blood test and this government has come to assist these mothers and for some people to say that it is Papi show that's nothing or just giving these people things that's nothing for the people to go and make chicken and that kind of thing if you do not want the service and you want to go to the private sector that's fine but we are saying to you that we are offering this service and the parents the expectant mothers are using the service and in some cases the doctors and the nurses are telling me that the number of expectant mothers have doubled since we introduced this program have doubled Mr. Speaker so I wish to thank the prime minister for his foresight and I wish to thank all my colleagues for the support I wish to thank all the staff of the ministry for the support I know it's difficult I know it's difficult sometimes they say Mr. Speaker this minister want us to be decent doctor want us to run and push but they don't know our prime minister behind me tell me go go give me you know and the colleagues in cabinet so I wish to thank everybody but we are going to get this job done I said over and over again it's difficult but we are going to get it done we have a plan and we are going to get it done Mr. Speaker so I thank you I support this bill Mr. Speaker and the 2.5% levy will assist the health sector will assist the ministry of health wellness and health to roll out these programs and hopefully Mr. Speaker we will present to the parliament the results will come to you and tell you this is what we did with the money and here are the results and that's how this government rolls I thank you very much Mr. Speaker