The Healthcare System in Barbados: How a Foreigner Gets Treated

The Ministry of Health and Wellness describes public funding through taxation, its budget resulting from annual appropriations voted by Parliament, and private funding through health insurance, fee-for-service payment, direct spending and pooled insurance funds fed by employer-employee contributions. Public services are organised to be accessible and, in many cases, free at the point of service; these benefits mainly concern Barbadian citizens and permanent residents.

• First-line care: nine polyclinics (Branford Tait, Winston Scott, Eunice Gibson and Edgar Cochrane in St. Michael; Maurice Byer in St. Peter; David Thompson Health and Social Services Complex in St. John; Glebe in St. George; Randal Phillips in Christ Church; St. Philip) and two satellite clinics, the St. Joseph and St. Andrew Outpatient Clinics.
• Acute, secondary and tertiary care: provided at the Queen Elizabeth Hospital, in Bridgetown.
• Care of older people: long-term care at the geriatric hospital and in the district hospitals of St. Philip, St. Lucy and Gordon Cummins, adult day care, and the “Alternative Care of the Elderly” programme, which places people in private establishments under the public programme. The website lists about 55 private homes spread across several parishes.
• Private sector: private practices and establishments funded by insurance, fee-for-service payment or direct spending; tariffs are not made public on the official pages consulted.

The free care described does not expressly target the foreign visitor or the expatriate without permanent resident status, whose billing conditions are not detailed on the pages consulted: the information should be requested from the establishment and cover should be arranged. See healthcare reimbursement in Barbados.

The National Insurance Scheme (NIS) is Barbados’s social protection scheme. It pays sickness, maternity, paternity, employment injury, unemployment (six months at most under conditions) and disability benefits, old-age pensions and funeral grants. Sickness benefit is a cash benefit calculated on insured weekly earnings, at 66 2/3% divided by six for the daily rate; the pages consulted do not present the NIS as a scheme that reimburses healthcare costs. It should therefore not be presumed to be equivalent to health insurance.

NIS contributions include a Health Service Contribution of 1.00% for the employee and 1.50% for the employer, in force since 1 October 2018. The pages consulted specify neither what this contribution is used for, nor any individual right to reimbursement arising from it. The conditions under which temporary residents can access free public care are not detailed on the websites consulted.

• Citizen or permanent resident: public services in many cases free at the point of service.
• Holder of a work permit or remote work visa: no particular right to coverage of care is mentioned; personal insurance remains to be arranged.
• Visitor: payment in advance possible in several hospitals (France Diplomatie); insurance to be arranged.

Polyclinics offer preventive and curative care: maternal and child health, vaccination, family planning and reproductive health, general medicine, dental and eye care, environmental health, communicable disease control, rehabilitation, pharmaceutical services, nutrition advice, chiropody, and voluntary HIV/AIDS testing and counselling. The Winston Scott Polyclinic offers extended hours and a “Fast Track” service. For an urgent request, the ministry advises consulting its contact directory and its general number: +1 246 536 3800 (info@health.gov.bb).

For a newcomer, a family doctor is chosen in the public sector (the polyclinic of their parish) or from a private doctor. The medical record, the prescription in international non-proprietary form and the list of up-to-date vaccines make the first consultation easier: see the guide to the medical questionnaire and medical history.

The Queen Elizabeth Hospital (QEH), on Martindales Road, Bridgetown, is presented by the government as the main acute care establishment and as an accredited teaching hospital, affiliated to the University of the West Indies, Cave Hill campus. Its website lists in particular an emergency department (Accident & Emergency) and an emergency ambulance, the laboratory, pathology, radiology and imaging, internal medicine (nephrology, neurology, psychiatry, radiotherapy, pulmonology, acute stroke unit, urology), surgery (cardiovascular, ophthalmology, orthopaedics, ENT, general), obstetrics and gynaecology, paediatrics, and supportive care. The hospital is accredited by Accreditation Canada. A public notice reports that high demand continues in the emergency department. The number of beds, fees for non-residents and insurance accepted do not appear on the pages consulted.

• Ambulance: 511; police: 211 (France Diplomatie).
• Queen Elizabeth Hospital: +1 246 436 6450 (switchboard).
• Ministry of Health and Wellness: +1 246 536 3800.
• French embassy in Saint Lucia: +1 758 455 60 60; consular agency on Chelsea Road, St. Michael: +1 246 429 4546.

For a life-threatening emergency, payment in advance may be requested: France Diplomatie warns that, without cover, access to care may be refused, even in a life-threatening emergency. Medical evacuation is covered by an assistance contract: see the guide to how medical repatriation works.

The Barbados Drug Service provides the pharmaceutical services of the public system: each year it produces the Barbados National Drug Formulary and ensures the supply and distribution of the medicines on that list. The inspection of pharmacies, public and private, and of manufacturers falls to the drug inspection service, under the Health Services Act. Polyclinics also offer pharmaceutical services. The criteria for free provision or cost-sharing for a non-resident are not specified on the pages consulted.

France Diplomatie advises taking only the medicines needed, in their original packaging, with a prescription giving names in international non-proprietary form, and checking that they are permitted locally.

• Mosquitoes: France Diplomatie reports chikungunya, dengue and Zika. There is no curative treatment; in case of dengue, anti-inflammatory drugs should be avoided. Pregnant women or those planning a pregnancy should consult before travelling. Covering clothing, repellents, mosquito nets and getting rid of standing water limit the risks.
• Water and food: typhoid fever linked to contaminated water or food; frequent hand washing, well-cooked food, peeled fruit and vegetables, drinking only safe water.
• Vaccines: up-to-date French schedule (diphtheria, tetanus, polio, whooping cough, measles); depending on the stay, hepatitis A and B and typhoid fever. Yellow fever is compulsory when arriving from an endemic zone.
• Local schedule: the Ministry of Health and Wellness lists 14 antigens (polio, diphtheria, whooping cough, tetanus, pneumococcus, hepatitis B, Haemophilus influenzae type b, measles, mumps, rubella, chickenpox, BCG, human papillomavirus, influenza).
• Hurricanes and sea: hurricanes from June to the end of November, which disrupt essential services; one decompression chamber for divers.

Consult your treating doctor or an international vaccination centre well before departure to allow time for boosters. The cover to plan for is described on the page on expat health insurance.