The Saint Kitts and Nevis Healthcare System: Hospitals, Access for Foreigners, Emergencies and Health Risks

The government portal presents two public hospitals: the Joseph N. France Hospital (JNF) for Saint Christopher and the Alexandra Hospital for Nevis. It states that they treat many conditions and that serious cases are evacuated as an emergency, generally to the United States. The government’s list of health institutions also includes the Mary Charles Hospital, the Pogson Hospital and the Cardin Home, without describing their role or capacity. The same portal mentions several private hospitals and clinics, not detailed, and recommends having adequate health insurance as well as funds for care abroad and repatriation.

Several projects are changing the landscape. The Camps site was handed over to a company for the construction of a new JNF general hospital described as climate-resilient and designed for current and future needs, with no completion date or capacity published. The government also announced a universal health insurance to be rolled out in stages, with the technical support of the Pan American Health Organization. The rollout timetable is not published and should be confirmed with the Ministry of Health.

The announced objectives for this universal insurance are to allow all residents to use a full range of quality services without financial hardship, from health promotion to palliative care, to remove payment at the point of care, which the government regards as a barrier to access, and to improve the purchase of medicines, supplies and equipment. The planned consultations involve the Ministry of Finance, the Social Security Board, professional organisations, trade unions, private insurers and the media, with public meetings. For the new JNF general hospital, the Prime Minister stresses a climate-resilient design and spin-offs in jobs and activity during construction; residents near the Camps site are to be consulted on changes to access and traffic. A foreign resident follows these developments with the Ministry of Health before choosing where to settle.

The World Bank records about 4 hospital beds per 1,000 inhabitants and about 3 doctors per 1,000 inhabitants. These indicators do not replace information on the establishments themselves: the government lists five public institutions, including the JNF and Alexandra hospitals, and does not detail their capacity.

These orders of magnitude describe a small island state where each establishment counts for a lot. France Diplomatie describes the equipment of local hospitals as very inadequate and recommends, in the event of a serious accident, evacuation to a hospital in Guadeloupe. Evacuations are prepared with the insurer before settling rather than at the time of the crisis: ask for the list of establishments that accept direct payment and the transfer conditions. The full Saint Kitts and Nevis country page gathers the general benchmarks.

The Social Security Board has existed since 1978 and pays cash benefits. Sickness benefit is 65% of average weekly wage, for up to 26 weeks, after 26 contributions in total including at least 8 in the 13 weeks before the illness; no benefit is paid for an incapacity of three days or less, and the benefit is refused in the event of a stay outside the Federation without a doctor’s notice. Voluntary contributors cannot claim it. The page on sickness describes it as compensation for loss of income; the pages read present no coverage of medical care.

No official source read publishes a fee scale for care for non-residents or conditions for a foreign resident to join a public health scheme: these points should be confirmed with the Ministry of Health before settling. On the French side, the country does not appear in the CLEISS list of social security agreements; the carte Vitale (the French health insurance card) cannot be used locally and the arrangements by status are detailed in healthcare reimbursement in Saint Kitts and Nevis.

The official sources consulted do not describe how first-line consultations are organised: the Ministry of Health, attached to the Prime Minister’s office, and the hospitals provide information on the centres and practices available. France Diplomatie points out that several hospitals require payment in advance, hence the value of checking before departure that insurance covers this advance or provides for direct payment.

• Emergency services: 911 for ambulances and the fire brigade; Saint Christopher police (duty line): +1 869 465 22 41.
• JNF Hospital, Basseterre: emergency department on +1 869 465 25 00.
• Alexandra Hospital, Nevis: emergency department on +1 869 469 54 73 or 54 74.
• French consular agency in Basseterre: +1 869 465 30 54; French embassy in Saint Lucia: +1 758 455 60 60 during working hours, non-administrative emergency line +1 758 484 31 67.

Keep your insurance certificate, the assistance number and the list of your treatments with you. In a life-threatening emergency, the insurer’s assistance arranges referral and, if necessary, evacuation.

Before a non-urgent consultation, ask in writing for the fee, the accepted method of payment, the time to receive reports and the documents useful for a reimbursement. Keep prescriptions, paid invoices and proof of payment: they are used by the CFE, by the insurer or, for a posted employee, for form S 3125c. A person on chronic treatment asks their doctor for a medical summary in English, the list of molecules in international non-proprietary form and the quantities needed for the planned length of stay, and checks with the insurer the conditions for covering pre-existing conditions.

The local government cites the United States as the usual destination for serious cases; France Diplomatie recommends Guadeloupe for a serious accident. The French embassy can pay neither medical costs nor medical repatriation. An assistance contract providing for evacuation to the most suitable establishment, and not only repatriation to France, answers this reality. See repatriation and assistance.

For diving, France Diplomatie specifies that the island has no decompression chamber: the nearest are in Antigua and Barbuda and in Guadeloupe. Divers check that their policy covers this activity and that evacuation is included.

France Diplomatie asks you to update the French vaccination schedule, including measles, an alert on the rise in cases having been published. Other vaccines are discussed with a doctor or an international vaccination centre well before departure: yellow fever for travellers coming from an endemic zone, hepatitis A and B, typhoid and, in some cases, dengue.

• Dengue: no curative treatment; treat the symptoms, avoid anti-inflammatory drugs and consult without delay.
• Chikungunya: symptomatic treatment; prevention combines protection against bites and vaccination.
• Zika: pregnant women or those planning a pregnancy consult a doctor before travelling.
• Typhoid fever: food hygiene and vaccination.
• Water and food: sealed drinks or water made safe to drink, hands washed often, raw or undercooked food avoided, fruit and vegetables peeled or washed.

The most common combination pairs an assistance contract with evacuation and cover for routine care: the CFE (Caisse des Français de l’Étranger, the voluntary health insurance body for French people abroad) or international insurance. International insurance generally offers direct access to the private sector and a higher limit. See CFE or private insurance, expat health insurance and long-stay travel insurance. Expavy helps you weigh these options against your situation, for example through the online diagnostic.