In January, the Ministry of Health of the Republic of Iraq will become the first independent, accountable department in the new Iraqi government, says Health Minister Khudair Abbas, M.D.
The Coalition Provisional Authority relationship with the Health Ministry, or MOH, has been one of "a good working team," says Abbas, an expatriate Iraqi surgeon who has practiced in the United Kingdom for 23 years.
"We already treat him as minister, as if he is fully in charge," says Bob Goodwin, chief of staff for the CPA-MOH team.
Goodwin says he and his boss, James Haveman, CPA senior advisor to the Health Ministry, will stay in Iraq "as long as Dr. Abbas needs us," but that the role of CPA will change from one of oversight and guidance to that of providing technical assistance.
During his first visit to the United States, Abbas met with President Bush at the White House on Monday and addressed reporters Tuesday. Before he returns to Iraq, Abbas is scheduled to meet with the leadership of the departments of State, Defense and Health and Human Services, in addition to leaders of medical education institutions and Arab-American medical leaders.
Abbas has plans to improve the accountability and transparency of the ministry, Goodwin says, and will install an independent watchdog entity, similar to the Office of the Inspector General in U.S. federal agencies, to ensure those changes take place.
Nine working groups are being established to assess needs in healthcare sectors such as information technology, finance, licensing and credentialing, medical education and public health, Goodwin says.
Abbas says his ministry is starting to rebuild the Iraqi healthcare system, with initial areas of concentration in reconstructing hospitals and health centers, providing primary care and preventive services in secure facilities, and medical training.
The work will be funded by a $1.8 billion budget for 2004, Abbas says, noting that international organizations have pledged additional funds.
"We would like to bridge the services of primary and mental health and make them community-based," Abbas says. "That is the strategy for the next few years."
Care will be paid for by the state, Abbas says, as opposed to the self-financed system under the regime of Saddam Hussein.
"In the immediate and short-term, we will provide free care," Abbas says. "The poor already suffered under self-finance."
He says he has written to the Governing Council to abolish the self-financed system for the near future but acknowledges that the private sector will have a larger role to play in the future.
Asked if the physicians who performed mutilations ordered by Saddam Hussein, such as the removal of ears and tongues of dissidents, will be tried, Abbas says those doctors will be investigated and brought to justice.
He referred to Iraq's strong legacy of law, beginning with the Code of Hammurabi, one of the first written codes of law in history.
"In his court, there was a special section for what to do to doctors who mutilated people," Abbas says. "Everywhere in the world there are certain medical councils to protect society because doctors have to work according to a certain code of ethics. Not to harm patients is the objective of any doctor."
Abbas adds: "One should differentiate between who is a doctor and who is a butcher."