Amid talk of new budget cuts, the Barbados Association of Medical Practitioners (BAMP) is warning that the state-run health care system is currently stretched, with doctors running short on vital supplies and equipment, which poses a serious threat to the delivery of patient care.
However, during the last in a series of Ministry of Health-sponsored town hall meetings last night aimed at getting public input on the way forward for health care financing, patient advocate Malcolm Grant highlighted what he deemed to be a questionable accounting and purchasing practice at the hospital, while arguing that there was inefficient use of funds.
He noted that intravenous (IV) poles were listed on the QEH’s “wish list” of needs at a cost of about $750.
“Now a private doctor can bring in an IV pole into Barbados, pay shipping, freight and duty for less than $200. So there is somebody that is making $550 in between there, and that has to be addressed,” he said.
Lecturer in Public Health and Epidemiology at Cave Hill Dr Natasha Sobers-Grannum also said she was “deeply concerned” about inefficiencies in the local health system.
“I’m afraid that we are being asked to pour more into a leaking system,” she said, warning that any discussion on health care financing must take into consideration other aspects of reform.
“We talk about financing, we should also be talking about governance and organization, and bring those factors to bear,” she told the meeting, which focused on efficiency in public medical care.
However, while highlighting a shortage of medical equipment and supplies, BAMP President Dr Carlos Chase warned that the operations of the state-run QEH were anything but efficient.
“We have ten ophthalmologists at the hospital but [each] operates one half day a week because only one operating table is there for them while the other three tables are shut down inside the Lions’ Eye Care Theatre waiting for $3 million to open up. But that was cut from the budget,” Dr Chase told the fifth town hall meeting.
He also suggested that if the QEH’s theatres operated efficiently from eight in the morning to six in the evening – including the three in the eye care theatre – the current backlog of patients awaiting surgery would be cleared.
“[However], we come to work there is no air conditioning, there are no sutures, the bed is not working, nurses are short and stressed out. Then there is no anaesthetist, therefore you could operate halfway and then go home. So the theatre is there vacant all day doing nothing, and nobody could be done [operated upon],” said Chase, who also complained of the absence of support staff.
“The hospital does not function 24 hours. The doctors and nurses run 24 hours [but] at four o’clock administration shuts down, lab shuts down, laundry shuts down, x-ray shuts down, cafeteria shuts down,” the doctors’ spokesman said, while pointing out that the majority of persons using the QEH could not afford private diagnostic tests and had no option but to go to the hospital.
“So the people come to the hospital, they can’t afford to go anywhere else, and that is why you have a back up of cases.”
Dean of the University of the West Indies Faculty of Medicine, Cave Hill Campus
Dr Peter Adams agreed, while pointing out that QEH had been plagued by bottlenecks for decades.
Recalling the days of his post-graduate training there, Dr Adams said, “I discovered there were so many ophthalmologists and there was just that one theatre.”
However, with the country currently spending in excess of $700 million a year on health care, 55 per cent of which is financed by Government, veteran insurance health care professional George Vanderpool said it was time to address the inefficiencies that plague the system.
“Before we talk about investing funds and instead of throwing more funds and money down into a dark hole, let us look at the inefficiencies that we have within our systems.
“Maybe we need to look at things like readmissions in hospital where more services are being utilized for the same patient continually, rather than having that one visit count. When they attend to the hospital, ensure that person is not back there three and four times with the same complaint,” he said. (GA)