Ex-minister calls for urgent reforms to improve delivery of healthcare

Former health minister Donville Inniss took to a town hall meeting organised by the Queen Elizabeth Hospital on its strategic plan for the next three years to call for urgent reforms to polyclinics and private healthcare systems, suggesting that the hospital will remain overwhelmed without these improvements. His critique also extended to financial planning and policy leadership.

The former DLP minister framed the issues at QEH as symptomatic of a broader breakdown in primary healthcare across Barbados. He pointed to inefficiencies in polyclinics and private healthcare facilities, which he said fail to manage conditions early, forcing patients to seek care at QEH unnecessarily.

“The QEH continues to take the heat for inefficiencies in the primary healthcare system,” Inniss declared. “Unless we get it right in the polyclinics and the private healthcare system, we’re going to be forever screwed here in the QEH.”

He also suggested there was a disconnect between the hospital and other healthcare providers “Another quick point is the role of health economists and health planners within the QEH,” he said. “Because too often, the focus is on the very clinical staff and HR and whatnot. But unless you have staff within your institution who are actually measuring and costing the various aspects of the functions of the QEH, then I’m afraid you’re going to be constantly going to the government with a begging hat asking for more and more money without looking at your inefficiencies in the system.”

Inniss told those present, including the hospital’s chairman and executive team, there was a need for QEH to step into a more prominent role in shaping healthcare policies. He argued that the hospital, as the country’s main tertiary care facility, has a unique perspective that should inform national strategies.

“The QEH cannot stand alone,” he asserted. “I think the QEH is at the centre of creating and influencing national health policies. You must not sit back and just take what is dished out but certainly give feedback.”

He urged closer collaboration between QEH and the Ministry of Health to ensure policies address systemic inefficiencies and patient needs holistically. Inniss also pointed to accreditation programmes as critical for ensuring quality and accountability across the healthcare system. “You spoke of all the things you want to achieve, but you know, what gets measured, gets done,” he remarked.

In response, CEO Neil Clark acknowledged the challenges outlined by Inniss, agreeing that the hospital must work within a broader ecosystem of healthcare providers. He described the interconnected nature of healthcare, emphasising the importance of primary and community care in preventing unnecessary hospitalisations.

“We’re surrounded by before and after—primary care prevents illnesses, and community care ensures smoother discharges,” Clark explained. “The prevention starts with public health. The early interventions and keeping people safe is with primary healthcare. And then when something goes wrong, you should end up in the hospital where they receive acute care.”

The hospital boss also agreed with Inniss that QEH needed to play a more active role in shaping national healthcare policies, stating, “Whilst I’ve written a strategy about the hospital, we work very closely with the Ministry of Health and Wellness and have discussions. Indeed, just this week, myself and the medical director were speaking with the community care providers about how we can better access and work together.”

Clark noted that there were plans to integrate financial and health information systems to enable more accurate cost tracking. “The implementation of more robust financial information systems and the development of the health information system will help us understand what funding we need to run the hospital,” he added.

Both Inniss and Clark agreed on the importance of improving patient flow and optimising QEH’s resources, with Clark highlighting ongoing initiatives, such as a bed optimisation plan, to reduce the hospital’s length of stay and improve efficiency.

“Our length of stay is higher than international best practice,” he said. “So I think there are opportunities for us to reduce that length of stay. That might be a challenge if we can’t move out at the back of the hospital.”

Clark stressed the importance of collaboration with community care services, saying: “We’ve got to engage very closely with our community partners to identify what the alternatives are for patients who need supported discharges.”