Poor management

Poor management

Head of doctors' association says public health system failing

Senior staff reporter

Wednesday, August 14, 2019

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THE body that represents the interests of junior doctors in the island is attributing much of the ills in public hospitals to poor management.

That, according to Jamaica Medical Doctors' Association (JMDA) President Dr Elon Thompson, is resulting in the public health system failing.

On Monday and Tuesday this week, the Jamaica Observer reported complaints of sexual harassment, abuse and long work hours made by junior doctors working in the public sector.

“A lot of times when you see these things happen, it's really a management issue,“ Dr Thompson explained to the Observer in June, during an interview. “Problems are management issues and that is where the public health system is failing; really in management.

“The minister wants to talk about every little thing that happens and feels obligated to speak about every little thing that happens in the health sector, but really and truly there are managers in every hospital for every area [but] there is a breakdown in communication,” Dr Thompson added.

“How can you have a ward where only one nurse shows up when there are about four assigned? That's a repetitive problem. I can't 100 per cent blame the nurses for not turning up 'cause they call in sick because you have 50 patients on a ward that is designed probably to hold about 40, if so many. It's ridiculous. They are frustrated, and as a result of that they come down with illnesses and they don't turn up. We have a serious problem, especially at KPH (Kingston Public Hospital) because I work there so I know what happens,” he said.

At the same time, the JMDA head said while consultants must be mindful of subjecting junior doctors to undue pressure, some from the latter group have not responded well to the workload as expected.

“You will get complaints but you have to put them into context. We can't respond to every single complaint that is verbalised because not all of them will have the full story coming through. So I agree with some of the complaints, but there is a mixture of things at play,” Dr Thompson stated.

Nonetheless, he said he has repeatedly urged Minister of Health and Wellness Dr Christopher Tufton and technocrats in the health ministry to assess staff morale at public hospitals.

Thompson said, too, that quality assurance tests or surveys conducted at each institution would go a far way in charting the way forward.

“Ask them what they are going through. Ask them what they are feeling. They can't [give the patients 100 per cent]; they simply can't,” he said.

Dr Thompson also had a question about the influx of doctors and nurses from abroad, including Cuba.

“I need to know how this is going to be done. I hope they are getting persons who are very proficient in the English Language. We need to stop beating around the bush. We have gotten a lot of persons who are not able to communicate with patients clearly and it's a problem. We need to be careful about that. We need to be getting persons that are able to communicate with our population,” he said.

Added to that, the senior doctor said an expansion of hospitals to facilitate bed space will not solve any major issue as the hospitals remain significantly short-staffed.

“This is the problem with the bed situation. We've already established that we are short-staffed; there's no doubt about that. If we expand the hospitals, let's say we get more beds. If we get 100 more beds, we're still going to be full and we are not going to have any nurses still to take care of those patients,” he said.

“We're probably not going to have enough doctors to take care of those patients, but we have more beds and we have more space. We're taking in more patients but they are not going to get any care because we don't have any doctors or any nurses. We are going to run into problems with the human resource component,” he argued.

“So, we really need to look into what the issue is with the nurses leaving in these high numbers, really extraordinarily high numbers and generally speaking, why staff morale is so low. The impression people get when they go to the hospital is that health-care providers don't care and I cannot stand by and allow that impression to just grow. I've tried. I've said it to the minister multiple times, that there needs to be an assessment and there needs to be customer service training. To this day they have not taken me on,” Dr Thompson said.

“We are our own worst enemies and we need to know what we deserve as a population and try and just pressure persons to get what we want as a population. We can't just roll over and take injustice and take anything that we get. A lot of things that are meted out to patients, especially at KPH, they don't deserve and they just sit there and take it. [They have] roach crawling over them and all kinds of chaos going on. There are many issues. That being said, good things happen on a daily basis, but things can be much much better,” the JMDA president said.

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