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Editorial: The Patient Must Come First

WHERE to begin? That is the question. The only answer to the under financed, under staffed, poorly equipped Princess Margaret Hospital would be to demolish it — right down to its foundations and start all over again.

But how to finance the redevelopment? That’s when Bahamians will have to get out of their comfort zone; think outside the box and pray for extra generous benefactors and international partners who will be vital in helping to bring our facilities up to world class standards.

Seriously, the Princess Margaret Hospital and government’s other medical services have been so unconscionably neglected after five years of PLP mismanagement that when Minister Sands inherited the herculean task — the hospital roof hadn’t been repaired from Hurricane Joaquin; staff contracts were increased despite already consuming more than 3/4 of the PHA’s budget; insufficient funds for medicines, vaccines and surgical supplies, not to mention neglected maintenance programmes, vital to keep the hospital’s equipment in running order. In some sections of the hospital — from the laundry department up — a machine will break down and remain to gather dust for years, with, in some cases, no one seemingly reporting to the person in charge that it needs attention. This situation suggests that there is no accountability nor is there any daily inspection by the head of that department to make certain that all equipment is in good working order. The result? A machine that could have been repaired, now has to be replaced, because of a department head’s failure to be aware of a problem.

Having been around machinery all of our lives, we know that only a fool would purchase an expensive and complicated piece of equipment without making certain that a service agreement had been secured. This equipment needs almost daily inspection by whomever is in charge of the department in which it is located. Not to do so would be negligence by the head of the department.

It was reported that from 2014 the PHA inherited new responsibilities to manage MInistry of Health’s family island clinic upgrades without receiving funding from the Ministry of Finance to cover them, although the mobilization funds — more than $11 million — were approved by Cabinet. Among these extra burdens were more staff for the new critical care block, physicians internship programme, and a lump sum payment for each of three industrial agreements.

According to Minister Sands, since May last year the Public Hospital’s Authority (PHA) had received no capital funding for five years, which significantly affected the quality and timely delivery of service. It was also said that because of inadequate funding for its preventative maintenance programme, the Authority was unable to repair and maintain critical equipment for the ICU, A & F and Operating Theatres in a timely manner. As a result, patients were either unable to receive care or often had to be referred to the private sector at extra cost– significantly higher than PHA.

It is reported that the nurses’ antiquated shift system – four days on and four days off –which is not in line with current international hospital rotations — is not only creating a staffing problem, but also a financial problem. There is a nursing shortage in the critical care area, accident and emergency, and the neonatal baby care unit, where a baby requires one on one care.

The Bahamas Nurses Union was threatening industrial action in a dispute with the PHA over non-unionised foreign nurses, who are willing to work the international 12-hour shifts. What a nurse must understand — if in fact she is a true nurse – the patient’s needs come first. If they want to stay with their shift system, then the hospital should be free to recruit as many foreign nurses as are needed to take care of suffering Bahamian patients.

We agree with Health Minister Dr Duane Sands who told a group of doctors: “All Bahamians and particularly people who can least afford it are entitled to good care. While my responsibility is for every single person in this country who requires medical attention, I am particularly concerned about those people who have limited options and I want to make sure that person, the uninsured whose only option is the public sector gets healthcare in an environment that is dignified, clean and safe and they are cared for no differently than the very wealthy in this country.

“That’s where we need to take healthcare in this country,” he concluded.

The Tribune agrees.

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