The Tribune

YESTERDAY, The Tribune reported that all but five striking nurses — they officially called it taking “sick leave” — had returned to work after walking out on patients and a hospital that anywhere else would have been condemned for not being up to acceptable standards.

Health Minister Dr Duane Sands, who has inherited a problem that the nurses have been arguing about for several years without solution, and a hospital that is short of money even for medical supplies, described their absence as a “peculiar sick out”.

We sympathise with the nurses, but not with their actions. They now have a new administration that has inherited an impossible situation that cannot be solved overnight. The nurses should know this, because what they are now arguing about is not new. They have been arguing about it for years under previous administrations with no relief. However, the Princess Margaret Hospital has been so mismanaged and neglected that none of its problems can be solved overnight, including the concern of the nurses. So going on strike — or “sick out” if indeed that is today’s fashion – helps no one, least of all the patients, who should be the first consideration of a truly dedicated medical staff.

More than a year ago, we had the misfortune of spending a weekend at the PMH with our critically ill infant grandson. In those few days, we saw that there was a major problem among the nursing staff, some of whom seemed to have a chip on their shoulders. Unless, they get over this, their future in their profession is bleak. This does not only apply to some of the nurses, but also to team members in the other departments. It is only by working together and with the new Minister and his board that a hospital that anywhere else in the world would be condemned as “terminally ill” has any hope of being resuscitated.

On his retirement after almost 40 years in the public service, Public Hospital Authority’s head, Mr Herbert Brown left a report for the new minister. It revealed the areas of massive underfunding and inefficiencies which he warned were having a direct affect on patient outcomes and health. The crisis went back years and, while not naming them, Mr Brown’s finger seemed to point directly at the defeated PLP government.

“Government,” he wrote, “had approved a whole list of projects to improve the health care system but without giving the tens of millions of dollars needed to actually carry out the work.” In this “unacceptable” state of public health services, Mr Brown said, access to service is compromised on a daily basis, physical infrastructure is deteriorating, and there is a more worrying unnecessary patient risk factor, blamed on poorly functioning medical equipment.

His eight-page letter, sent to Dr Sands about two weeks before he retired from the service, highlighted a catalogue of capital works projects, just a few of which have been started. However, generally no funding has ever been provided to carry them out. To complete these projects, said Mr Brown, the Public Health Authority (PHA) would need $43,181,178. In his letter dated September 25, 2017, Mr Brown said the strengthening of the health system also had a hefty price tag of $27,050,616.63. Where was this money to come from?

“Collapsing infrastructure, broken equipment, inadequate provision of staff; particularly nurses, doctors and allied health personnel has led to a situation in which access to healthcare services and patient dignity – particularly in Accident and Emergency (A&E) and the Maternity ward, are compromised on a daily basis,” wrote Mr Brown. “Indeed our inability to properly budget and allocate sufficient finances for medicine, medical and surgical supplies, equipment, staff and infrastructure upgrades and maintenance has directly impacted the delivery and quality of our services and the ongoing deterioration of our physical infrastructure.”

On maintenance of equipment, he warned Dr Sands: “Without this essential equipment and instruments, patient care can and will be compromised.

“Further, failure to maintain existing or purchase new equipment, has meant that healthcare professionals are hampered in their ability to correctly diagnose and treat patients.” The PHA, he said, had not had an equipment budget for “many years”.

“This unfortunate situation is and will continue to have significant implications on the delivery of care,” he wrote. “For example, a lack of sufficient working radiology devices (which is currently a major problem at PMH in particular) prevents diagnosis of many diseases. In addition delays in patient diagnosis can often impact timely treatment of diseases, leading to poor health outcomes.”

We understand the problem is that the unionised nurses get overtime - in some instances time and a half pay after working eight hour shifts while non unionised nurses – the foreign staff – like most hospitals around the world– work 12-hour shifts with no overtime pay until they reach 36 hours a week. For some reason, the local nurses are upset with this situation. They apparently want the foreign nurses to be on the same pay scale as themselves — they probably don’t want to be shown up. Yet they just got a pay increase, lump sum payments and other benefits as a result of contracts executed by the former chairman, Frank Smith.

And then out of the shadows comes PLP Leader Philip “Brave” Davis with the suggestion that the political directorate be “more responsive to the concerns of the nurses”. It is a pity that Mr Davis didn’t have this solution sooner when he was in government and could have been more responsive instead of leaving their unfinished business for the FNM government to solve.

Yes, concern should be shown for the nurses. But everyone involved should understand that the health of the Bahamian people must always come first.