Minister Estwick
CEO Collymore
Minister David Estwick in his contribution to the 2008 budget debate cited several difficulties which he has encountered since assuming the post of Minister of Health in January 2008. Since the halcyon days when Senator Branford Taitt was Minister of Health, the QEH stock has been diminishing at a concerning rate for Barbadians. In 2008 the problems at the QEH appear to be complex and will take the cooperation of all the players to ensure that the healthcare dispensed from that institution is not compromised. Minister Estwick from the House of Assembly has sent a clear warning to the several factions at the QEH that enough is enough and he will be taking decisions in the interest of the PEOPLE of Barbados.
At the centre of his frustration appears to be two core issues:
- The Queen Elizabeth Hospital Board is being undermined
- Some Doctors at the QEH appear to be shortchanging the PEOPLE of Barbados by ‘moonlighting’ on the job. Consequently the core medical pool which is required to ensure an above adequate healthcare delivery is under threat. He cited the example of Consultant Brian Charles who appear to be a jack of all trades if we are to judge by the number of hats he is currently wearing. Then there is the matter of the Human Resource practitioner whose contract was terminated.
The Minister Estwick has sent a strong message in a way only he can, he will not be tolerating any behaviour which seeks to undermine the authority of the QEH Board – see media release below written by QEH Board Chairman
112 responses so far ↓
Body Slam // July 10, 2008 at 3:51 am
David Estwick ole stupid dog.
Always barking like a idiot.
He could shut e damn mout and keep quiet.
David // July 10, 2008 at 4:33 am
Sometimes a government may start out with the best of intentions but then reality sets in. The incestuous relationships which exist in in a small country and the supported by practices which have become routine overtime will make the task of running the QEH a nightmare challenge for Estwick.
We do not wish this job for our enemy. We wish him all the best.
The scout // July 10, 2008 at 5:42 am
Dealing with the QEH is a complexed issue that needs to be handle with deplomacy. I’m not sure Dr Estwick method will work.
JC // July 10, 2008 at 5:58 am
I agree totally with David! Good luck Mr. Estwick you will have a tedious task ahead of you.
Bush tea // July 10, 2008 at 6:09 am
Scout,
Which other approach has worked?
I fully support Dr Estwick strong stand for what is right. It is obvious that any other approach at this time is give us the same results that we have been seeing for the past 20 years – gradual decline in the service offered.
…Sometimes leaders NEED to put their foot down for what is RIGHT.
I was impressed by his intensity and passion for doing what is needed for the QEH.
….and if his ‘facts’ are indeed correct, I think that it is time for a heavy hand in dealing with some of these sordid messes that the new government has inherited.
David // July 10, 2008 at 7:05 am
Members of the BU family should factor that the Chairman of the QEH Board is Mitch Codrington who is a former Chief Labour Officer and the Deputy Chairman is Eddie Corbin an HR practitioner. These are the two people heading the Board which indicates one thing to the BU household, the government anticipates that HR ‘issues’ would be a priority at the hospital.
boredickey // July 10, 2008 at 7:06 am
Body Slam! You are an arschloch a real Big arschloch. Are you a Barbadian? Do you care about our country? Do you want to have and to see an efficient QEH. You sick bastard
Anonymous // July 10, 2008 at 7:19 am
Hear,hear Bush Tea.
I don’t know why Scout seems to think that ‘diplomacy’ – whatever that might be in this case – is required in this instance.
The QEH doctors have long been known to steal the equipment brought in to the hospital and take it to their private practice.
In addition they collect money for ’supposedly’ doing work for the QEH while in fact they hardly turn up and leave all the work for the junior doctors who have to work very long hours.
One wonders that we haven’t seen more accidents at that institution.
Then we have brian charles -who was given the position of medical director of services,yet holding down his private practice,as well as being the vice president of the inurance brokerage firm that provided insrance coverage for the QEH,as well as having a position with CERO,and with the prison and with the defence force….
Cuddear man,be reasonable -you say scout that dr estwick should exercise diplomacy – I in fact was rather surprised that he was so diplomatic in presenting some of the facts.
Imagine hiring a human resource director who turns out to be a former research officer for the NUPW – hence dennis clarke fixation with the issue – but most unbelievable of all you hire this person without a contract.
It seems the BLP was averse to giving contracts – no contract for the ABC highway,no contract for the H.R. Director at the QEH . Wow!
boredickey // July 10, 2008 at 7:29 am
Dr Estwick does not need to be a Minister to make a living here. His heartfelt passion to help improve our lot sometimes seems unauthodox but that’s his way. Public support for his efforts is much needed at this time. The rebels involved CANNOT rule and MUST be publicly condemned.
David // July 10, 2008 at 7:33 am
Healthcare delivery is a plank upon which a successfully nation is built. This is not about liking a person’s style. This is about the fight to keep the QEH from going down the toilet. For so many years we have heard the complaints in the media and no one up to now has tried to deal with the fundamental problems at the QEH, at the top of the list are the many factions and interest groups.
The BU household pledges its support to Estwick or any servant of the PEOPLE who is trying to do better!
Wishing In Vain // July 10, 2008 at 8:29 am
I fully agree with you David, Dr Estwick not only needs the support of the Gov’t but he needs the support of every Barbadian as he tries to clean up the mess that exist at the QEH.
This type of corruption cannot and will not continue to happen, this is a new dawn a new Gov’t and most importantly A NEW MINISTER IN DR DAVID ESTWICK, let him do what he needs to do and allow him to deliver us from the evil of the BLP corrupt regime.
YOU ALL ARE SO FUNNY // July 10, 2008 at 10:19 am
ANNONYMOUS
You better believe That Big Mouth David Estwick will need real ‘diplomacy’ to deal with the QEH doctors, because if the doctors close ranks, and if BAMP closes ranks, his balls will be squeezed real hard!
Now let us understand that all QEH doctors are not in the same category. For example junior doctors DO NOT HAVE PRIVATE PRACTICES. They work full time- and that means FULL TIME & OVERTIME! For some of this, they are poorly paid, and for the rest they are not paid at all.
Annonymous can you provide evidence to support your claim that “The QEH doctors have long been known to steal the equipment brought in to the hospital and take it to their private practice?” You are off course referring to the specialists or consultants.
You show your ignorance – abject ignorance when you write “they collect money for ’supposedly’ doing work for the QEH while in fact they hardly turn up and leave all the work for the junior doctors who have to work very long hours.”
1- All over the world junior doctors have to work very long hours-
2- QEH consultants work. They see new patients in out patients department, assist in teaching medical students in these clinics, in operation theaters and on ward rounds. It is absolutely unnecessary for QEH consultants to come to hospital to do the “donkey work” as it is called. This is done by the junior house staff, and is adequately supervised by the Residents or Registrars as we call them. Registrars at QEH often have the same qualifications as the consultants.
The QEH consultants are more effective and proficient than the average MP and Minister of Government……….and big mout David Estwick
The reason why “we haven’t seen more accidents at that institution” is because we usually have good doctors, and the system works.
Well Brian Charles is a different case all together- HE IS A POMPOUS ASS.
But if he is a QEH consultant he is entitled to have a private practice.
Take a way the private practice from the consultants, and you will not have the level of expertise, supervision and teaching of the junior doctors that is required.
Tell me how much is paid to visit the prison or the defence force weekly- very little! These are inconveniences that very few doctors in Barbados love to do. These jobs were taken away from a Bajan who used to do them cheerfully and well, and given to Charles who is not a Bajan. Nobody complained when the Bajan doctor was displaced who was faithfully serving his people.
Periodically you people will talk shite about things you do not know. When you are supposed to open your mouths you say nothing. There have been threads on this forum this year to which few have contributed. Now you guys want to support big mout blabber mouth estwick in his brawling?
I predict that if he approach esthe doctors that way he will lose- and lose badly. When the consultants leave and expand Bayville Hospital then you will see.
It is easy to write shite on BU without possession of the facts!
J // July 10, 2008 at 10:37 am
Give Brian Charles a break and stop calling him a foreigner. He has been here long enough to be one of us. He has looked ofter my elders in A&E and did a fine job and was courteous too and not at all pompous. But that was years ago. I hope that success has not spoiled him.
Adrian Hinds // July 10, 2008 at 10:48 am
I maintain that the problems at the QEH are the fault of the Doctors and other staff, enabled by their respective bargaining bodies. I was probably the only non-partisan person in Barbados who did not agree with the vilification of Jerome Walcott as the reason for all that is wrong at the QEH. A new government and new minister of Health and strike action and same lack of service and amenities are still with us. How could this be if the Minister was/is at fault? Sooner of later Estwick will be force to admit that which Walcott did.
Why he suh damn ugly doh? // July 10, 2008 at 11:48 am
BU,
Perhaps you could find another photo of Dr. Estwick to publish.
Or was he born wid dah naturally damn ugly look?
Talk ’bout Frankenstein!
Why he suh damn ugly doh? // July 10, 2008 at 11:49 am
Please change dah photo fuh real.
You are FRIGHTENING MY CHILDREN!
Georgie Porgie // July 10, 2008 at 11:52 am
Adrian wrote
I maintain that the problems at the QEH are the fault of the Doctors and other staff, enabled by their respective bargaining bodies.
How can this be? The doctors do not run the hospital— the hospital is run by a board……….most of whom are medical illiterates!
How many times has BAMP held a strike in the last 30 years.
Georgie Porgie // July 10, 2008 at 12:08 pm
Adrian wrote
I was probably the only non-partisan person in Barbados who did not agree with the vilification of Jerome Walcott as the reason for all that is wrong at the QEH.
================================
Whereas you can not say that Jerome Walcott should be blamed for ALL that is wrong at the QEH in the last 6 years or so, he must be blamed for a lot. Jerome trained and worked at the hospital.
Therefore, he would (or should) have been aware of the problems such as
How long does it take to get a routine emergency Xray
How long does it take to get an operation theater ready for emergency surgery at night
What are the deficiencies with the Central Supply Department etc
and other routine important questions that deal with function
Jerome Walcott was in the unique position (in contrast to many previous Ministers of Health) in having experienced the defects and deficiencies of the QEH in many facets of its operations. He had the opportunity to fix them.
If not allowed to do so, he should have rebelled and told the people that he was not given the permission or the funds to do the necessary.
Jerome Walcott because of his unique position was a failure. To whom much is given, much is required.
Georgie Porgie // July 10, 2008 at 12:45 pm
David wrote that at the centre of Minister Estwick’s frustration appears to be two core issues:
1- The Queen Elizabeth Hospital Board is being undermined
Perhaps he needs to get a board that knows what it is doing.
Man I am sure the Board at Bayville on top of things.
David wrote you point out that the Chairman of the QEH Board is Mitch Codrington who is a former Chief Labour Officer and the Deputy Chairman is Eddie Corbin an HR practitioner. Do these guys have any knowledge or experience or experience in running a hospital. Or are they just party pimps?
2- Some Doctors at the QEH appear to be shortchanging the PEOPLE of Barbados by ‘moonlighting’ on the job. Consequently the core medical pool which is required to ensure an above adequate healthcare delivery is under threat.
Is he saying that the junior doctors don’t come to work, and are doing private practice? If so that is illegal, especially since most junior staff are not fully registered.
Is he saying that the Consultants should come to the QEH everyday all day and do what?
If he doesn’t like the terms under which the Consultants work, let him fire them! Don’t bark, bite! Fire them and see what will happen next?
David ma boy Minister Estwick will need a steep learning curve soon..
3- You say “He cited the example of Consultant Brian Charles who appear to be a jack of all trades if we are to judge by the number of hats he is currently wearing.”
Well here is a case of chickens coming home to roost. Brian Charles is a foreigner who has been doing as he likes at the QEH for ages. He has contracts which can be terminated. And if he does not have citizenship, then that is easy. So why bark?
4- Then there is the matter of the Human Resource practitioner whose contract was terminated.
Here is an interesting thing. A Bajan Human Resource practitioner’s contract was terminated but foreigners can do as they wish. Does anyone know what she did or did not do? Or is she affiliated to the wrong party.
It seems that there will be nuff fun down at the “horrrrrrrrrse-pital!”
Adrian Hinds // July 10, 2008 at 12:51 pm
GP I am going to assume that you are not suggesting that the problems you have highlighted started with the Board! But if you are, can you recall in what year was there a commission of enquiry into the QEH Led by Richie Haynes and a report with their finding and recommendations listed was issued?
Do you know how many or if any of the recommendations where acted on?
Tell me Why // July 10, 2008 at 1:14 pm
I believe in reverse psychology. If you place your party faithfuls in positions and you are still getting strikes and rebellious behaviours, why don’t you use someone from the opposition? We keep hearing that it is your friends that you should be cautious with, since your enemy once given a chance, will ensure that everything done must be perfect since the intentions will be to show that he/she is better than you. With that in mind, your job will be accomplished.
Georgie Porgie // July 10, 2008 at 1:15 pm
@ Body Slam
Whereas the Minister appears to be an ole stupid dog who is always barking like a idiot, he really cant shut e damn mout and keep quiet, because he is PAID to deliver in the tedious task ahead of him.
I predict that if he don’t come down off his high horse, he will get a whipping!
@ The scout
I agree with you that the QEH is a complex issue that needs to be handle with diplomacy.
It must be done area by area and department by department in such a way that success breeds success. I agree with you that Dr Estwick’ method will NOT work.
If Bajan doctors could defy Tom Adams and could stall the implementation of his precious National Health Service for 10 years, our contemporary doctors can ensure that Estwick becomes a failure.
@ Wishing In Vain
How will every Barbadian support Dr Estwick as he tries to clean up the mess that exist at the QEH. Tell us how man. Tell us how.
How will he deliver us from the evil of the BLP corrupt regime?
This is good emotional rhetoric, but tell us how?
@ David
Do you think that that Dr Estwick’s fight to keep the QEH from going down the toilet will be accomplished by barking and hollering, and ignorance? What has he accomplished in six months? Pray tell?
Does the former Chief Labour Officer Mitch Codrington or the Deputy Chairman Eddie Corbin – the HR practitioner have any training or experience in Hospital Administration or Healthcare delivery, or are these party pimps who are essentially square pegs in round holes?
Is not Hospital Administration and Healthcare delivery areas of health that in other countries people study and work before getting these positions?
You write “Sometimes a government may start out with the best of intentions but then reality sets in………….the pactices which have become routine overtime will make the task of running the QEH a nightmare challenge for Estwick.”
Estwick should go talk to Kieth Simmonds or Branford Taitt- who had the best approach to the job IMHO. They spent a lot of time working with the persons involved
@. Boredickey
Whether Dr Estwick needs to be a Minister to make a living here is irrelevant. Your emotional outburst “The rebels involved CANNOT rule and MUST be publicly condemned” is very interesting. But
TELL ME ARE THERE REBELS AT THE HOSPITAL ON ST PAULS AVENUE?
HOW IS IT THAT THERE ARE NO PROBLEMS THERE?
WHO RULES & RUN THAT HOSPITAL?
CAN WE LEARN ANYTHING FROM THE MANAGEMENT PRACTICES THERE?.
@ Bush Tea
Intensity and passion for doing what is needed for the QEH is ok, but that wont do the job. Standing for right is great rhetoric, sounds good…….but how will he translate that into positive, practical action. Will his present ploys give us better results? If he indeed has the facts will shouting and barking do the job?
If he has really dissected out the real maladies at QEH, how will he perform the necessary surgery by himself? He needs co-operation from the major players. If he has the facts he should stop barking and do something positive!
If the trouble trees are not contracted workers but appointed civil servants, how will he easily get rid of them. (Please note that the doctors are now all under contract and can easily be dismissed when their relatively short contracts are up.)
We are in for some………cant say fun……..cause it aint going to be funny.
Georgie Porgie // July 10, 2008 at 1:24 pm
Adrian Hinds
NO NO NO I am NOT at all suggesting that the problems that I have highlighted started with the Board!
NO I do not recall what year the commission of enquiry into the QEH Led by Richie Haynes was held or if a report with the findings and recommendations listed were issued, or any of the recommendations where acted on.
I sincerely believe commissions of enquiry in Barbados are designed primarily to give lawyers money.
But I also believe that the issues at the hospital and other factors that affect the health institutions paid out of the public purse can be solved.
Georgie Porgie // July 10, 2008 at 1:33 pm
Adrian
Maybe you should be on the Board! At least you have the administrative sense to review the pass in order to see what you can take from that to go foward.
I think that you are alluding to the idea that if the findings of the Haynes commission have useful ploys that have not been implemented, that they should be examined and modified as needed and implemented.
Your approach must be commended because rather than an emotional outburst it suggests that you have thought about the issue at least for a minute. Lol
Adrian Hinds // July 10, 2008 at 1:49 pm
Georgie Porgie // July 10, 2008 at 1:33 pm
Adrian
Maybe you should be on the Board! At least you have the administrative sense to review the pass in order to see what you can take from that to go foward.
I think that you are alluding to the idea that if the findings of the Haynes commission have useful ploys that have not been implemented, that they should be examined and modified as needed and implemented.
Your approach must be commended because rather than an emotional outburst it suggests that you have thought about the issue at least for a minute. Lol
=================================
ha ha ha please don’t put me in the mist of the solution. I will not be visiting the rock anytime soon, and at this time have absolutely no intent of returning for any permanent or long term reasons. I will continue to serve my country voluntarily via ideas and suggestions. I have nothing more to give.
Georgie Porgie // July 10, 2008 at 2:16 pm
Adrian
I was giving you a complement not sentencing you to hell! I aint got nuttin against you man to wish upon you such evil LOL
Working with these politicians is hell, and fixing the mess in Health is………only God knows.
Adrian Hinds // July 10, 2008 at 2:21 pm
The following was written by Bajan blogger Stephen Mendez back on Sept 20th 1998
“HOSPITAL HORROR
—————
The QEH commission of inquiry has now gotten under way… here are a few
of the stories told to it by patients.
- One patient was about to have his foot amputated, when it was discovered
that his non-recovery was simply the result of a deficient diet.
- A disabled patient who was unable to use her hands had a meal placed on
her bedside table, but since there was no one to assist her in the eating
of it… it remained untouched and was eventually taken away.
- One daughter, with the help of untrained family members, looked after her
sick mother and she did not develop one bed sore, but after two weeks in
the QEH she had bed sores all over her.
- A former QEH worker said, staff often referred to the place as “Hollywood”
because there were so many “acting” employees !!
so people.. be warned… with your last breath, say to the medics… “take
me to the Airport… take me to the Bayview… take me anywhere
BUT NOT THE QEH !”… and pray you are never in that situation.”
Professor la la // July 10, 2008 at 3:40 pm
mr rah rah
david estwick is so noisy that i call him mr rah rah.RAH RAH RAH RAH RAH RAH
i do not like how things going in barbados under this government. this is the worse government ever in the history of barbados over a six month
period. —– I AM NOT HAPPY———–
anotherview // July 10, 2008 at 3:48 pm
Problem under the Bees now problems under the Dees. What does this say?
The problems are mainly institutional.
Solution: heads will have to be crushed!!
Adrian Hinds // July 10, 2008 at 4:25 pm
anotherview // July 10, 2008 at 3:48 pm
Problem under the Bees now problems under the Dees. What does this say?
The problems are mainly institutional.
Solution: heads will have to be crushed!!
=================================
indeed, a change of scene and charaters, but the pantomime continues the same.
JC // July 10, 2008 at 5:23 pm
Every body I find (excepting Adrian Hinds and BU) have not given any positive hindsight into this delicate and serious issue.
I have a friend in hospital right now and I am scared for her!
You think anyone in Barbados in 2008 should have to say that they are scared to go into the hospital. Most bajans do not have money to go overseas like Glyne Clarke and crew;
We need to correct this nasty situation. If we as the citizens of this country keep on saying that this wont work and that wont work it will not manke the situation any better.
We need to get this thing right for my friend’s sake, for our children’s sake but most of all
FOR ALL BBARBADIANS SAKE!
We need to assist oursleves.
Forget about how ugly or how loud the minister is. (I dont think he cares how we feel anyway.)
Let’s unite and make Barbados’ health system the envy of the world.
Georgie Porgie // July 10, 2008 at 6:37 pm
JC
Don’t expect me to tell Estwick how to do his work from exhile.
I will never forget the day 9 years ago, when my brother who is a BLP stalwart, told me GP you better leff de island , there aint nuttin here for you.
The DLP cronies will give the little insight that they have- if they have any.
It is a natural fear for anyone to be scared if they have to be admitted to hospital- if they are unaware of what is happening.
Re Most bajans do not have money to go overseas like Glyne Clarke and crew;
We need to correct this nasty situation. If we as the citizens of this country keep on saying that this wont work and that wont work it will not make the situation any better.
We need to get this thing right for my friend’s sake, for our children’s sake but most of all FOR ALL BBARBADIANS SAKE!We need to assist ourselves. Let’s unite and make Barbados’ health system the envy of the world.
All this sounds so sweet but how will the citizens help themselves. You voted out the quiet amphibious minister and you vote in the impotent boisterous minister. What can the citizens do?
I know what I was able to influence in 1985. I know too how I begun to advise the incumbent imbeciles.
Georgie Porgie // July 10, 2008 at 6:47 pm
JC
Suppose you had a old wooden house with wood ants in it…………….and you didnt have no lot of money, how would you fix it?
Would you keep nuff noise in the village? Would you burn down the ole house? Would you go into debt in a big way to replace the ole house?
What would you do?
Same way the hospital can be fixed?
Remember a lot has been done with the original structure opened in 1964.
Maybe you might start in the back in the corner where the library and chapel and physiotherapy used to be? Maybe you would come across quietly piece by piece, thinking consulting. Changing things slowly quietly.
Maybe you would do this by having all departments submit there ideas and you would LISTEN well to see if there are any merits in what they are saying,
Maybe you will ignore what the medical illiterate civil servants in the ministry have to say, and listen more to the department hospital heads. Maybe Maybe Maybe. I dont know. I am far away in exhile. LOL
Animal Farm // July 10, 2008 at 6:56 pm
Every time there is issue with the QEH, people villify the doctors…surely, they cannot be the ones that have run the institution into the ground. From my personal experience with a relative there as a patient, I can say that certainly the ‘junior doctors’ run that place. I watched them work day into night and then day again. Up and down….worked to the bone, trying their best.When could they have time to have the private practices people suggest? Perhaps those comments are aimed at the Consultant level staff. …
It may be useful in the investigations and fixing of the QEH that a closer look at the ‘junior doctors’ and how they work relative to the Consultants. From where I sat next to my mother’s bed, something just is not right.
Georgie Porgie // July 10, 2008 at 8:16 pm
Of course the junior doctors run the place- i.e they do the donkey work. That is how you get experience.
You cant expext Consultants to continue doing the donkey work, because there wont be any work for the juniors to do to learn. The Consultants are there to keep them on tract.
JC // July 10, 2008 at 9:00 pm
That is what I wanted to hear GP, suggestions!
We have to try some where in order for things to work. There have been too many ministers of health!
maybe if politicians start listening to persons who seem to have an idea and a very good one at that like yours then maybe just maybe they will be hope.
Hopefully, I hope that the press secretary and crew of the pm are reading these blogs because most of the times
the people are always right! I like your suggestions!
Animal Farm // July 10, 2008 at 9:08 pm
I hardly think that caring for the ill and infirmed can be considered ‘donkey work’….
While I agree that Consultants should ‘keep them on track’ and provide guidance, I question a system in which they appeared (to me) to slip in for a few minutes here and there leaving the juniors to struggle alone most of the time
Bush tea // July 10, 2008 at 9:33 pm
GP,
For a man who admits to running from bout here due to professional pressures that were brought to bare on you, you certainly seem to have a lot of advice on this matter…LOL
For those of us who have never had to manage a large complex organisation, we cannot even begin to imagine the difficult decisions that must be made on a daily basis.
Many of these are HARD choices. The absolute worst kind of manager is one who cannot make hard decisions – who try to please everyone…. you can rest assured that his business will fall to pieces.
Obviously the union is committed to proving that their position on creating a Board at the QEH was right, and are determined to frustrate the Board. …That they are also destroying our most important institution seems to be secondary.
In the absence of working cooperation, the Board would be foolhardy to just sit back and allow the union to wag the dog.
Sometimes, it comes to the point where there must be a clear battle -and let the best man win. Then we can move on. This is not a job for a sissy or coward – at last, Dr Estwick seems well suited to save this country’s health systems in the current circumstances.
Those of us who operate in the fairy tale world where everyone smiles and shake hands to resolve all their problems and where there are no saboteurs, should make an effort to awake from our dreams…..
With respect to the Doctors;
I have said before, doctors are in the interesting position where they make more money when more people are ill;
They make more money when the QEH is inefficient;
They make more money when national health management is in shambles.
It therefore takes a special doctor to truly put aside his personal affairs, his private practice, his ownership of his private clinic and investment in his pharmacy and lab – to work for the success of the QEH which, if successful, will erode his customer base….
Why is it hard to understand the difficulty that the Board has in managing the QEH?
Unless the environment is created where Doctors can win, where the QEH wins, and where patients win; then we will continue to have challenges -no matter WHAT anyone says…
The solution?
Somewhat like what was done to the PSVs.
Unless the QEH improves in one year:
1) Massive increased taxes on private clinics
2) Use proceeds to pay high salaries to full time QEH doctors
3) Create an INDUSTRIAL COURT NOW.
…one of the things we do not have a lot of, are effective leaders, so I am surprised that so many of us know how Dr Estwick should proceed…
Georgie Porgie // July 10, 2008 at 9:55 pm
Ok JC
Just to please you!
When Thompy selected Estwick to be MOH he should have applied a classification he must have learned in medical school for managing the post op patient.
Immediate post op period ie first week after elections in this case
Early post op period ie first six months after elections in this case
Late post op period ie first year after elections in this case
I would have put those headings each on a sheet of paper and I would have written down all the things that I thought that I should do in each of these time periods.
Immediately i.e on the first day I sat at my desk, I would have summoned the consultants for the emergency room at the QEH and ask them to submit in one week thier suggestions for the staff and equipment they thought they should have to effectively improve the QEH ER.
In addition I would have asked them to submit thier ideas of what proper and realistic triage systems should be put in place in the peripheral public clinics to enhance the delivery of emergency care, and simultaneously take the weight of the QEH ER.
I would have done this very quietly, by letter email, telephone whatever on day 1.
If I had not worked for the rest of that first week, man I would have accomplished more than the incumbent twit has done. Dont you think?
BY NOW THESE IDEAS WOULD HAVE BEEN IMPLEMENTED PARTIALLY AT LEAST DEPENDENT ON AVAILABLE FUNDS. IN OTHER WORDS THEY WOULD HAVE BEEN HALF DONE IN THE EARLY PHASE POST ELECTIONS.
With such a start, ideally by year end or January 12 2009, the desirable improvement in the emergency services would be well on the way.
This would certainly involve the planning and implementation of training for all emergency personel in both the QEH ER and emergency personel in all the peripheral emergency centers at the poyclinics.
Funds permiting, this could probably even include some provision for overseas training for some of the officers.
See how easy it is JC.
Would you believe that this info was communicated to the GOB on the same day the ministers were sworn in at the Oval?
The scout // July 10, 2008 at 9:57 pm
Any sensible person would realise, the doctor’s profession is like a faternity. Let’s say the minister start getting rid of senior doctors, all those fellows will walk out. What would we be left with junior doctors and interns? Who will suffer? Not the big boys, they can go overseas even by air ambulance if it’s serious or to Bayview or Sandy Crest. It is the average bajan who needs the QEH that will suffer. Even though the minister is a medical doctor, he can’t replace any of those consultants. Maybe he’s trying to prove that he’s bigger than them even though they are more qualified but again who’s going to get hurt in this power struggle. This reminds me I heard the goodly minister while campaigning shout in his unique way ” we want POWER,POWER , POWER”. It’s nothing wrong in wanting power but it is how that power is used that determine the character of the individual.
Georgie Porgie // July 10, 2008 at 10:51 pm
Bush Tea
I have not seen on this forum where anyone else has expressed any knowledge or ideas of how Dr Estwick should proceed… but I have read emotional outbursts.
I might have had to run, but I have an understanding of our Health System and how it works. As a student, for my peculiar interest, I read about the various Health Systems around the world. So when I got the opportunity to opine on what should be done for Barbados, I think I was fairly accurate in my proposals.
It is not known that the decision to run the National Health Service via a number of polyclinics by the then MOH Obrien Trotman was based on proposals I submitted to PM Adams in 1985. It was not done exactly as I proposed it, but it is a better system than following the original British System that impressed Adams as a youngster in the 5O’s. And it does work, doesn’t it?
You write “ For those of us who have never had to manage a large complex organisation, we cannot even begin to imagine the difficult decisions that must be made on a daily basis.” But you will run the hospital like how you eat an elephant—- one bite at a time. Or actually a lot of little bites going on simultaneously here and there.
You write “Sometimes, it comes to the point where there must be a clear battle -and let the best man win. Then we can move on.”
I say that there is no need for any battles. What we need is a leader with a vision, and one who can communicate that vision. In the early 80’s the doctors had no plans to run a NHS like the British do. They were not going to sign to be in charge of a clinic 24/7 365 days a year; but they were willing to accept the two workers the government were going to give to their practices. At that time BAMP closed ranks, and were phoning around persuading general practitioners not to participate in the implementation of the NHS.
I sent a note to Tom in early 1985 saying “Why are the Doctors and the Government fighting about the implementation of the NHS. This is what needs to be done.” He answered my note with a thank you, even though he wanted his idea to stand. But he died, fortunately. And we do have the foundations of a practical NHS that works for us. Meanwhile in the British NHS, doctors continue to commit suicide!
Our NHS works, and it costs the individual nothing at the point of service. It needs only to be improved. You don’t have to have expensive insurance to go. We have a better system and service than the USA or the UK.
Our system was changed from the old Vestry system etc without A FIGHT! What battle what? (to quote you lol)
Doctors may make more money when more people are ill; but serious doctors cant be happy when the QEH is inefficient or when national health management is in shambles.
If you are doing primary or secondary care, you need an escape route for when you cant do any more for the patient, or you don’t know what else to do with the patient, because you don’t have specialist training. You need the QEH to function!
I never saw the success of the QEH as an erosion of my customer base. I was proud to know, or have been taught by, or have worked with, or gone to school with the specialists in the QEH, since these chaps could take my problems off my hands. The QEH in shambles is no good for a GP.
Just this morning on the phone my mom told me that a certain old lady in the country called to inquire of me, and to speak favorably of the night I sent her to the hospital in 1981! All I did for that lady was to make a diagnosis and send her to QEH, to have surgery done that I could not do, nor had the facilities to do.
Bush tea. I don’t find it hard to understand the difficulty that the Board has in managing the QEH. Most of the Board are medical illiterates. And the doctors on the board probably can only doctor— but nothing else.
Some doctors can only doctor. Dont you know that? They can not think about anything else but medicine. They can not plan. They cant apply principles that they have learned outside of the medical scenario (cf my last post for an example.)
I agree with you that fixing the health system in Bim is not a job for a sissy or coward but Estwick is not the answer in the current circumstances, as you opine. He has not shown me this in six months. We need someone with a brain. Some one who thinks! Some one who can out thinks the saboteurs, you are talking about! Estwick is definitely not an effective leader in my opinion.
You err in thinking that the success of the QEH is a function of what happens in private clinics. Private clinics are involved largely in primary care or secondary (specialist )care; the QEH is involved with tertiary care. Massive increased taxes on private clinics is not the solution.
Bush tea you boil your tea too long, and the tannins gone to your brain man. You will pay high salaries to the junior doctors? Man you need that same money to pay more doctors to expand and perfect the system. You need more Indians not chiefs. Trust me the chiefs are doing their jobs.
Georgie Porgie // July 10, 2008 at 10:59 pm
The scout
Sir you seem to have a grasp of the situation.
If Estwick messes with any consultant, and BAMP disagrees, the doctors will close ranks. Estwick will lose the power struggle and end up with egg on his face.
Junior doctors and interns can do the donkey work, but they need the expertise and advice of the Consultants. This can often be done by phone- except if it is surgery. And many of our juniors do surgical procedures that seniors do abroad. Ask any one who went to the UK to do their post grad exams.
It is the average bajan who needs the QEH that will suffer in this power struggle.
Again the scout you are correct It’s nothing wrong in wanting power but it is how that power is used that determine the character of the individual.
Estwick needs a PLAN B, or he will have to beat a hasty retreat with PLAN R!
Georgie Porgie // July 10, 2008 at 11:51 pm
@ Animal Farm
Re I hardly think that caring for the ill and infirmed can be considered ‘donkey work’….
Are you a nit picker?
IT is called donkey work because HARD WORK or the MOST of the WORK everywhere in the world is called DONKEY WORK OK? We call it the same thing in cricket, don’t we.
You can question a system in which the Consultants seem to you to slip in for a few minutes here and there leaving the juniors to struggle alone most of the time, as much as you like. But that is the system universally. NO junior expects a consultant to come do his work. The Consultants also had their time doing donkey work or “SCUT WORK” as the Americans call it.
Since you do not know, listen and you will learn. Your questioning will not change it. Are you going to provide more interns? To expect a consultant to come and do the donkey work is hilarious. Why don’t you get the minister to come and do some of the donkey work too. You sound as stupid as David Estwick when he talks.
Juniors should only struggle on days when their team is admitting. Juniors who come to work at eight and pace them selves , and MANAGE THEIR TIME well should not struggle. Now when you are admitting, that’s another story.
But thats what you went to study to do- WORK as a doctor. When that chap becomes a consultant you then want to deny him his fees, and expect him to come do donkey work. LOL
David // July 10, 2008 at 11:59 pm
@Georgie Porgie
We always give way to you on matters the BU household knows very little about but something is missing from your arguments which makes some sense of course. The problem is many of the approaches you have suggested may have been tried by other Ministers before Estwick, and they have FAILED.
The reality of the small rock is that cronyism exist big time in Barbados. Doctors ‘making-out’ with nurses, patients making out with nurses, doctors and nurses making out, doctors and nurses making out with administrators, medical personal making out with prominent civil servants and politicos and it continues. This is not the USA Sir! This is a little island island called Barbados where incestuous relations exist.
It is against this background that the complex operation of hospital management at the QEH must be applied. A commenter made the point before that the problems at the QEH straddle both political parties which moves the problem at the hospital into another realm.
Bush tea // July 11, 2008 at 6:07 am
Well said as usual David,
This is not a medical issue, it is a management issue, and the problem stems fundamentally from conflicts of interest of various parties.
All sorts of approaches have been tried, by all sorts of people. I recall Richie’s intervention and we all expected positive results…
After hearing Dr Estwick’s rant during the debate many issues finally became clear to me…
I am more than happy to give him a chance to try his approach.
GP is to far, to removed, and to much a doctor to understand the problems that the Board, and all the various QEH administrations have been facing….
There is a time for quiet diplomacy, there is a time for fun, there is a time for listening – but there is also a time for action, for decisiveness – even for battle occasionally… this is the challenge of high quality management.
… and a people ALWAYS get exactly what they deserve.
Real Ting // July 11, 2008 at 10:53 am
Such is the power of a blog. the level of discourse on this topic is simply exceptional. it was a pleasure to read GP and Bush Tea propose rational although contradictory approaches to managing the beast that is QEH. I will say that i lean more towards Bush tea’s ideas but i will caution that if any progress is to be made after a battle then an escape which saves face must always be offered to the loser else he remains hostile, embittered, resentful and uncooperative. I will say to GP that for his proposal to work the doctors and employees have to want it to work and this may not be the case especially when you consider that a high level of apathy and general disinterest in results seems to exist particularly in Public service employees. Not all employees maybe not even the majority but enough to matter.
Georgie Porgie // July 11, 2008 at 10:58 am
David
You and Bush Tea getting on as if 5 years over seas has caused me to forget my roots. You sound as if anywhere in the world including the USA have a better NHS than we do. What we have needs improving. You see, unlike you guys I understand our system.
I don’t know that any other Minister has tried to improve the Emergency system as I have detailed. Do you? Tell me when. Please tell me when? Tell me when has any minister announced plans to improve on the delivery of health services at either the QEH emergency room or in the peripheral clinics since 1985.
Since as you say. the problems at the QEH straddle both political parties, then what is needed is a non partisan rebel WHO HAS VISION to fix it. But Estwick’s rants and braying like Balaam’s ass will not fix anything, I promise you. The men will close ranks and crush him
Also if Estwick wants the people’s support he must tell the people what he plans to do, and when and in what time frame, as I detailed in my glossing over the surface example of a plan submitted in this forum last nite……which you admit makes sense.
You must make the jokers in the system part of the solution, and make them think that they are part of the solution. He has to gain respect. He does not have to be friends with them, but they must respect him as being knowledgeable.
Everything that is complex can be made simple. You have to dissect the parts to understand and execute the whole.
The hospital is not as complex as the human brain or the human body. In the same way that we can dissect and unravel the mysteries of the brain, we can fix the QEH, if we have the WILL to do so.
Kieth Simmonds and Branford Taitt had a better approach. Taitt got a whole hospital renovated that the Bees let run to ruin. Taitt got a whole wing added on to the hospital for optometry. Then there were a succession of jackasses who brought or NHS to its lowest.
In 1985 when I lambasted a certain minister of government about the Bees of that time fighting with the Government he persuaded me to talk with the them MOH. The result is history.
Kieth Simmonds Branford Taitt and Trotman listened! Estwick is ranting and braying!
David there is more cronyism in the USA and other places than there is in Barbados. Everything thing that you describe goes on elsewhere.
David. I can stay here and tell you the wicked mean ugly jackass that Estwick listening too, from the time I read the remarks on Brian Charles.
I don’t like Charles, but I know that many doctors in Barbados not getting out of their beds to drive to St Ann’s Fort early once a week to see the soldiers for the pittance you are (were) paid. I know also that it was not easy for Banny to get folk to deputize for him at the prison for a few weeks a year (again for a measly sum). And dealing with the prisoners is not an easy thing.
Bush tea
The issues at the hospital is both a medical issue, and a management issue, and must be dealt with by a BENIGN DICTATOR WHO HAS VISION!
You must listen before you act. Then you quietly set things right man. I wish I could show you how I made the last offshore medical school at which I taught close down.
I am not too much a doctor to be a rebel! And I don’t want no medical illiterates on any Hospital Board. How can medical illiterates decide the direction in which a hospital should go? How?
Also you guys think too much about doctors and hospital when you talk of health matters. We should be seeking NOT to admit folk to hospitals.
In the last ten years a lot of our best nurses migrated, or died out. There was a time when we were not training nurses as we thought we had enough, until we found we had none. Rapid training then could not replace those who had years of experience.
No nurses or poor nurses = poor medical care.
Richie had a commission of inquiry, but he could not intervene by himself. Politics screw up the hospital. It started with the big mout brawling animal L Thompson.
After hearing Dr Estwick’s rant during the debate, I cant see how things could have become clear to anyone, except that after six months he still does not have a clue or he still does not have a plan. Fellas don’t get distracted with Estwick’s ranting. …… because the man talking nuff but aint saying nuttin or not reaching the standard expected.
Georgie Porgie // July 11, 2008 at 11:20 am
Real Ting
I got to discourse at a high level on this blog on which David has appointed me the MOH emeritus! So I work very hard to earn my pick and the honor bestowed upon me.
What Bush Tea what? It is time people stop drinking bush tea. They don’t even use bush to sweep the yard no more- we got patent brooms now for that. What Bush Tea what? LOL
Don’t worry with Bush Tea Mr Real Thing. He not contradicting me. He and David just trying to force me to bring more proposals to the table. You think these two old fellas are idiots neh? They have the patience and necessary diplomatic skills to get the job done. I would like to appoint them to the ministry of health.
Your caveat on how to deal with the man beaten in battle evinces that you like psychology.
I believe that doctors are generally results oriented people. Doctors will go into the OR and attempt surgery on a patient knowing that they have little chance of success, and then come out of the OR vexed and deflated when the patient dies.
One problem with Public service employees is that they need motivation. There needs to be a system of compulsory on going relevant training and assessment to assist in this.
However, it has just occurred to me that I might be thinking as folk of my generation think, and maybe the youngsters don’t think like the oldsters do. I hate to think that my younger colleagues are less committed.
Re I will say to GP that for his proposal to work the doctors ……..have to want it to work
Well if they don’t you can just not renew their contracts. Simple.
Real Ting // July 11, 2008 at 11:58 am
ok fair enough and i like the openmindedness and the willingness to tweak here and there based on feedback and differing opinions. what i will say about Dr. Estwick’s methods is that the big stick achieves the best results if there is a small carrot somewhere in the offing.
Trained economist // July 11, 2008 at 12:25 pm
I think we are also dealing with some serious issues of governance in Barbados.
1. Does the security of tenure afforded to “independent ” senior civil servants such as a permanent secretary for example, apply to managers in statutory corporations? If so, what are the managerial type advantages of statutory corporations? How in effect are statutory corporations any different from government departments ?
2. How is one to assess the performance of say a Minister, if security of tenure for senior employees prevents him from putting in place a management team that shares his vision for the organization and the direction of policy?
Georgie Porgie // July 11, 2008 at 12:27 pm
Real Ting
I blog also on a medical student/doctor forum that dont even come close to this forum in terms of the level of information shared, the level of licks shared or the level of debate.
I have a healthy respect for our people, and this blog………….but it will be amiss of me if I dont put the occasional lash in Bush Tea now and again. You cant let cawmere boys get out of hand, you see LOL
Georgie Porgie // July 11, 2008 at 1:09 pm
Trained economist
You got some hard questions there on issues of governance for a little doctor like me Sir. People like David, Bush Tea and Yardbroom etc would have to answer you there. I definitely cant speak with authority on question 1.
Your assessment of the performance of say a Minister is based it seems on senior employees sharing his vision, but how can they share a vision that a Minister does not have, or can not project?
However, you will notice in my sketchy plan to fix the QEH emergency room and the peripheral emergency issues, including developing and testing and redeveloping systems for mass casualty situations, I don’t involve no permanent secretary or no “independent ” senior civil servants. These guys wont have any say in medical issues, because there are medical illiterates. How will they know, or understand?
I would deal with the medical issues with the medics. And consult on other issues with those who are supposed to know. I will get second and third opinions from others also. And I wont ask the medics about economics either, because they are economic illiterates.
The senior civil servants would do the things that civil servants are able to do according to their training or experience. Those who don’t share the vision will be transferred, or ignored. Simple.
Why should we suffer fools gladly. I don’t. I have always had to be right or get punished all my life, from home, at church, in school, at work; everyone has been hard on me. I have even be punished for excelling. So I have not much times for twits.
You may ask “How can they share a vision they don’t understand?” I will make it clear that in my watch they are not paid to understand , but to do. Great leaders are dictators, who earn respect because they lead by example and are themselves brilliant. The greatest will listen to the input of others and modify it to suit the needs of their plan. Sometimes understanding comes with the passage of time and with performance.
Why do Bible scholars NOW understand Daniel’s prophesies? Because 80% of them have been fulfilled?
Why do Bible scholars NOW make sense when they discuss the mark of the beast? Because we now know that there are bar codes, computer chips that can be placed in the body with information, there is GPS, there are techniques for scanning individuals and identifying them etc. It certainly makes more sense to me than it did 40 years ago when I first started to read it.
Similarly, if the minister is so far ahead of his staff as he ought to be on medical matters, he should be in charge and large! For heaven’s sake, he is supposed to be a doctor!
The problem with the Ministry of Health seems to be that the folk dont know what the problems are, how or when the problems started, where or how to start addressing the problems. They are old clueless!
These guys like they playing against Mendis at one end and Murali at the other end.
Adrian Hinds // July 11, 2008 at 1:40 pm
GP says:
The problem with the Ministry of Health seems to be that the folk dont know what the problems are, how or when the problems started, where or how to start addressing the problems. They are old clueless!
=================================
I think we all know what the problem is, and further to this we know that there cannot be solved without serious dislocation. They are institutional, and at this point cultural.
….I remember a story about an American regional telephone company that changed it’s name several time as each one became associated with bad service. When it went into the cell phone business it deliberately kept that new company seperate in everyway down to empoloyees seperate, and was able to break the cycle. Maybe for no other reason than to break the institutional culture that i think is core to the problems at the QEH, a new hospital seperate in every way from the QEH is in fact the best approach.
Georgie Porgie // July 11, 2008 at 1:58 pm
So you will hire new Consultants Adrian? Those don’t grow on trees? Also an additional cost. Also our Consultants are part UWI paid and part Government paid.
To get the requisite number of junior staff you might have to train more doctors. This takes five years and is an additional cost right now.
To build a completely new General hospital is unnecessary.
Dislocate the institutional culture that you talk about Adrian.
I still say that the guys don’t have a plan! I have not heard any health plan since these mendicants came into office except that they will build a polyclinic in St John at the wrong location. If they don’t like my suggestion of below the fork at Salters, it must be below the fork at Turnpike.
It is written WHERE THERE IS NO VISION THE PEOPLE PERISH.
Georgie Porgie // July 11, 2008 at 2:00 pm
I forgot the nurses.
Right now we behind in training nurses even for QEH.
Who would have thought it? Barbados importing nurses from Nigeria and the Philipines.
Tell me Why // July 11, 2008 at 2:39 pm
But Estwick’s rants and braying like Balaam’s ass will not fix anything, I promise you. The men will close ranks and crush him
…………………………………………………………………….
Hi George Porgie. The words used “Balaam’s xxx, says that you attended St. Giles’ and traversed Belle Gully. What say you.
Animal Farm // July 11, 2008 at 3:07 pm
@GP
I am not sure which decade you refer to, but it hardly universal in 2008 for intensive care units for adults and premature babies alike to be run mostly by juniors who are barely trained in subspecialty care while consultants pop in and out. It is not about donkey or scut work….high level patients need high level trained care. How many of the junior doctors who work in the QEH are recently graduated interns as opposed to residents in various stages of specialty training?? I suggest you check before you answer from your rear…I suspect you will be surprised. In other parts of the world it is the training residents who ‘run the show’….not interns and there is a big difference.
Georgie Porgie // July 11, 2008 at 3:32 pm
Animal Farm
The junior doctors at QEH are supervised by Registrars (what you call Residents in the USA) as wel as Consultants.
I can assure you that I know what I am talking about.
I prefer a UWI trained intern to a US resident anyday.
I have been teaching in US type schools. The doctors are trained to do donkey work in thier residencies- during which time they specialize in one area. They are not as roundly trained as a UWI or UK graduate.
The US doctor cant fart unless he has done a battery of tests and xrays and MRI’s. THEN AND ONLY THEN HE CAN MAKE A MIS DIAGNOSIS
Your fancy training residents cant match my UWI trained interns. Your fancy training resident is just an intern with less clinical acumen than our UWI trained doctors.
THAT IS NOT WHAT I THINK
THAT IS WHAT THE US CONSULTANTS THAT COME DOWN AS EXTERNAL EXAMINERS SAY ABOUT OUR DOCTORS.
Our Junior doctors are able to do the work they have to do supervised firstly and aided by the Registrars.
Georgie Porgie // July 11, 2008 at 3:33 pm
TMW
No I went to Bay Primary.
Georgie Porgie // July 11, 2008 at 3:38 pm
In British Medicine you are trained to make the CORRECT diagnosis, BEFORE you order tests, because funds are limited.
In US medicine uneccessary tests are done and often the diagnosis is not made.
Animal Farm it is obvious that you are shooting from your shelves of Houston. and you dont know what you are talking about.
I have a colleague in Barbados – now a Consultant- who was doing ALL THE OPERATIONS IN GYNAECOLOGY & OBSTERICS WHEN HE WAS A JUNIOR HOUSE OFFICER.
I wont call the name here, but that is no lie.
Barnabas Collins // July 11, 2008 at 3:43 pm
Undergrounders
Everything in this country can’t boil down to corrupt Bees and saviour Dems. That is a myopic partisan view. We were having problems with the QEH from “forever” and the problems were across both parties’ rule. And lest we forget, the QEH was not built in 1994 more like 1894 but I digress.
The doctors run the hospital and the culture there is so engrained that it is almost impossible to fix. I don’t care if you bring in all the HR specialists known to us and placed them on the board.
I contend that that is the reason why the former government PROBABLY wanted to build a new hospital so they could have rid themselves of some of these doctors. CULTURE is people.
Therefore, please leave Mr. Estwick, Mr. Walcott et al alone. I don’t care who they bring, once they want to effect change they will be problems a plenty. Having said that though, I am not suggesting that we put our collective hands in the air and continue as it is ad infinitum but I think this needs thought, ingenuity and lots of prayers. I am not sure what can be done to effect change at the QEH to be honest.
What I can tell you, shouting at people from the confines of parliament will not do it.
BC
ROBOT // July 11, 2008 at 4:18 pm
wuh he so damn ugly
———
i hold no brief for dr. estwick
i find your comment distasteful
and i think you should leave it alone
it sounds really silly and harps back to a time that we could best forget.
so ease on those type of comments -we can do without such comments-please !
Yardbroom // July 11, 2008 at 5:36 pm
Tell me Why
I am a St Giles boy, please do not hold that against the school, it is not the school’s fault.
Georgie Porgie // July 11, 2008 at 5:39 pm
Animal Farm You started with
From my personal experience with a relative there as a patient, I can say that certainly the ‘junior doctors’ run that place. I watched them work day into night and then day again. Up and down….worked to the bone, trying their best. When could they have time to have the private practices people suggest?
=============================
I assumed that you saw this going on in this decade? Right? So we are talking about this decade right?
Has it occurred to you that these doctors have had three years of clinical experience, when they have been helping to manage patients BEFORE they became doctors?
Do you know that in their training that they have had MORE clinical experience, more “hands on” training and MORE responsibility for patients, than the US resident in his first year?. In fact the US year 1 resident is really what we call an intern, but with much less experience than one of our interns.
Furthermore in our system, one must finish internship BEFORE one can start training to be a specialist. In our system a junior doctor has had four years clinical experience before he can think of starting to do specialty training. That is two more years training than in the US. Do you know any of this?
The US starting resident is not up to the standard of one of our interns in experience or clinical acumen. OK? I teach medical students in their system, so I know what I am talking about. OK?
I hope that the above answer helps answer your question “How many of the junior doctors who work in the QEH are recently graduated interns as opposed to residents in various stages of specialty training.”
Now you write in your abysmal ignorance
In other parts of the world it is the training residents who ‘run the show’….not interns and there is a big difference. Good point ColumbUS- not Colombo.
Now learn :.
In our system it is the Registrars that run the show by supervising the interns. Many of our Registrars are to the level of Consultants in their training OK?. They are not consultants because they are no posts available. In our system we call these relatively senior doctors, junior staff also because they are not Consultants. It was probably them that you saw coming in and out briefly, because they are supervising work on a number of wards. Some of them are in effect “consultants who pop in and out” OK?.
It is indeed universal for patients to be seen according to an HIERARCHY starting with medical students and well trained junior doctors in the British system or barely trained residents in initial or various stages of specialty training as in the US. Consultants are called when they are needed. OK?. This is the case all over the world.
Re high level patients need high level trained care. What does that mean? What is a high level patient? The Governor General? The PM?
Acutely ill patients are monitored more regularly, usually by highly trained nursing staff all over the world, under the supervision of doctors. You want a Consultant to come and watch over your momma, and hold her hand?. How will that help? What about the other patients. Doctor sees the patient. Hopefully he makes the correct diagnosis, orders the right treatment. Hopefully it is available. THEN YOU PRAY! GOD DOES THE HEALING! Not the doctors!
Intensive care units for adults and premature babies are run by juniors (interns and registrars in our system) who are barely trained in subspecialty care. [ In the US it is done by barely trained residents in initial or various stages of specialty training OK? ]
Do you know THAT COMMON THINGS ARE COMMON? Does that make sense to you?
If it does it might just facilitate your ability to understand how juniors can perform well in caring for your so called ” high level patients” and give “high level care.” In training you see it over and over so you can do it in your sleep OK?
This is possible in our system because in their training our doctors have had more exposure in time than US doctors get in their training. Oh by the way I teach at US offshore schools, and I have also seen the system work up here.
Re It may be useful in the investigations and fixing of the QEH that a closer look at the ‘junior doctors’ and how they work relative to the Consultants. From where I sat next to my mother’s bed, something just is not right.
What is it that you want fixed Mr/Ms Think you Know? How do you know the level of knowledge or competence the doctors you witnessed have? Did you examine them at finals? Being an obvious medical illiterate how would you know if something is right or wrong?
I hope you have learned a bit today.
David // July 11, 2008 at 5:50 pm
On the very critical questions posed by Trained Economist we can partially say that the days of the ‘civil servant’ or the ‘government’ worker must come to an end. No longer can this mildew Human Resource practice be allowed to compromise the efficiency of how our government entities are run. Very applicable in the case of our statutory boards. This is especially true with the QEH which is not only charged with the burdensome responsibility of delivering healthcare in the modern era but MUST do so by being held to account for the enormous slice of the national budget which is consumed by health.
The days of managing our QEH cannot now be done with the old management approaches. ACCOUNTABILITY must be the order of the day. It is against this background that the HR must be rewarded but they must also be held to account. The option to terminate employees at the hospital for non-performance or incompetence is expected. More relevant to the discussion is the importance to have competent skills on board at the QEH. In this regard when we examine the resume of the HR practitioner who is under fire we are forced to ask the question: What special competencies recommend this lady to the job?
Georgie Porgie // July 11, 2008 at 6:02 pm
@Barnabas Collins
The QEH was opened in 1964.
The doctors do not run the hospital- at least not QEH. Doctors work at the hospital- but doctors don’t run QEH. Doctors run Bayview Hospital though.
When I was an intern the Sisters were in charge of the wards. Unfortunately, these experienced nurses have retired or died; and those whom they trained have probably migrated. QEH is suffering because we have lost many of our nurses. I learned a lot from the nurses as an intern; especially in Labor Ward.
I tell all my medical students, “ When you go on the wards respect and listen to the opinion of the nurses. They have seen a lot more than you have. They may just have something to teach you.”
BC: A higher accountability must be expected of both Drs Estwick, and Walcott, because they should better be able to identify needs than those who are non medics. They ought to be ahead of the game.
Change can indeed be effected without problems. That’s all I am hearing. Culture this and culture that. But I have not yet heard a plan to change anything. All I hearing bout is people being fired, new board, and lots of noise.
Man if I am in charge of anything for five years and I have a free hand, it will change…… and as you rightly say with thought, ingenuity and lots of prayers.
Bush tea // July 11, 2008 at 6:08 pm
Man GP, you share licks enough in Bush tea!!!.. …thanks to ‘real thing’ for trying to pull yuh off o’ muh -yuh hear!!!
…. the only other blogger that hurt the Bush tea so badly was MME with his twin otter analogy… I still taking a special brew to get over those licks…
…but when all is said and done, you will discover, in one of your more reflective moments, that when it come to management analysis and effectiveness, Bush tea is is well brewed…
Your error stems from your inherent good nature. As I have always said, apart from your propensity to attack graduates of the hallowed university at Waterford, you are obviously a good person and a good doctor.
This anomaly on your part causes you to presume that most doctors are like you…
The rest of us know that most doctors are doctors because -you get to drive a Benz, you hardly pay taxes, you live a life of luxury and you get lots of other fringe benefits….. OH, you may also save a life here and there…
Now the QEH depends on doctors to operate at a high standard. HOWEVER, the QEH can never pay the kinds of salaries to match those that can be made in private practice. We therefore allow doctors to do both jobs simultaneously.
Where do you think that their priorities will lie?
From the Board’s point of view, its focus is on the doctors HOSPITAL duties, but it cannot compete with renumeration….
Can you see difficulties brewing?
Now you want to solve this by ‘listening to ideas’? By medical analysis?
Do you think that any doctor will admit that he neglects his duties because ‘IT DOES NOT PAY HIM TO DO OTHERWISE?’ …..people are not like that, all kinds of distractions will arise… constant war and rumours of war.
What we have is a systemic problem. Whoever the players, the problem will persist.
Again, Bush tea’s solution – Radical systemic change.
1 – Disincentive for highly profitable private medical services (High taxes in their behinds)
2 -High pay for efficient and effective expertise in the public facilities – partly funded by these taxes
3- …and an industrial court to ensure that when unions flex their muscles it is for legitimate causes.
Trust me GP, this will work like a dream… but the Doctors (who own the clinics) won’t like it, and the Union don’t want no court to stop their bullying.
The ONLY way that such change is possible will be through a personality such as the goodly Doc Estwick….. Committed, Strong, Fearless and more i’grant than the saboteurs…. a man after Bush tea’s own heart in terms of relevance and suitability for the task at hand.
…now, can we get back to polyclinics – where you have an extremely strong case?
ROBOT // July 11, 2008 at 6:12 pm
when I heard that Estwick had been given the HEALTH portfolio , I said uhmnn !, david th-o-m-p-$ON really setting up this man to fail because Q E H and SSA gwine squeeze this man to failure.
it is suspected that estwick is not a favorite of his leader so putting estwick in health was a strangletegic move.
Georgie Porgie // July 11, 2008 at 6:18 pm
David
You are absolutely correct when you opine that “On the very critical questions posed by Trained Economist we can partially say that the days of the ‘civil servant’ or the ‘government’ worker must come to an end. No longer can this mildew Human Resource practice be allowed to compromise the efficiency of how our government entities are run.”
But remember that delivering healthcare does not only mean hospital care. We must seek to take care to the periphery. Too much stress is put on the hospital. I know that that is a big part of our culture and tradition- running to the hospital for everything.
Re “being held to account for the enormous slice of the national budget which is consumed by health.”
I have always thought that our very poor parents and the single mother who sold sweets long side the road were able to manage their budgets; but highly educated and trained politicians and civil servants can’t manage the public purse just because it is not their money. Ideally, all public servants should try not to waste and to treat the people’s money as it was theirs.
I agree with you too when you write “In this regard when we examine the resume of the HR practitioner who is under fire we are forced to ask the question: What special competencies recommend this lady to the job?”
Do you know it is easier to fire a doctor in the public service than a maid? All you have to do is not renew his one year contract. You cant easily get rid of an appointed civil servant. And I continually read the myth on this thread that doctors run the hospital. That is bovine excrement.
Georgie Porgie // July 11, 2008 at 6:58 pm
Bush tea
Thank you for your kind remarks and your magnanimity despite the licks I had to put in you in case you raise your cawmere head too much. LOL
I agree that the QEH depends on doctors to operate at a high standard. And it does. But we do have good junior doctors and registrars i am sure!
I agree too that the QEH can never pay the kinds of salaries to match those that can be made in private practice. Remember that doctors work in hospital and in private practice simultaneously elsewhere.
The solution to the dilemma you are posing might be to bite the bullet, and promote the senior registrars with consultant qualifications and give them more pay for a five year contract, while you phase out the uncooperative Government Consultants. You cant touch the UWI consultants though.
I don’t like no board of medical illiterates Bushtea.
And I don’t think the focus should be on doctors. Other hospital workers are involved in hospital care. A lot more has to be fixed than the Senior doctors, man.
Bushtea you got to listen to ideas, because you might got some bright sparks like me with good ideas to help you think!
Bushtea you need to analyze to set up your game plan in every game. I want to get a century on the first day of a test in which I open the batting. I want to be 33-40 at least by lunch. 66-80 by tea.
That’s why I said if Estwick devised the plan I gave JC last night, he would have a major plank of concern to the public covered- accident and emergency or casualty and without keeping noise. But every body missing that.
All he had to do is set up bout 20 similar plans in January, and now he could most of his time on Burke’s beach or Browne’s beach!
When I teaching and I know I have to give an exam every four weeks and one final exam. Before I go into lecture 1, I got 3-5 questions in a file called exam 1, and 2 questions in a file called FINAL EXAM complete with the key. If my lectures not prepared four weeks I advance I want to panic
Back to your systemic problem with persistent problematic players. I don’t have no problem with radical systemic change, cause I am a rebel- always was .
1 – Disincentive for highly profitable private medical services (High taxes in their behinds) That is counteractive. Highly profitable private medical services MIGHT indicate that good medicine is practiced there (or that the people think so) That is not undesirable. LET THESE GUYS STAY IN THEIR PRACTICES FULL TIME. AND HIRE MEN TO DO HOSPITAL WORK FULL TIME AS I MENTIONED ABOVE.
Also fellas aint going to work to pay your taxes. They will migrate.
2 -High pay for efficient and effective expertise in the public facilities – partly funded by these taxes NOT NECESSARILY THE ANSWER. WHO WILL MONITOR THE STANDARD? THE PATIENTS? WHAT DO THEY KNOW?
3- …and an industrial court to ensure that when unions flex their muscles it is for legitimate causes. WELL THAT MIGHT WORK
Bushtea, you can be committed, strong, fearless and more i’grant than the saboteurs, and beat them with out keeping noise.
I planning right now to destroy a man medical school before he get off the ground cause he think I am a monkey. (He offering me peanuts). Here is a black man offering me half what the white man paid me and want me to do twice the work. I am not arguing with him. I see that his aim is not excellence, and I abhor bogus medical schools. I aint gwine pick my tooth.
JC // July 11, 2008 at 7:33 pm
GP you have really brought a serious set of ideas that would work!
I hope that Dr. Estwick listens to David, Bush Tea, and GPs’ advice.
With my fingers crossed I really am hoping for my friend’s sake and all Barbadian’s sake……….
ROBOT // July 11, 2008 at 8:03 pm
That is bovine excrement.
—————————
w t f
is bovine excrement.
man speak to me in a lingo i understand
Georgie Porgie // July 11, 2008 at 8:08 pm
bovine excrement = bull shit!
bos, bovis = cow or bull in Latin
bovine= pertaining to a cow
now you can use it too LOL
Barnabas Collins // July 11, 2008 at 8:43 pm
GP…….Thank you for the info. We will wait and see what happens at the QEH. I am not sold on “because you are a doctor that you can manage the QEH”. It reminds me of WI cricket “because a man played 116 tests, he can coach, manage or know about cricket”. But I will wait and see what happens!!!
BC
Georgie Porgie // July 11, 2008 at 8:51 pm
BC
If you check earlier on I said that not all doctors can do anything else but do medicine. Some cant manage anything else. So I know that all doctors are NOT capable of managing the QEH.
But technically doctors should BETTER KNOW what is involved.
boredickey // July 12, 2008 at 1:36 pm
Having lived abroad for a considerable amount of time, I know that every hospital has its problems and one must wait a long time when seeking attention . However, this is Barbados the little rock on the map and most people can’t take a plane and seek medical attention elsewhere. We have to make things right at the QEH because its all we have. I am not interested in all the fancy talk and how much someone knows about the system.We live here and its up to us to get it right. The QEH is as unavoidable as death is inevitable. The institution should be a-political.You dont need to be a doctor to be Hospital Administrator, COW Williams is no Barbados scholar. It seems to me that the NUPW and others within the hospital want to do as they like and I’m opposed to that. I voted for the DLP for many reasons. One of them being to get this country – that I love more than the USA- back on track. Dr Estwick is the Health Minister and I therefore trust his judgement and give him my support as I feel all people who love this country should do. You might not like his style, but I remember living in NYC when former Mayor Rudolph Guliani was not liked either because he had to get rough and tough with New Yorkers. The city was over=run by the criminals; crime was rampant; 42nd street was where you could buy anything. Guliani cleaned it up using unpopular methods. Being a nice guy sometimes is not always good. Jerome Walcott seemed to be a nice guy, but he came across as being soft. This QEH case needs a new approach ruthless as it might be. Dr.Estwick needs all of us behind him, because it is for the benefit of all your family and mine. Georgie Porgie, you seem very brilliant but last Feb.15th we kicked out a bunch of brilliant guys from government whose brilliance have left a sea of debt. You do NOT live in Barbados;we have to deal with this. You stay there, make your money. I live here and care more about the country than hoarding more and more money. One illness can wipe you out, and furthermore, I have never seen anyone take a dollar with them into the grave. Urge those you know within your proffession to support Dr.Estwick and then give a critical assessment five years down the road, I implore you. Thank you.
Anonymous // July 12, 2008 at 3:50 pm
what is the real problem at the hospital
is it that people cant get rice and sugar to thief and carry home ?????
is it that people have been restricted from using hospital equipment to do their private work and they get vexx ?????
is it that people playing the yardfowl game and looking to punish non conformers ??????
what is the real problem at the hospital ??????
David // July 12, 2008 at 4:12 pm
One of the planks upon which our friend GP seems to have built his argument, to his detriment we might add is his anticipation of Doctors closing rank.
Now Doctors are suppose to be intelligent by the very nature of what they do, at some point in the history of the QEH Doctors must come to an understanding that they are part of the problem and therefore must become part of the solution.
The Doctors have a responsibility to save lifes by delivering the best healthcare. part of that responsibility will be to work with government to dismantle the culture of inefficiency which is inbred at the QEH.
On a side note GP we understand that it has become fashionable for Doctors nowadays to avoid the signing on to the Hippocratic Oath!
Georgie Porgie // July 12, 2008 at 4:17 pm
Boredickey
Your post is another emotional rant that does not address the issue at hand.
In response
1- I agree that every hospital has its problems and one must wait when seeking attention
2- I have advanced a partial plausible solution to solve the problems on our little rock . No one has asked for amplification of my ideas or sought to modify my plans except David & BushTea. Everyone else has continued the emotional rant.
Believe me. I do understand that sick folk can be very anxious while waiting- mainly because they don’t have any idea of their problem. I do understand too that sick folk often get angry when health care personnel seem a bit slow or not so in a rush to help them. BUT….
Have you thought that having heard your initial complaint that they know the prognosis is not so serious? or not as serious as YOU THINK? Have you thought that since COMMON THINGS ARE COMMON that they have seen it all before?
Have you thought that many folk in ER’s ought not to be there, but at a more suitable clinic for their situation? Do you realize that our folk often burden the QEH ER because that is our traditional response, even though we have a number of free peripheral clinics all over the island?
The plank of my proposals is to improve and expand the service at the peripheral clinics, in order to reduce the load at the QEH to REAL medical emergencies; NOT WHAT THE PUBLIC THINK IS A MEDICAL EMERGENCY.
3- Can I get it into the heads of my people that health care does not necessarily = care at QEH? Can I get it into the heads of my people that we have more than the QEH (although the Bee’s let the vandals tek over the revamped St Joseph Hospital.)
Can I get it into the heads of my people that health care does not necessarily involve doctors only?
4- Cant you understand that you have to understand our system, in order to fix it? For example do you understand that our tradition to run to the Casualty for every scrape and bruise is nonsense, when you can go to your nearby polyclinic for many things? Do you understand that this is one of the first and easy things the MOH and the people can address without spending one cent?
5- IT IS NOT TRUE that the QEH is as unavoidable as death is inevitable.
Do you know that UWI personnel have been seeking to carry heathcare to the mases since the 70’s?
6- You may not need to be a doctor to be Hospital Administrator, but you need to be trained! Are any of the Board members trained? If so, how many?
7-. COW Williams is no Barbados scholar, but he is in CHARGE OF HIS BUSINESS and he is focused. He does not have a lot of fools making decisions that matter.
He is sucessful because HE HAS A PLAN!
8- Neither the NUPW or others within the hospital should be able to do as they like
9- Dr Estwick is the Health Minister and you trust his judgement. That is your right! I also have the right to say that I think he is a loud mouth failure. Unlike you I have brought ideas to the forum which you yourself consider to be very brilliant. And I only making sport pun de forum. Our highly paid minister that you voted for has done nothing in six months. Ah lie?
10- Don’t you think that I love Barbados too?
11- I don’t like the ministers style or his apparent ineptitude.He can not do the job.
12 Mr Boredickey, you have insulted me big time by mentioning me in the same breath, on the same line, and in the same paragraph as the asses you call brilliant that you kicked out at the last election. If they were truly brilliant they would have done a good job with out the stealing.
Truly brilliant folk know that you cant take more out of system than what is in the system. Hence the inordinate debt. My solutions will not incur any debt.
13 Skipper I scrunting like every body else. I am now virtually a pauper because of the way the BLP treated me. But I still have my brain, and I have offered reasonable solutions. If you will forget the emotionalism and patriotism and read, mark, learn and inwardly digest what I have written, you will see.
I do NOT live in Barbados because I am in exile!
14- If you have read my post well, you will have seen that I went against my professional colleagues in 1985 when I made my proposals for the running of the NHS via the polyclinics, when the profession were fighting the BLP government on the implementation of the NHS.
15 I cannot support Dr.Estwick until he presents a plausible plan.
Why should I wait five years down the road to give a critical assessment? Do you know how many Bajans will be dead by then, because he is impotent?
HE HAS DONE NOTHING IN SIX MONTHS EXCEPT KEEP NUFF NOISE.
Georgie Porgie // July 12, 2008 at 5:25 pm
David
You guys seem to not to be reading or comprehending.
Please read my posts again with an open mind.
One of the things that you do not understand is that I know some of the fellas in Barbados better than you do, and I KNOW they are capable of closing ranks. In mid 1985, I had men that I did not know calling me and advising me not to support the Government proposals on how the NHS should be implemented. The doctors voted then almost to a man not to support the Government proposals as written. With an election approaching, and having promised at the 1976 election to implement a National Health Service, the BLP government of the day partially adopted my ideas to run the NHS via a series of polyclinics.
The planks upon which I build my argument is NOT that the doctors will close rank but THAT you must have a PROPER PLAN with
1- immediate objectives
2- short term objectives
3- long term objectives
For each project you must have such a plausible practical plan.
I have also outlined ideas of how to overcome and outwit and replace PROBLEM PERSONNEL as needed.
I agree with you that as part of their responsibility Doctors will individually attempt to deliver the best healthcare that they can give whether they work in the public or private sector. Doctors also have the responsibility to co-operate with government via the Public Health Department to help maintain certain standards e.g reporting communicable disease.But doctors don’t have no responsibility to work with government to dismantle the culture of inefficiency which is inbred at the QEH.
What I discern is a lack of trust and respect for the local doctors, and the standard of health care by folk who know no medicine, and by folk who are emotional. I also discern that people are so biased that they are not LISTENING!
I can not get you folk to understand that there is more to healthcare than the hospital doctors and the QEH.
I can not get you folk to understand that doctors do not run the hospital or the polyclinics. They have to follow certain directives from the ministry of health
I can not get you folk to understand that doctors don’t control the training or availability of nurses- a crucial plank for healthcare.
I can not get you folk to understand that doctors don’t control the availability of radioiodine and a lot of things.
I can not get you folk to understand that we cant have a proper health care system without a proper plan.
I have failed miserably! I give up! But I tried to educate the forum.
Re On a side note GP we understand that it has become fashionable for Doctors nowadays to avoid the signing on to the Hippocratic Oath!
Why should anyone sign this nonsense -http://members.tripod.com/nktiuro/hippocra.htm
What I agreed and swore to at UWI was much more meaningful and relevant.
David // July 12, 2008 at 7:44 pm
@GP
We understand you too well don’t worry. But at the root of solving many of the problems is if BAMP shows leadership. As we write this comment the Doctors at the hospital have called on the CEO to resign and they have demanded explanation as to why the medical insurance was changed by the new board.
The beat goes on!
Georgie Porgie // July 12, 2008 at 8:02 pm
David
I tell you man you cant depend on BAMP.
I circumvented BAMP in 1985, and the BLP implemented the NHS from the polyclinics.
Estwick has to find away of doing that again.
David // July 12, 2008 at 8:20 pm
GP we were waiting to hear you say that all the doctors need to join one union. We have the junior docs in NUPW we think. Some of the other docs in BAMP. The nurses in NUPW, and we believe there is a minority membership in the BWU.
Boy the QEH is confusion. No wonder GP had to run!
Georgie Porgie // July 12, 2008 at 8:29 pm
I agree with you that BAMP should show leadership.
That is why in early 1985 when I wrote PM Adams and when I confronted Vic Johnson I said to them ” Why is GOB fighting with the doctors about the NHS? This is what must be done.”
I guess I was a little young rebel then when I confronted the PM and told him what to do.
BAMP should be able to tell GOB what should be done, and how they will participate. But that will not happen. They will close ranks I tell you.
So as my mom will say YOU GOT TO EASE YOUR HAND OUT OF THE LIONS MOUTH fellas. You got to be as harmless as a dove and as wise as a serpent.
Georgie Porgie // July 12, 2008 at 8:51 pm
David
The docs used to be all in one union-BAMP.
Is it really true that the junior docs in NUPW now? Very interesting. If that is true, that makes sense. Junior doctors (mainly interns) are in a unique situation. They must work because they must complete their internships to get full registration. Without full registration they cant enter post graduate training etc. Guess who determines if they get full registration? YEP YOU GOT IT! THE CONSULTANTS!
GP’s and doctors in private practice WILL NOT STRIKE cause they will lose money. They are in BAMP for other reasons—like medical insurance better mal practice insurance rates etc..
Being in BAMP does not help the junior docs. Consultants always urge juniors not to strike The consultants don’t want junior docs to strike. Who will look after the consultants’ patients in hospital during a strike?
BAMP as you can now see is not really a homogeneous body. And I see that the QEH in more confusion than ever, it seems.
That is why we need the MOH to have a great plan that will captivate the junior’s because they are essentially a captive set of workers. The fact that the doctors are more heterogeneous is in his favor.
David the solution demands an understanding of the system. It is not as hard as you think! Honestly!
From your post I see a wedge that the MOH can use. Very interesting.
Anonymous // July 12, 2008 at 9:09 pm
We does take ourselves real seriously pun these blogs. You think estwick here reading BU to find out what to do next? If this GP fellow feel he got answers why he dont write estwick and tell him what to do? and this exile talk sound fishy. I hope GP ain’t on the run from the law.
Gapp // July 12, 2008 at 9:10 pm
David Estwick I am behind you 100% and do not relent… We are depending on you to deal with the QEH.. Lizz made a mess of it.. Jarome well I not sure what he did while he held that post the only thing I can think of when i hear his name is that porn woman in the morgue… anyway The people on this island sometimes amaze me .. them complaining about the QEH and cant get abc done the A&E this and that but now its time to make wrong things right them getting in the way.. I am a man behind the Trade Union Movent.. I have even been the Union rep for my company at one point but this time i gottah brake ranck with the union.. the Hospital is too important too the well being of Barbados.. “Estwick do what you got to do”
Georgie Porgie // July 12, 2008 at 10:30 pm
@ Anonymous
I don’t give two hoots if Estwick reads BU or not. I read BU! And I have stating my view on BU!
You think Estwick is Moses? Or his Antitype Christ?
I don’t FEEL I have answers I KNOW that I have answers. I had answers in 1985 and my ideas are working up until today. I have ideas today too. I have revealed some. Do you have any?
How do you know if I have written, who I have written or when I have written?
If you cant understand what I have written, why do you suppose that Estwick will understand if I did write.
Why do I have to write Estwick or anyone and tell him what to do? Is he not paid to know what to do.
I have colleagues that will see my family for free? Do you?
I am not going to bow or bend to beg Estwick to try to help . Why should I?
I hope to go help run a new offshore medical school soon, God willing.
I am trying to make a contribution hereon the forum, and trying to explain certain things and you talking bovine excrement because you have access to a PC and to the internet, and because you are not literate enough to understand what I have written.
People of your ilk suspect every thing. Why cant you believe that I am in self exile. Why should I be running from the law? I had to run from the BLP oppression.
I had my scholarship. I was not bonded. Yet I served my people faithfully for 20 years everytime I got the chance in many capacities, until the BLP felt I should not work in Bim! I don’t owe the Bajan public anything man.
@Gapp
You can stand behind Estwick100%.
You can depend on him to deal with the QEH.
You can engage in emotional rants.
You can shout “Estwick do what you got to do”, “and do not relent” as much as you like, but when the fellas close ranks quietly as they are doing, his balls will get squeeze. Watch and see. If and when the men close ranks, Estwick cant do a thing.
Estwick has to outfox and circumvent who ever the trouble trees are!
Again in your statement “the Hospital is too important to the well being of Barbados” you demonstrate the myth that healthcare is all about the QEH..”.
What happens if the men borrow money and build other private hospitals. We already have private ER’s.
Estwick vs BAMP. That sounds like fun.
The youngsters may not be like the lads in my day.
They may engage in emotional rants like you guys and strike.
David // July 12, 2008 at 10:42 pm
GP don’t despair we know for a fact that the very important people read the blogs:-)
boredickey // July 13, 2008 at 12:42 am
@ Gapp. My feelings exactly.I’d like to know the relationship between Dennis Clarke and the HR woman involved.Hmmmmmm!GP. The current CEO Winston Collymore was recruited under the former hospital board, from London where he was involved in hospital administration there. This as far as I can remember. So the baker can’t run the bakery. The current board are well qualified men, I say give the board and Dr.Estwick a five=year chance please.Right now the Dr. is fighting an octupus against change the back of which must be broken. I voted for the DLP not NUPW or Dennis Clarke or BAMP.If I have any suggestions I will write the Minister.This one I’ll give him here though! “Kick Butt man!”, change must come.
JC // July 13, 2008 at 7:01 am
GP all your ideas are workable I think we need you back here amongst your own ‘we need persons like you more than ever’
You make me feel proud to bajan and that is the truth!
However, I still like Estwick’s style but if you combine the two of you, Lord have mercy, I would go to QEH smiling, happy knowing my friend is in capable hands!
I agree with David importnat people read the blogs, they will send the message,
I hope Estwick listens ……..
Wishing In Vain // July 13, 2008 at 9:54 am
David // July 12, 2008 at 10:42 pm
GP don’t despair we know for a fact that the very important people read the blogs:-)
Including the PM my friend.
Winston Collymore // July 13, 2008 at 10:11 am
UNDER FIRE
Published on: 7/13/08.
The Queen Elizabeth Hospital’s chief executive officer Winston Collymore.
by SANKA PRICE
BAD MANAGEMENT is one of the major causes for the decay of patient care facilities at the Queen Elizabeth Hospital (QEH), say doctors.
But they contend this rot can be stopped if the QEH’s chief executive officer Winston Collymore is removed.
The Barbados Association of Medical Practitioners (BAMP) stated this yesterday in a Press release issued to set the record straight on the continuing industrial unrest at the QEH over the last two weeks.
In the release, the doctors said they were committed to ensuring the well-being of the public and pledged they would redouble their efforts to remedy the QEH’s ills and restore confidence in the institution. But to achieve this, Collymore must go, they say.
They stated that despite BAMP’s executive holding several meetings with Collymore there had been “no real measurable success in outcomes or noticeable improvement in the day-to-day function of the hospital”.
“It remains our opinion that the CEO has been ineffective in his capacity to manage the affairs of the Queen Elizabeth Hospital and once more ask for his replacement,” said the statement which was signed by BAMP’s public relations officer Dr Abdon DaSilva.
Unanimous opinion
The release said this was the unanimous opinion of the BAMP meeting held at the Martindale’s Road institution on Friday, July 4, where “members expressed overwhelming dissatisfaction at the performance of the CEO of QEH”.
BAMP also took issue with the “unilateral” manner in which the hospital’s management switched insurance coverage from the Medical Protection Society (MPS), the leading provider of comprehensive professional protection, indemnity insurance and expert advice to doctors, dentists and health professionals around the world.
The association said it did not support the notion that doctors at the QEH or any other individual should, or must agree to the terms of an insurance policy because they consent to having their employer select their insurance coverage.
“Furthermore, the exclusion of insurance coverage as it relates to HIV/AIDS regardless of the reason is particularly worrisome and bodes of institutional discrimination and stigmatisation of people living with HIV/AIDS, and individuals infected with non-Hepatitis A.
“BAMP is not convinced that the board’s interest in containing costs justifies the compromise in insurance coverage for doctors such as the loss of help with ethical problems that arise from professional practice, complaints, medical council enquiries, legal and ethical dilemmas, disciplinary procedures, inquests and fatal accident enquiries.
“These issues are particularly challenging given the continuing “stock-outs”, a persistent and long-standing depleted (X-ray) radiology department, a recent shortage of diagnostic equipment in the respiratory unit, and the excessive delays in the Accident & Emergency Department,” the release said.
Georgie Porgie // July 13, 2008 at 2:04 pm
@David and Wishing In Vain
I am glad that very important people read the blogs including David.
@ JC
Thanks for your kind remarks I would dearly like to be home amongst my own more than you know. But we don’t like rebels in Bim.
I don’t think I could work with Estwick , cause he keeps too much noise. I wont be able to think.
@ boredickey
You seem to think that “The current CEO Winston Collymore was recruited under the former hospital board, from London where he was involved in hospital administration there…… The current board are well qualified men.”
It seems that the doctors don’t agree with you sir.
All of BAMP cant be wrong on this one.
If he must go in the interest of the health of the people as BAMP thinks, seems to me there should be a compromise here. CEO Winston Collymore must go. He cant run the board and he cant doctor either. Bye.
If we give the board and Dr.Estwick a five year chance, things will be worse at the rate it is going. The DLP comes and goes; BAMP will remain whether you vote for them or not.
What suggestions of consequence you can have to send the minister what? What s “Kick Butt man!”, change must come what?.
Note this Bible story and see if you can find sense in it.
Wicked Pharisees brought a woman alleged to be an adulteress.
They seem to have the Master on the horns of a dilemma, because they have the correct charge under the Law and she is indeed guilty..
If he say don’t stone the woman; they will say “you don’t keep the law.”
If he says stone the woman; they will say “ You don’t exhibit the grace and mercy you profess to have.”
These guys are like some of you. You commit the fallacy of the unexcluded middle. You think its EITHER/ OR. Its this or that. Its not to be the old way; it has to be Estwick’s way. I’m saying that there might just be an alternative way. They might be other ways.
What did Jesus do? He quickly get into position, and played a master shot that eventually caused the case to be thrown out for lack of witnesses, and didn’t condemn the woman because he knew he was going to the cross to take her condemnation.
What must Estwick do. Quickly get into position, and QUIELY play a series of master shots like Chanderpaul. And he will get the job done.
You guys must leave out the emotion.
When the Ministry asks you to respond, then you must respond.
You get worked up about the hospital, but do you dump irresponsibly in our beautiful gullies, and affect our water courses?
You get worked up about the hospital casualty, but dont you clutter it up when you can often go to the polyclinics for the same service.
If the Ministry should ask you to put out your garbage in different colured plastic bags or containers on different days so that we can help the recyclers help Sanitation reduce the garbage that goes to Mount Stinkerro, will you obey, heed and cooperate?
Do you comply with the request of our Public Health Inspectors? Do you parents/ mothers cooperate with the instructions of the midwives and visiting public health nurses? Are you aware of the great job they do in child health care and obstetric health care?
Will our school teachers help the MINISTRY OF HEALTH brain wash our people from tender ages in what are the nation’s goals for health care.
These are just a few of the ways that the public at large can help the MINISTRY OF HEALTH and the Minister, instead of inciting a foolish sounding man to do foolishness.
Georgie Porgie // July 13, 2008 at 2:08 pm
My Dear BU DAVID
Re :UNDER FIRE
Published on: 7/13/08.
The Queen Elizabeth Hospital’s chief executive officer Winston Collymore.
by SANKA PRICE
Now I will help you whip my colleagues when they err, because to err is human.
However, according to the details in the post from the public announcement in the newspaper by BAMP, I am forced to side with BAMP.
If the guys want these few things sorted out to make them happy. compromise with them and do it. WHAT WILL THEY BE ABLE TO COMPLAI ABOUT AFTERWARDS? They requests as mentioned are reasonable.
Georgie Porgie // July 13, 2008 at 2:11 pm
Oh I forgot in my comment on JOhn 8 above.
Dont we Bajans still believe that THERE IS MORE THAN ONE WAY TO SKIN A CAT?
JC // July 13, 2008 at 3:00 pm
I myself can considered to be a rebel and I am not going anywhere GP!
Come back home WE LOVE REBELS!
Georgie Porgie // July 13, 2008 at 4:17 pm
JC
Have you ever took on Mia Owen or Liz?
JC // July 13, 2008 at 4:35 pm
Nope not yet I assumed you have; and knowing by your syance you gabe them hell; actually I am now starting my career;
As for Mia SHE nearly took me on lol
A day I was walking by and that woman dropped a comment at me that I thought was DISGUSTING!
she really wanted to take me on. lol
David // July 15, 2008 at 7:11 am
Some members of the BU family would have heard resident health expert refer to the semblance of a plan for health Barbados. For those who would have wondered what he is talking about here is the link.
Georgie Porgie // July 15, 2008 at 11:27 am
David
If you review the comments made as far back as February on the posts associated with the link you posted you will see that the BU MOH presented to the nation his IMMEDIATE PLANS for the QEH emergency issue by suggesting how we could decentralize emegency care and try to involve the public sector in the deal. There is no war or cussing any one in the process.
If we on BU can preseht reasonable plans to the people, where is the GOB that we elected?
We can understand that the opposition cant comment on the above because they didnt have a clue in the 14 years they were in power.
JC // July 15, 2008 at 3:42 pm
I really hope that they are listening to you GP. I really do!
David // July 15, 2008 at 6:23 pm
Not sure if BU family heard the news today but BAMP doctors have refused to meet with CEO Collymore. The crap continues!!!
Georgie Porgie // July 15, 2008 at 6:40 pm
It is easy to see that once all these clinics (some as yet unbuilt, and perhaps a few others) are erected and functioning according to the specifications noted in my posts of February, that there would be no need for Bajans to be crowding up the QEH ER.
It is easy to see how the patients of Private Physicians could benefit from the clinics in the respective catchment areas, and how it might be possible for them to even participate in their activities and services.
It is obvious that in each catchment area there are other services that are needed- such as satellite ambulance stations. These might be close to Fire Stations or Police stations or Anglican Churches. Why? The wise first Bishop of Barbados had chapel of eases built in each parish close to the points of the compass for each parish. This is not a hard and fast rule here.
Ideally each catchment area should have 2-3 ambulances for that catchment area. Such an ambulance will GENERALLY travel from station to pick up point and to the closest polyclinic only for triaging. Roving ambulances will travel to the polyclinic to pick up patients who need to be transported, so that the ambulance coverage of the catchment area should not be compromised at any time. .
FYI & BTW I sent these ideas to the power that be in early January. I got no response.
I am not very smart. I am not the exalted and elevated MOH. I am actually one of the least of the apostles. Don’t you think that if I could come up with these stupid ideas. That the more brilliant fellows could do better?
Don’t you think that if the exalted and elevated MOH has made plans like this in his IMMEDIATE period in January, that six months later in what I would call the EARLY period, some of these things could have been implemented?
For example the MP’s/Ministers/representatives/would be representatives for each catchment area should have held some fetes, done some begging from businesses to raise funds for ambulances for their region? And if they couldn’t get the latest top of the line appliance at least get vans and fit them with basic equipment. Could not more have been done as we advance to wards Jan 13 2009, when we would have reached LONG TERM? At which time we would start again IMMEDIATE LONG TERM, EARLY LONGTERM etc
Georgie Porgie // July 15, 2008 at 6:50 pm
David Thanks for posting the Maps on the old post entitled What should Barbados Government Do About The St. John Polyclinic?
Readers can read the post above along with the maps on that post.
Georgie Porgie // July 15, 2008 at 6:57 pm
David
If the doctors think the CEO is a twit, why should they waste time with him?
I honestly dont blame them.
When I was an intern there were two particularly stupid nursing sisters ; they were definitely not like the big maguffy ones whom you had to respect because of thier efficiency.
When these sisters would come on my rounds I would totally ignore them. I would even address my comments and instructions to the student nurse on the round.
Similarly the doctors are dealing with Collymore, so too do the elected GOB with my silly sugestions posted in BU, and so should the MOH do with any stupid senior civil servants.
Tell me Why // July 15, 2008 at 7:42 pm
When these sisters would come on my rounds I would totally ignore them. I would even address my comments and instructions to the student nurse on the round.
……………………………………………………………………..
Georgie Porgie, you have been making constant points that I was just reading and reading without commenting, but alas! that above statement cannot be overlooked. Although you might have issues with the sisters, you should still show maturity as a professional. How would you respond if the MOH visited the ward and overlooked you as a senior doctor and went to a trainee doctor for information? Professionals work as one once on the job, anything can happen after hours….no fighting please.
Georgie Porgie // July 15, 2008 at 7:59 pm
TMY
Actually I respected the sisters except these two morons. Man I wished you had met those particular sisters. They used to chat cha chat and chat BS!
Also that was almost 30 years ago when I was a youth.I didn’t fight nor did I stay long enough to be a senior doctor. I am just an older washed up doctor now shooting hot air OK?
The MOH is now overlooking my opinion, but you dont see me complaining. I am having fun on BU giving my ideas. But truly if the MOH were to go to a trainee doctor for information that would show that the MOH was not too smart- really! LOL And perhaps the youngster might have the answer. Some of the youngsters are indeed sharp.
Georgie Porgie // July 15, 2008 at 8:05 pm
What I would like to see you guys do is improve on or modify my ideas or advance alternative ideas. That would add to my fun here.
Tell me Why // July 15, 2008 at 8:40 pm
OK GP I understand. Anyway, I would like to ask two questions. Will the hospital ever be without problems? What difference will the present MOH make, especially the aggressive way he is known for and the fighting language directed to doctors?
Georgie Porgie // July 15, 2008 at 9:31 pm
TMY
Of course we will always have some problems at the hospital. We will always have slackers or folk who don’t understand their roles etc; folk who are in the wrong position etc Our goal is to reduce the problems to a reasonable level such that the delivery of healthcare is not compromised too much – irregardless to which political party is in power.
I personally believe that the present MOH will not help himself if he continues to be aggressive and use fighting language directed to the doctors. As I have said before, if he continues so to do, he will sow to the wind and reap the whirlwind.
I believe that the MOH can be successful as I have said along, if he can develop plans which demonstrate that he is on top of things. I believe that this will earn him respect even from the doctors. Then he will have an easy ride.
Going on what I personally experienced in 1993, when I read the Minister’s statement about Brian Charles, I can tell you the ugly, envious bastard in the ministry who is leading the Minister astray on this score. Working in the prisons and the Defence Force is working for peanuts, and it is working for the State, in jobs that few care to do. The MOH has to be cautious of these jokers in the ministry. What moonlighting what?
I don’t think that all is lost. Just as I can present what I think are useful ideas, I believe (and hope) that there others who are capable of giving other practical ideas.
My attitude, as I have stated all along is to try to fix the issues related to the Emergency Room at QEH, and to expand Emergency coverage out to the periphery and continue working to improve this. This will renew confidence in the minds of the populace.
Health care given to folk who can pay is OK.
Once the MOH can get the emergency room issues to function properly, he can breathe a sigh of relief, and quietly get on to fixing the other issues at QEH and health in general gradually.
The more he accomplishes, the more the general public will breathe a sigh of relief, and the PM will be one up on the opposition as far as health is concerned.
MORE POWA FOOLISHNESS! // July 19, 2008 at 9:52 am
Seen In todays’ NATION
MINISTER OF HEALTH Dr David Estwick plans to launch a special forensic audit into the emergency ambulance service.
“How can a building (the Tercentenary School of Nursing) which was renovated for World Cup to the tune of $2.5 million already be leaking so badly that the whole top floor was destroyed?” he asked.
Estwick was speaking to the SATURDAY SUN yesterday after the Democratic Labour Party’s lunchtime lecture at George Street, Belleville, St Michael.
The minister said problems with the building were present before the renovations were completed and the work signed off, which was why he wanted to find out exactly what went on.
The building flooded on June 12 after developing leaks during heavy rainfall.
About 80 workers moved in late last year after complaining about the poor physical conditions under which they were working at the now abandoned building at Enmore, Lower Collymore Rock. (CA)
==============================
Certainly having renovated the Tercentenary School of Nursing to the tune of $2.5 last year, the roof ought not to be leaking so badly so that the top floor is destroyed.
Certainly Estwick should launch a special forensic audit into this matter and also the emergency ambulance service.
But should not a special forensic audit be launched into the matter of his non performamce since being appointed as MINISTER OF HEALTH ? Honestly!