A Vision for Healthcare

In Barbados many think of the healthcare sector has those services delivered by the Queen Elizabeth Hospital and to a lesser degree, the polyclinics. This is wrong. The video provided (16 min) is worth watching to dispel such thinking. As an educated nation in 2013 we need to keep pace with how progressive countries are managing healthcare to deliver a QUALITY result.

Human Cost of Getting Older

Submitted by Charles Knighton

Dr. James (l), Minister of Health Donville Inniss (r) – Image/Barbados Advocate

In discussing the spiralling cost of health care at the QEH, the Nation’s editorial of Dec 13th mentions, inter alia, the ” new development of a lot more older patients needing greater intensive care.” While cloaking itself in a mantle of love for our fellow man, the tragic irony is that among the elderly the struggle against disease has begun to look like the trench warfare of WW1: little real progress in taking enemy territory but enormous economic and human cost in trying to do so.

Our main achievements today consist of devising ways to marginally extend the lives of the very sick. In the war against disease, we have unwittingly created a kind of medicine that is barely affordable now and forbiddingly unaffordable in the long run.  Ours is now a medicine that may doom most of us to an old age that will end badly: with our declining bodies falling apart as they always have but devilishly—and expensively–stretching out the suffering and decay.

This may be called many things, but “loving” does not apply.

Notes From a Native Son: Physician Heal Thyself

Hal Austin

Introduction:
Recently, the British intellectual and journalist, Will Hutton, asked the question: “How do you successfully break a mistaken and destructive intellectual consensus?” It set me off immediately thinking of the cosy social world and the mental processes in which the political, professional and academic elites in Barbados conspire to converge on the same ideas, which are implemented in much the same way, often by the same people – and, no matter which party is in control, they all expect different results.

Two ideas come to mind: the break of the consensus by the attorney general on the silly and ill-advised decision to plant taxpayers’ money in to the Four Seasons project, which he rightly sees as a private investment which should be let to private investors. The other is equally as irresponsible, the decision to build a spanking new Bds$800m hospital in Kingsland. Both ideas are loopy and reveal the poverty of our policy-making, especially when it comes to major capital projects.

First, there is nothing fundamentally wrong with the Queen Elizabeth Hospital, opened to the public in 1963, which competent and firm management cannot sort out. What patients are complaining about are issues such as time-wasting, spending hours before being seen by a doctor in Accidents and Emergencies, of under-productive nurses spending time on the wards talking to each other while surgical patients are in pain and crying out for help, over-paid and arrogant, sometimes even questionably competent, doctors being on the public payroll while spending their time looking after their private patients. The list goes on. So, to the ordinary man and woman in the street, the real problem at the QEH is not the building, although that us falling apart, but what goes on inside the building.

Proposed Location Of New Hospital Announced … No So Fast Mr. Minister!

Submitted by Crusoe

Donville Inniss – Minister of Health

Yesterday we heard the Minister of Health, Donville Inniss, indicate that the site chosen for the new $800MM hospital is in Kingsland. Firstly, I state that I am pleased that Donville Inniss has taken an open approach to the blogs, by choosing to comment. I also think that Donville has a good political future. However, there are issues related to the new hospital and its location, that I wish to highlight, as relevant to all projects.

Firstly, on the point of location, we are told that relevant stakeholders have discussed this, or at least the news report refers to the Town Planning etc. My question is, how can relevant stakeholders be seen to be consulted, when the citizens of the country have not had an input? This is not a canteen at a school, where the head and Board or Ministry can decide. This is an $800 million facility, the only major one, for the country. I am not saying that a referendum is necessary, but certainly town hall meetings and a public panel (we so love commissions and panels) is actually relevant here. Can we see a preliminary report, that demonstrates why the site is suitable as agreed by Government, Town Planning, doctors, the QEH administration?

Barbados Money Class Attracted To Private Healthcare Delivery

Peter Harris

The directors of Warren Healthcare Complex were ‘commended’ by Minister of Health Donville Inniss at its launch earlier this year. In his address he was quoted: “…the state cannot provide all services to all residents and hence it is my considered opinion that we must encourage the private sector to provide services which may or may not be provided in the public sector…”. The report details the players who formed the partnership to make the Warren Healthcare Complex a reality. Although it is not mentioned in the report quoted, BU understands that Peter Harris, one of the principals of CGI – is Chairman of the recently opened Warrens medical facility. The truth be told BU welcomes entrepreneurship wherever it rears it head but we have to be vigilant!

BU has been keeping an eye on how ownership of the private healthcare sector in Barbados has been taking form. Not many Barbadians are aware that then Minister of Health Jerome Walcott bought a 20% stake in Diagnostic Radiology, a company owned by the emerging deep pocket Peter Harris. Of course Walcott has a ‘front man’ who sits on the Board of Directors to represent his interest! Peter Harris we understand owns Diagnostic Radiology Inc; Teleradiology Inc; Emergency Room Inc; MRI Services Inc all key players in the healthcare sector.

To date BU has not been able to uncover any evidence which gives Minister Inniss beneficial ownership in any of the private healthcare facilities in Barbados. This includes The Sparman Clinic. What we have become a little uncomfortable about is the  high number of government radiology requests which originate from the QEH and polyclinics which find their way into the private healthcare system.  BU readers should recall Dr. Richard Ismael’s concern about Dr. Alfred Sparman allegedly being  allowed to poach patients from the QEH. As citizens we have to begin to connect the dots. We are suppose to be an educated people.

Notes From a Native Son – Physician Heal Thyself

Hal Austin

Introduction:
The government has recently announced a plan to spend Bds$800m on building a new hospital. But, like most things it has done since unexpectedly coming to power, it is in danger of putting the horse before the cart.

In principle, as many of you would have known, I am all in favour of a stimulus to keep the economy moving, in fact I am on record as calling for the central bank to print Bds$1bn to feed in to the economy. I believe that this would allow the disgraceful case of Al Barrack to be settled by allowing the businessman a central bank drawdown – of about $250000 a month – better that than nothing.

The only real danger from this liquidity is inflationary, and this can be managed. In any case, it is an issue that should be publicly debated by the central bank, the minister of finance and interested parties. Typically, all we get is silence.

Doctors On The Take

Barbadian expectations were raised when the Queen Elizabeth Hospital (QEH) switched from being a department of government in 2002 to being run by a statutory board. We were convinced by the then government that the autonomy of a board was just what the doctor ordered for the QEH.

Successive governments have had to battle many challenges when asked to manage our premiere health institution.   To read the full-page ad which was placed by BAMP in the weekend newspapers detailing yet another conflict with the Board of the QEH would not have registered on the cognitive index of the vast majority of Barbadians. We have come to expect it. One is left to wonder why the industrial relations climate at the QEH always seem to ring of a discordant note.

Based on what BU has observed over the years the problems at the QEH are many and solutions difficult. The question which has to be asked is whether healthcare delivery is now being compromised as a result of unresolved issues between doctors and Board which have been outstanding for too long. BU’s sense is that there is a hardening of positions at the QEH. According to our sources the junior doctors especially are being asked to work extremely long hours which means there is no work life balance and a 12 hour day is not uncommon.  A spirit of cooperation which was part of a now distant culture has reversed to the detriment of the patient. As if this isn’t enough some in the know believe the quality of Interns entering the QEH in recent times is inferior compared to that of old.

Barbados has always prided itself on its standard of healthcare delivery, the unsettled industrial climate at the QEH over time is beginning to undermine it all.

Are Bajans Jackasses or Jennyasses?

From the Facebook Page of Agyeman Kofi

Hermaphrodite for an ASS called Barbados

Today the following fell off a truck I was driving behind. I seek where possible to bring the facts uncovered without favor or bias. Neither do I hold any quarter or brief for any political party.

A pregnant 15 year old and her uncle arrived in Barbados with a letter from the St Martaan government for admission to QEH. Baby was born with complications and is still in ICU, mother and Uncle fled island leaving baby behind. Unfortunately, no one in St Martaan is returning QEH calls and we now have a child born in Barbados by a fugitive mother and with uncle as an accomplice.

Kidney patient turns with an admission letter to QEH and dies in A&E and no one in his country has come forward to claim body.

Tell Dr. Dexter James There Is A Cancer Drug Shortage

The latest controversy in Barbados is about the Queen Elizabeth Hospital (QEH) running low on cancer treatment drugs and local drug suppliers inability to respond in a timely manner to purchase orders. The CEO of the Queen Elizabeth Dexter James was interviewed in the media on Wednesday about the matter and he was very terse in his condemnation of the Barbados Drug Service as the agency responsible for supplying drugs to the QEH in a timely manner. To be expected they are those who have taken the opportunity to make political mileage out of the issue.

It seems the only hospital in the world that did not know of a cancer drug shortage was the QEH given Dr. James publicly stated position. The 12 cancer suffering patients who need the drugs in question should not have to listen to James pointing fingers at the Barbados Drug Service. Dr. Dexter James should have been aware there is a cancer drug shortage on the world market. Here is an extract from CBC Canada website:

“Cancer drug shortages are forcing Canadian hospitals to scrounge for medication to avoid delaying treatment, CBC News has learned. For weeks, hospitals and pharmacists across Canada and in the U.S. have struggled to cope with spot shortages for about five chemotherapy drugs. Many of the medications are decades-old, highly toxic cancer drugs that kill dividing cancer cells and are mainstays of cancer treatment.

What has been interesting to observe has been the reporting by local media about the cancer drug shortage which has had the affect of stoking an existing debate about changes to the drug service. cbc.ca”

Senator Francis Chandler was quoted in the media recently that Barbadians seem to seek comfort in being controversial nowadays. Here is another example of it.

Leaked Letter Written By Dr. Richard Ishmael Which Got Him Suspended From The Queen Elizabeth Hospital

L - r) Director of the Sparman Clinic, Cardiologist, Dr. Alfred Sparman; Minister of Health, Donville Inniss, his wife, Gail Inniss and the Minister's Personal Assistant, Cindy Downes at the start of the official opening of the $20 million facility for cardiac care located at No. 4, 6th Avenue Belleville St. Michael

Prominent Cardiologist Dr. Richard Ishmael has been suspended from the Queen Elizabeth Hospital QEH with full pay pending an internal investigation. At the root of the problem is a letter written by Dr. Richard Ishmael which is addressed to Dr. Delores Lewis, Director of Medical Services at the QEH on the Queen Elizabeth Hospital’s letterhead.

In the interest of the public’s right to know BU now post the document. Feel free to use BU’s  Confidential Feedback Form which can be used to send information to BU without using an email address.

Letter Written By Dr. Richard Ishmael:

Pages: 1,2,3

The Queen Elizabeth Hospital’s View Of The Ishmael, Sparman, Inniss Blow-up

The following was received from a BU Source:

Queen Elizabeth Hospital (QEH)

• Dr Ishmael, as a senior member of the Consultant staff of over 30 years, is held in high regard by the Ministry and Board of Management of the QEH.
• The decision to suspend Dr Ishmael was done only after consultation with a legal and industrial relations expert and in the best interest of both Dr Ishmael and the QEH. It is consistent with current practice where a serious breach of the Staff Rules is alleged. A full investigation into the matter is being conducted.
• It is important to note that in June the Board was advised in writing by Dr Ishmael that he could not guarantee that he would be renewing his contract which expired in April of this year. Notwithstanding, the Board delayed advertising the post of paediatric cardiologist, given Dr Ishmael’s standing at the QEH and also to accommodate the personal and professional commitments that took him away from his duties for considerable periods. Notwithstanding these prolonged absences, the Board received no correspondence from the Department of Paediatrics on the “increased risk of adverse outcomes” similar to the one issued after only one day of suspension.

Related Link – Internal QEH Memo

Is Dr. Richard Ishmael Being Silenced?

Acquired from a source

 

Dr Richard Ishmael (Nation)

As promised, here are the documents – this is the first tranche as the files are large, it took a while to get them scanned and if you don’t act soon? Someone else will as not only Caribbean but every news entity across the globe has been told. This is the background below:

A few weeks ago a story broke but the traditional media hardly seemed interested. Don’t they want the truth? Don’t they care when the innocent is being abused and un-faired? While the traditional media seem totally disinterested, Barbados Underground was running a blog asking: “Is the Barbadian Population being properly served by its news media.” But if the truth of the recent issue between Sparman, the Health Minister and Dr. Ishmael are know, the answer to this question would have been obvious.

The question is, does the traditional media want the truth? Secondly, exactly how committed to the proposed Freedom of Information legislation are the members of the ruling DLP government, especially since not long ago, we were being told that government ministers are: “squeaky clean,” now this!

What Is The Plan For The Queen Elizabeth Hospital?

Submitted by M*M*

Queen Elizabeth Hospital (QEH)

What is the definitive policy action that the Government has in place for our Queen Elizabeth Hospital (QEH)? This question remains unanswered in my humble opinion at today’s date. Let me explain to you why this is the case.

Before the DLP came to office in January 2008, then Opposition MP Richard Sealy proposed the much talked about Rescue QEH Plan. The intimate details of this plan were never presented but it seemed like a catchy phrase or buzzword to throw at us the tax-paying public that definitive and critical action would be taken to improve the QEH.

After the change of government in January 2008, the then newly appointed Minister of Health Dr. David Estwick publicly announced that a new hospital would be constructed and he cited amongst other reasons, the limited room for expansion of the QEH, its position in a low lying flood plain and the cost involved in revitalizing an aging plant as opposed to constructing a new one amongst others. Within two weeks of Dr. Estwick’s pronouncement, Prime Minister David Thompson refuted this saying that no decision had been taken as yet and that a decision would have to be made by his Cabinet as to whether to build a new (and second) hospital or to revitalize the QEH thus pouring cold water on Dr. Estwick’s earlier statement.