RAD­HI­CA DE SIL­VA

Se­nior Mul­ti­me­dia Re­porter

Rad­hi­ca.sookraj@guardian.co.tt

New­ly ap­point­ed di­rec­tor of the South­west Re­gion­al Health Au­thor­i­ty (SWRHA), Dr Anand Cha­toor­goon, has is­sued a warn­ing to doc­tors at pub­lic fa­cil­i­ties un­der his purview, say­ing, “Shape up or ship out.”

Speak­ing to Guardian Me­dia dur­ing an in­ter­view, Cha­toor­goon said pa­tients were fac­ing long wait­ing lists for surg­eries, while some se­nior doc­tors who are paid con­sul­tants in pub­lic hos­pi­tals were putting pri­vate prac­tice first.

“It’s not that we want to fire any­one, but you know what? It’s ei­ther they shape up or ship out. I say to them, if you don’t want to help us, if you on­ly want to go in­to your pri­vate prac­tice, I have no prob­lem with that. Go in­to your pri­vate prac­tice and stay there. But if you work in the hos­pi­tal, do your work and be avail­able, ac­ces­si­ble, and reach­able,” he said.

He said the SWRHA will adopt a new ap­proach to pa­tient care, start­ing with a di­rect feed­back sys­tem. Cha­toor­goon said this would be an easy way to know the con­cerns of pa­tients, es­pe­cial­ly since house of­fi­cers and reg­is­trars were un­will­ing to “re­port their boss­es” who do their per­for­mance ap­praisals.

“That’s why the first thing I want to do is to es­tab­lish a de­pend­able and re­li­able pa­tient feed­back sys­tem. Let them know that they can call Anand Cha­toor­goon at 773-7838 if they are en­coun­ter­ing prob­lems any­where. That is just the start of what we are go­ing to evolve as a good pa­tient feed­back sys­tem so that they can con­tact us when­ev­er they are hav­ing prob­lems,” he ex­plained.

Cha­toor­goon, who for­mer­ly served as med­ical di­rec­tor of the San Fer­nan­do Gen­er­al Hos­pi­tal, iden­ti­fied long wait­ing times at the emer­gency de­part­ment, long wait­ing lists for surg­eries—es­pe­cial­ly eye surg­eries—is­sues with med­ical records, drug short­ages, and the avail­abil­i­ty of con­sul­tants as pri­or­i­ty ar­eas to ad­dress.

“We are aware too that some of the doc­tors are quite naughty. We know the doc­tors will post­pone pa­tients’ surg­eries with the hope that some of those pa­tients will come to them in pri­vate prac­tice.”

He said some doc­tors were pre­scrib­ing drugs not avail­able in the pub­lic sys­tem and or­der­ing tests not of­fered at the hos­pi­tal. “Why are you pre­scrib­ing drugs if you know those drugs are not avail­able in our CDAP sys­tem? Why are you pre­scrib­ing tests that are not avail­able in our hos­pi­tal so you can force pa­tients to go to your pri­vate prac­tice? The peo­ple who come to pub­lic hos­pi­tals can­not af­ford pri­vate care,” he added.

He said the SWRHA will al­so ad­dress er­rant con­sul­tants.

“We are pay­ing con­sul­tants on-call al­lowances. So what are we pay­ing them for? I want con­sul­tants to come out and help the ju­nior doc­tors, the house of­fi­cers, and the reg­is­trars work as a team so we can speed up things,” he ex­plained.

Cha­toor­goon said he is aware of chal­lenges such as nurs­ing short­ages and med­ical sup­ply gaps. He vowed to work with Min­is­ter of Health Dr Lack­ram Bo­doe to ad­dress them.

On the short­age of nurs­es, he said, “Nurs­es are very im­por­tant be­cause, as doc­tors, we treat pa­tients on the wards and then we go home. We leave the pa­tients in the hands of nurs­es. We need nurs­es, and the Min­is­ter of Health is aware of it al­ready. He is look­ing to re­cruit more nurs­es so that we will have a bet­ter nurse-to-pa­tient ra­tio and so that the nurs­es, too, wouldn’t feel burnt out.”

He added that the short­age is a re­al­i­ty the health sys­tem must work with­in, adding that the SWRHA will al­so look at bet­ter use of ex­ist­ing re­sources, in­clud­ing hos­pi­tal beds.

“We need to make sure that we have op­ti­mal us­age of the beds at San Fer­nan­do Gen­er­al Hos­pi­tal. Is it that pa­tients are stay­ing longer on beds than they should be­cause se­nior doc­tors are not send­ing them home?” he asked.

Mean­while, Pres­i­dent of the T&T Na­tion­al Nurs­ing As­so­ci­a­tion, Idi Stu­art, wel­comed the es­tab­lish­ment of a pa­tient feed­back sys­tem and a crack­down on er­rant doc­tors who put pri­vate prac­tice first.

“We are pleased to hear this from the di­rec­tor be­cause this has been a bone of con­tention which trig­gered a Com­mis­sion of In­quiry in 2015, on doc­tors hav­ing sub­stan­tive po­si­tions in the pub­lic sec­tor whilst hav­ing a pri­vate prac­tice,” he said. He not­ed that rec­om­men­da­tions were made but were nev­er fol­lowed through on.

“If the di­rec­tor is giv­ing a firm com­mit­ment to deal with this, it will go a long way to en­sur­ing that qual­i­ty of care is im­proved,” he said. He not­ed that doc­tors had pushed back af­ter the rec­om­men­da­tions were made, and the CEO and di­rec­tors of SWRHA had to back down in 2015. Stu­art said he hoped the poli­cies worked and there was ad­e­quate su­per­vi­sion to en­sure the new mea­sures were ef­fec­tive.