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Independent QEH audit needed – CEO

Conceding that there are inefficiencies in some operations of the Queen Elizabeth Hospital (QEH), Chief Executive Officer Dr Dexter James has called for an independent audit to weed out slack areas.

The CEO’s call came as he spoke of an almost $800 million annual cost to taxpayers for services at the island’s premier health facility and polyclinics.

James told participants in a town hall meeting at the Princess Margaret Secondary School last night, organized by health officials to discuss rising costs to the sector, that he had requested that the Ministry of Finance carry out the audit this year.

The town hall meeting was the first of three aimed at getting the opinions of Barbadians on health care financing against the backdrop of concerns that Government could no longer afford to carry the cost of free health care at the QEH.

Dr James said the question of efficiency arose, while stating that it would be better for an independent agency and not the hospital to conduct a study on value for its services.

“Instead of us being self-serving, we recommend that an independent efficiency audit is conducted of the entire heath system, the hospital and the polyclinics, identify where those inefficiencies are, and address them in a more meaningful way.

“In so doing, [it would] reduce the burden of the hospital in having to deal with a lot of primary medical conditions that should be addressed at the polyclinics,” Dr James said.

The CEO pointed to persons seeking treatment at the QEH’s Accident and Emergency (A&E) unit that really should be sought at polyclinics as an example of current inefficiencies that affect patient waiting time and diverts QEH resources away from urgent matters.

He spoke of doctors having to see 40,000 patients in the A&E every year, saying, “23 per cent of them are patients who are presenting for non-urgent emergency care but require some amount of diagnostics.

“They’re the ones who have to wait 12 and 14 hours,” he added.

Recalling a mass casualty situation that arose from an accident involving 17 people yesterday, Dr James said: “They have to be given priority over those [23] per cent”.

Included in the figure for non-emergency cases were persons with ankle injuries, which he said could have been determined at a polyclinic.

“There are no diagnostics [at polyclinics], so they come to the A&E and they sit and wait.

“If the polyclinics had diagnostic services the doctor would have seen that patient, recommended an x ray, put on a cast and discharge the patient.

“So we carry a certain amount of inefficiencies at the hospital that we really need to identify, cost it and then decide which setting of care is best poised to take care of those patients.”

He also warned that improved service at the hospital would come at a higher cost.

“It requires cost to be able to meet that major recapitalization to improve the efficiency of the system.”

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