No shortage

QEH CEO says Barbados has enough docs 

Health TODAY Sandy-01“We have enough resources in the system to take care of the  resident population here in Barbados; more than enough.”

Though that assertion did come from the Chief Executive Officer of the Queen Elizabeth Hospital, Dr Dexter James, he was not speaking about his cash-strapped institution. He was referring to the number of doctors in Barbados, and the fact that there are enough of them for the country to not only meet but exceed the internationally recommended physician to population ratio.

Supporting his contention, James cited a report of Solucient, an internationally recognized company which provides health care business intelligence.

He said Solucient’s physician to population ratio recommendation is 4.2 cardiologists per 100,000 population.

“Based on the specialist register here in Barbados, we have eight (cardiologists per 100,000 persons),” the hospital CEO said.

“The general surgery recommendation is for six (surgeons) per 100,000 population,” he added, noting that with an estimated total population of 280,000 and 27 general surgeons in the health system, Barbados more than meets that requirement.

But the numbers stand starkly against public disappointment and frustration with services at the QEH.

James, a certified management accountant whose doctorate is in Public Health Organization and Management, however argued during a presentation to medical academics, professionals and other concerned individuals, that the problem lies in the approach to and utilization of human resources in Barbados.

“Every time we speak about the issue of  addressing the reforms in health, the preoccupation is that the public health system must do it by itself,” he said. “Unless we engage the entire public health system to address the health needs of the population, we will be forever strapped for resources.”

James’ argument that the thrust for affordable health care and patient satisfaction should go beyond the public health system, is aimed at reducing the bottleneck created by Barbadians rushing to the QEH Accident and Emergency (A&E) Department, even when they don’t need emergency care.

“Almost 69 per cent of the patients who present to the emergency room are for non-urgent care, some requiring some amount of treatment, mainly diagnostics, but some really don’t need to be in that setting for care,” he explained. “These are the patients that give the hospital negative goodwill. They are the ones who wait eight and 10 hours for non-urgent care.”

The hospital alone admits 16,000 patients annually, James added.

“We have a large number of diabetics, persons with [other] NCDs,  presenting and occupying 10 and 15 days length of stay.”

About outpatients, he said, “We have about 1,130 treatments in relation to chemotherapy . . . we now have 240 patients on haemo-therapy dialysis, and 55 on peritoneal, or home, dialysis.

“Our accident and emergency service now sees about 40,000 visits per year. Our ES (emergency services) call responses are about 13,000.

As a result of this rush, the hospital writes 350,000 prescriptions annually; conducts 3.7 million lab investigations every year; and prepares 26, 000 meals per month, including special meals for various categories of patients.

James further supported a call for the solution to Barbados’ current health care crisis to involve the private sector, by citing statistics that show the number of unwell Barbadians is high and the only way to reduce the A&E bombardment is by directing patients elsewhere.

He said 25 per cent of Barbadians have at least one chronic disease, and that “is projected to grow to at least one in three by the year 2025”.

And in a probable, partial explanation for the media-dubbed “sudden deaths” trend, the QEH chief indicated that there are 14 heart attacks monthly, all linked to diabetes, hypertension, and obesity.

“According to the Barbados national registry, we have 53 strokes per month, all linked to the NCDs, diabetes, obesity and hypertension,” he added.

4 Responses to No shortage

  1. Tony Webster August 27, 2016 at 3:26 pm

    The entire public-health structure in this country is constructed with political objectives front and center, and daily partisan politics makes it “tick”. Or to stick. Why is anyone surprised when the Q.E.H. shows obvious signs of late-stage cardio-pulmonary disease?

    Every time I go for my li’l walk, I am amazed at the mass of flesh I see waddling about. Our low “national health score” requires both policy change ( as distinct from just talk about such), and “up-stream implementation” to tackle C.N.C.D.’s- like getting into the heads of primary-school kids about eating better and exercise; and into our teen’s heads, about sexual pitfalls and parenting responsibilities. A comprehensive improvement to our nation’s heath, will take a generation or two of smarter politicians/ health managers, and a smarter and better-informed populace, before we can see really significant results in the CNCD stats – and the relief this will bring to the total cost of national well-being.

    Mind you, such an achievement might mean cutting-back (sorry) on all those folks who are now busily engaged amputating lower limbs, and also in in making and fitting prostheses. My madam’s relative just got hers; was fitted expertly and works just fine.

    Didn’t cost her a cent….but it certainly was not “free”, and was almost certainly paid for in that other scarce resource: F/X.

  2. Sheldine Dyall
    Sheldine Dyall August 27, 2016 at 4:32 pm

    Stop telling lies

  3. Tony Webster August 28, 2016 at 1:36 am

    @Sheldine…bring de bible. I will not embarrass the lady by calling a name….is that what you want?
    Denial, even when it is on a national scale and there is “comfort in company” …will never, ever be a solution to our CNCD epedemic….and to its “spill-over” effects on ALL Bajans who pay taxes. Don’t believe me, just read the official ” hand-wringing” platitudes from the big-brains who say the same thing….but actually do very little to bring about real, lasting changes.

  4. David Moskowitz MD August 29, 2016 at 9:01 am

    A few years ago I had lunch in Miami, Florida with the Minister of Health for Barbados to discuss my 2002 paper showing that 90% of dialysis could be avoided. He wasn’t interested. A month later the new dialysis unit at QEH was announced. If any readers with diabetes or high blood pressure would prefer to stay off the kidney machine, please contact us at


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