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QEH wants more autonomy

The state-run Queen Elizabeth Hospital (QEH) is looking to review its governance model to allow for greater autonomy and improved service to patients.

Chief executive officer Dr Dexter James told the hospital’s accountability meeting at the Lloyd Erskine Sandiford Centre last night that the review will consider moving from a board of management to a board of governance, “where greater scope is provided through service level agreements with the Ministry of Health”.

“We also want to review the expansion of legislative authority to perhaps consider primary health care services being brought under the ambit of the Queen Elizabeth Hospital,” he added.

“Much benefit could be achieved by such a move. The greater integration [and] coordination of care, the seamless movement of patients between the hospital and the polyclinics . . . the sharing of resources; we could have some synergies there so that we could have cost-effective solutions for providing care.

“We would like greater autonomy to be able to manage the people resources and perhaps consider a delink from the civil service. Because the changes we’re required to make require a measure of agility . . . the need to constantly refer to these agencies in a sense slows down the process of the board and management,” James added.

He said this was one of several areas the QEH planned to focus on for 2016/2017.

James added that the hospital would also be looking to review its fiscal management and funding model, and seek to further diversify its revenue base.

The QEH has reported a 40 per cent increase in revenue over the past five years, with earnings growing from $5.5 million in 2011 to $7.8 million in 2015.

He attributed the increase to private surgeries performed by consultants at the hospital. The consultants have been granted admitting privileges as the State cannot afford to pay their full economic costs, James said.

Under that agreement, 75 per cent of all surgeries performed at the hospital must be public work, while the remaining 25 per cent would be done privately.

“The decision was taken that we could no longer carry the level of receivables that we had on our books. And we had to take, I suppose, a business decision that all patients who presented to the hospital for elective private care must make a deposit before they are admitted to the hospital,” the hospital CEO said.

“It sounds so simplistic and logical, but that situation has transformed the whole revenue generation and collections policy of the hospital to the point now where we’re collecting 80 cents on the dollar . . . . The remaining 20 [cents] really comes from persons who present to the emergency room in a life-threatening circumstance.”

The QEH will also be trying to attract more overseas patients. The number rose from 20 in 2011, to 170 in 2014, James said.

The hospital is also considering philanthropy as another revenue
generator. Over the past three years, the QEH has raised about $10.3 million in donations.

“In terms of the future, our board is giving consideration to establishing a permanent desk for philanthropy and we will also look at establishing a donor Bill of Rights so that donors have the rights and responsibilities for ensuring that their donations are maintained and are kept in a good state of repair,” James said.

Another recommendation is for a comprehensive efficiency audit of the hospital, “with a view towards looking at their services and perhaps redesigning the way we deliver some of those services”.

The QEH has committed to reducing the waiting list across all clinical and diagnostic areas. James gave the assurance that the 411 patients who have been waiting for cataract surgery will be attended to by March 31, 2017.

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