Shake-up ahead for underperforming hospital management

FORT CHARLOTTE, Hanover — Strong action will be taken against the management teams of non-performing public health institutions warns Minister of Health and Wellness Dr Christopher Tufton following a national patient complaints report showing that long wait times remain a primary grievance across the island’s hospital network. “I am just giving a notice that we are going to be taking stronger action around throughput and the quality of throughput, and Noel Holmes is not going to be an exception. All institutions are going to have that,” stated Tufton during a press conference at the Noel Holmes Hospital in Hanover on Friday afternoon. Before the press briefing, the minister toured the Type-C facility, which is currently being rehabilitated following Hurricane Melissa last October. During the tour, several patients raised concerns about lengthy wait times. “Coming here and hearing that five people are waiting at an outpatient area from 9:30 or 10:00 this morning until 12:00, and the doctor has not yet seen the patient — the five or six people — not a good thing. Nobody should wait three or four hours and you haven’t seen one patient yet. Sorry. We are going to have to call these things out when they happen,” stated Tufton. The minister highlighted that staff numbers at Noel Holmes Hospital increased significantly from 189 before the hurricane to 270, including specialist doctors. He stressed that this expanded workforce must translate into enhanced service delivery, improved throughput, and shorter wait times. Moving forward, the ministry will closely evaluate staff counts against productivity and patient throughput across the entire public health sector. Tufton added that the recently completed national patient complaints report will be released publicly within three weeks. “The number one reason why people complain is access to service — timely access to service. And I know that there’s a default mode that says, ‘It’s because we don’t have this,’ or, ‘We don’t have that.’ But if we hire more doctors, the least that can happen is that the doctor must turn up and deal with the patient on time. Patients are not supposed to wait long if you have more doctors working. I can’t put it any plainer,” said Tufton. Tufton warned institutional and regional leaders that they will be held accountable for administrative and operational failures. “Hiring more people means greater levels of productivity, more efficient throughput, and less wait time. People see their doctors more on time. Management, leadership, and supervisors must ensure that it happens, and they must be at their posts to ensure that it happens. “And I’m charging the regions — this regional [acting] director [Deveta McLaren] is on the line now because I’m here in Noel Holmes, but when I go to the other places I do the same thing — they must ensure that their reports reflect that, because we’re ranking institutions now on levels of performance and on complaints. And if you fall below the satisfactory rank, a team is going to come in and they’re going to start with leadership: Are you the suitable person to run this institution or to provide leadership? Because, ultimately, the buck stops with leaders,” warned Tufton. When asked by the Jamaica Observer what specific administrative actions could be taken, Tufton explained that measures would range from performance warnings to removal from leadership posts. “It starts with appraisal; it starts with the board. The board is going to put the region under pressure, and the region will have to relate to your parish managers. Parish managers will have to look at the key performance indicators at the level of the institutions, and people will have to be spoken to,” argued Tufton. He cited a recent example in which a non-performing hospital chief executive officer (CEO) was removed from his post, two weeks ago, following a written directive to the board. “The board was told to find another place to put him, because he was not providing leadership in the hospital. And we’re going to get more of that. The board has the authority to do it. I appoint the board, and you know, the truth is I appoint or remove them at my discretion. They, ultimately, have responsibility, and they must ask for these reports,” stated Tufton. To avoid the perception of a totalitarian regime, Tufton said training and technology will be used to provide support to employees. “Where we need to train and retrain, it has to be a critical part of the culture going forward, and technology is an important thing — using technology to give support. Things like registration, follow-ups, those sorts of things have to be a critical part. It’s not just about the human component; it’s about the ecosystem that you build out around them,” he explained.