There is need for bureaucracy at GPHC

Jan 25, 2012 Letters

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Dear Editor,
This letter is being penned in response to Mr. Freddie Kissoon’s continued contradictory and sensational ramblings in the press regarding the management and operations of the Georgetown Public Hospital Corporation, wherein he appears to be fixated on an alleged incident which involved one of his relatives.
Management of the Corporation intends to correct the misinformation, exaggerated statements and Mr. Kissoon’s ignorance of the hospital’s Standard Operation Procedures; and to advise the general public of these operations and/or protocols.
It has been stressed that the GPHC is the country’s ONLY National Referral Hospital, which means that ALL cases of dire emergencies from all ten (10) Administrative Regions are referred to the hospital for advanced care, a total of 5198 in 2011.
This is, moreover, in addition to the vast number of persons who visit the A&E on a daily basis, an average of 181 patients per day in 2011. It therefore stands to reason that there will be an overwhelming number of patients who require treatment at varying levels of severity, with resources that are not unlimited. Some of these patients could very well be treated at the numerous health centers in their neighbourhood (regions) or GPHC’s Medical Outpatient Department (MOPD), which is also sometimes overcrowded, a situation about which management is well aware.
The Accident and Emergency Unit can be defined as an area that deals with acute or potentially life-threatening illnesses or injuries; however, flexibility occurs at GPHC’s A&E Unit.
It is noteworthy that some patients who come to the A&E fall beyond this scope and must be referred to the Outpatients Department but are first triaged by a qualified nurse and determined to be a non-emergency case. At the MOPD, the patient is registered or would be asked to return the following day if the Department’s bookings would have surpassed the maximum number – an average of 104 patients per day visited the MOPD in 2011.
GPHC, in its capacity as the country’s tertiary level healthcare facility also functions as the country’s only Teaching Hospital and as is common throughout the world, aspiring doctors are taught on-the-ground during what is termed ‘rounds’ but no patient’s privacy and/or well-being is compromised.
In reference to Mr. Kissoon’s grievance with the doctor who refused to re-write his ‘friend’s’ prescription, it must be said that the doctor was well within her purview. For the sake of clarification, patients are managed by a number of doctors at the A&E. However when that patient would have been referred to a specialist area, as in this case, doctors external to that department have no authority to cross departmental boundaries without consultation.
Further, A&E doctors do not write prescriptions; all documentations are recorded in the patients’ charts which are only obtained after he/she would have been registered. The request for an A&E doctor to (re) write a prescription crosses ethical and professional boundaries, which could have resulted in a liability for that doctor.
It may have been frustrating for Mr. Kissoon to have gone through such bureaucracies to get his prescription written, but it is sometimes necessary for bureaucracies to exist in order for protocols to be meaningful.
Management is aware of the crowd build-up at the Main Pharmacy and as such there are two (2) Satellite Pharmacies in operation where the majority of prescriptions can be filled: one a stone throw from the POP Room and the other which recently commenced operations at the Medical Outpatients Department.
Unlike the Main Pharmacy, it is not feasible for these Satellite Pharmacies function on a 24-hour basis, but the problem was recognized and efforts were made to rectify it.
Additionally, for obvious reasons, medications are stored at the Pharmacy in any hospital therefore Mr. Kissoon’s suggestion that these items be kept in the POP room is ludicrous.
Mr. Kissoon’s general contention is that nothing is being done at the hospital to improve its system or performance, where flaws have been detected, but this is obviously not the case.
As of January 2012, the Medical Outpatients Department has extended its service to everyday of the week, from 08:00h to 20:00h. Additionally, management finds Mr. Kissoon’s criticisms subjective and a ploy to intimidate staff into offering him priority treatment. He has constantly criticized the organization without offering practical solutions to the ‘problems’.
To conclude, management is aware that the system is not perfect, name the country that has a perfect healthcare system and GPHC will happily follow its pattern, but in the mean while management will continue to function to the best of its ability in effort to provide quality healthcare to all its patients.
GPHC Management

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