Medical regulator mum on licensing of health facilities

Nov 23, 2018 News

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Concerns are being raised about the licensing of health facilities under the Health Facilities Licensing Act of 2007. The issue is being highlighted by former Minister of Health Dr Leslie Ramsammy, who in a recent letter to the editor raised concerns over the issuance of licences by the Ministry of Public Health.
Ramsammy accused the Public Health Ministry of adopting a nonchalant approach to licensing hospitals and medical centres, although the law

stipulates every health facility operating in Guyana should be licensed. This includes all public (government-operated) and private health facilities. He noted that the whole idea of a licensing process was to lift standards and to protect patients.
Ramsammy said that as a consequence of the non-issuance, many health facilities operated by the government and the private sector are operating illegally. He stressed too that the law permits the Ministry to send inspectors at any time.

“Usually, the inspectors will flag certain deficiencies and a provisional licence would be issued, until the flagged deficiencies were remedied, then a full licence was issued. Each year, therefore, hospitals and laboratories operated with either a provisional or a full licence.
For example, when I was Minister, a team visited a private hospital where a patient’s family queried the high bill they received for a minor surgical intervention. The patient’s bill was close to $800,000 for an amputation of a toe. The clinical audit found that the bill was inflated and the patient’s bill was adjusted. But the inspecting team also queried a number of actions of the hospital pertaining to quality of care.”
In response to the concerns raised, Chief Medical Officer Dr. Shamdeo Persaud told Kaieteur News that some 55 facilities have been inspected and cleared for licensing by the Central Board of Health.
Dr. Persaud said that among the 55 facilities inspected were ten public hospitals, four private hospitals, ten laboratories, four optical centres, seventeen health centres, three surgical facilities, two dialysis centres and two nursing homes.
He noted however that although the facilities are technically approved for a licence by the Central Board of Health, representatives of the various facilities are required to pay a fee to obtain the licence.
“I am uncertain whether the administrators of the various facilities would have completed this step to get licensed.”
There is a fee attached and the payment depends on the type of facility and services offered…However, once the fee is not paid, the licences are not issued.
The CMO noted that the Director of Standards, Dr. Julian Amsterdam would be privy to the information on which facilities would have completed the process of being licensed. However, when contacted by Kaieteur News for a response yesterday, Dr. Amsterdam refused to comment. He said that he was at lunch and would provide a response later in the day. Further calls made to the Director proved futile.
In his letter, Dr. Ramsammy claimed only two healthcare facilities in Guyana operate with a current (2018) licence–Georgetown Public Hospital Corporation (GPHC) and the Balwant Singh Memorial Hospital.
The former Health Minister spoke of the difficulty incurred by some health facilities in obtaining their licence to operate. He noted the Balwant Singh Memorial Hospital is a key example. He said that the hospital only recently obtained its licence after it sent a lawyer’s letter inquiring why their licence was not being issued.
It was also mentioned that other healthcare facilities have been inquiring, but have faced a non-responsive partner in the Ministry of Public Health.
“Several of them are now contemplating the approach of the Balwant Singh Memorial Hospital of sending lawyer’s inquiries.”
Further expounding on the issue of licensing, Ramsammy said that under his tenure as Health Minister all hospitals, public and private, were subjected to an annual licensing process, including inspection.
“Until the end of 2011, I personally ensured that the inspections were done on a timely basis and the licence issued. Since 2015, I am aware that the law has been abrogated in many ways. Some of the hospitals and stand-alone laboratories have operated without any licence.
Some hospitals have been inspected for 2018. I am not certain that all hospitals have been inspected. The Inspectorate, in accordance with the law, was an independent, peer-review body, at least up to 2015. It was made up of inspectors from both the public and the private sector. It was a collaborative process intended to improve quality.”
Ramsammy was keen to point out that the Health Facilities Licensing Act promotes practices that safeguard the welfare of patients.

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