Value-for-money audit urgently needed in health sector – Former Finance Minister, Jordan

Aug 28, 2022 News

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– country spends US$108M in 12 years on Region 6 health services; now borrowing US$48M to modernise three hospitals
– New Amsterdam officials outline a dozen areas for improvement; say mould on walls and ceiling of the operating theatre not conducive for surgery

By Kiana Wilburg

Kaieteur News – A July 2022 assessment by the Inter-American Development Bank (IDB) which exposes the particularly deplorable state of the New Amsterdam Hospital, and the inefficiencies at the Linden Hospital Complex and Georgetown Public Hospital Corporation (GPHC) has left many citizens questioning the value of expenditure in the health sector over the years.

Independent examination and compilation of allocations from 2010 to 2022 have shown for example that the country pumped US$108M into health services in Region Six alone. Today, the country is now approaching the IDB for a loan to address many of the issues that ought to have been fixed with the US$108M investment of taxpayers’ money.

The assessment that was conducted by IDB officials and its consultants followed a request from the Guyana Government to borrow US$160M, a portion of which will be used to modernise the three hospitals.

Specifically, Component 1 of the project called, “Supporting hospital health services networks” will absorb US$48 million. This component will finance inputs to allow the hospital network to function more efficiently by expanding capacity at two strategic level four hospitals, thereby relieving pressure on the main national reference hospital (level 5) to provide lower-complexity services, while also increasing the ability of this facility to fulfill its mission in handling specialty referral cases.

The activities to be funded by this component include: infrastructure rehabilitation and expansion at the New Amsterdam Hospital (level 4), Linden Hospital Complex (level 4), and the Georgetown Public Hospital Corporation (GPHC) (level 5), considering energy and water efficiency and climate change risk reduction features; purchase of essential medical equipment and furniture for these facilities; services for architectural and engineering design and construction supervision; and equipment inventorying, corrective and preventive maintenance of infrastructure works and medical equipment and improvement of installed maintenance capacity.

In an interview with Kaieteur News on Friday, Advisor to Government and former Health Minister, Dr. Leslie Ramsammy admitted that while the findings of the IDB are factual as it pertains to the state of the respective hospitals, the administration pursued a suite of corrective action. He said, “It was 20 times worse than that. When the government assumed office, it inherited a health sector that was totally neglected…There were also many findings about the state that we found New Amsterdam Hospital in that was not even listed in the IDB report.” The advisor stressed that several initiatives were embarked upon at the hospital which was based on a separate evaluation that was done by the government when it got into office. The former minister was also keen to note that the upgrade of the hospitals is just part of a massive overhaul that will be done on the sector.

Upon noting previous publications by Kaieteur News which highlighted the IDB’s findings on the state of the New Amsterdam Hospital, former Finance Minister, Winston Jordan said a value for money audit most certainly needs to be conducted into the health sector.

The economist said, “I have seen the findings of the IDB which state that there was fungus and mildew on the interior and external walls, that there are no proper toilets and the facilities just being down right poor for patient care. The money being borrowed begs the question, where was all the money from before really going? The bigger issue at play is when we spend money to build and modernise the facilities what happens after? The maintenance has clearly been lacking over the years. Simple things like toilets not functioning should not be an issue at a premier hospital serving the region.”

The former Minister added, “It is alarming. You can go all over Guyana and you will see a lot of shiny things going up but there is no maintenance schedule which people stick to. In a high traffic place like New Amsterdam, you need people cleaning constantly and health inspectors checking every week and moving with alacrity to get things done…This state of affairs that was revealed by the IDB does warrant a value-for-money audit which the Audit Office should take up.”

At New Amsterdam Hospital which was found in the most deplorable state, the IDB said the CEO Dr. Bob Ramnauth and Medical Superintendent Mr. Hemchand Jhagroo expressed interest in the project and provided feedback for several improvements. Below are their verbatim recommendations as stated in the report.

1. Renovation and expansion of Accident & Emergency (A&E) Department from a 6 bed to a 15-bed facility, inclusive of a waiting area to provide more privacy and easier access for all patients and reduce waiting time.
2. Renovation and expansion of the surgical suite from a three-bed to a six-bed facility. This is to increase the number of surgeries conducted in the hospital, reduce the waiting time for urgent and non-urgent procedures, and adequately utilise doctors and other human resources. Address the mould on the walls and ceiling of the operating theatre, which threatens the aseptic conditions necessary for surgery.
3. Expand the Radiation Suite to meet the hospital’s current and projected needs. Include facilities for a digital x-ray machine and computerised tomography (CT) scanner.
4. Expand the ICU from a 2-bed facility to at least 7 beds.
5. Establish a 15-bed High Dependency Unit to house patients that are not critical for the Intensive Care Unit but need additional attention than what the general wards provide.
6. Expand the outpatient department and clinic area to accommodate the current 16 specialities offered at the hospital, and to provide the required comfort and privacy to the doctors and patients. This will reduce waiting time and prevent overcrowding of the outpatient areas.
7. Rehabilitate and expand the waiting room to accommodate more people, improve patient experience, and reduce the risk of infection.
8. Renovate the hospital facilities to meet current technology, innovation, and standards. Repaint the hospital with paint that is conducive to the area’s climate and hospital activities, such as paint that does not fade quickly and is easy to clean.
9. Replace the vacuum/suction system with a new fully compliant one designed to meet the facility’s specific requirements.
10. Replace the water supply system with an efficient water sourcing, storage, and distribution system to ensure that the water supply is adequate as per the requirements of the hospital. The new design should include a new reservoir, tussles, pumps, a purification system (reverse osmosis or UV light), and an emergency system.
11. Renovate the fire prevention system to protect hospital buildings while posing no risk to patients or personnel, accompanied by regular fire prevention training. The hospital management engaged the Guyana Fire Service to assess the premises, and the report will inform future fire prevention plans.
12. Establish a new Hospital Sterilisation and Disinfection Unit, separate from the operating theatre, which will house two new sterilisers and specialised staff to operate them. This will enable the New Amsterdam Regional Hospital to become the central sterilisation unit in Region Six, increase efficiency, reduce cost, and relieve some of Georgetown Public Hospital Corporation’s caseload.
13. Establish and equip a pathology laboratory to ensure that patients receive accurate disease diagnosis and timely and adequate treatment.
14. Although there hasn’t been any incidence of flooding, all new construction should be elevated above ground level.

 

 

 

 

 

 

 

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