Hospital heads need to be more accountable - Tufton
By about March next year, the Government should have a better look at how it will be able to strengthen the management and accountability of health institutions such as hospitals under a 10-year plan for the health sector, Health Minister Dr Christopher Tufton has said.
Tufton complained in an interview with The Gleaner recently that the current structures, which were established through the National Health Services Act 1997, need to be reformed to ensure that those directly in charge of health institutions are more empowered to do their jobs while also being held more accountable.
The National Health Services Act, which established regional boards that oversee hospitals and other institutions, is among the things being reviewed to develop a 10-year strategic plan aimed at enhancing Jamaica's public-health system.
A report, Tufton said, should come before him by the first quarter of 2017.
"I'm hoping to have some sort of preliminary positions, early new year - the first quarter of next year - but we're not waiting on that to do some of the things that need to be done," he said.
The review will lead to the 10-year plan that was initiated last year. After mounting public pressure, the then administration released audits of public hospitals, which pointed to a widespread lack of basic supplies, usage of expired ones, and a general breakdown of controls and management in various institutions.
The public clamoured in vain for people to be held accountable for the failures.
PROCESS NEEDS RETHINKING
Tufton suggested that the current management structures could be shielding those with direct supervision over institutions.
"You have a regional structure that, oftentimes, is the ultimate authority to determine and oversee the functioning of the institutions, which is the hospitals and clinics. I would like us, with the experts, to rethink that process.
"We took the regional structure from the British. It was expected to be reviewed in three years. It has not been to date. The British have gone through several variations of their regional approach. In Canada, Toronto proper has three million people with one authority. We have three million people and we have four [regional authorities]," said Tufton.
According to the health minister, "To get greater value, [the answer] must be to return authority and accountability to the institutional leadership.
"Each hospital has a chief executive officer (CEO) and senior medical officer (SMO), and then under that, you have differing levels. To my mind, a CEO and SMO who are given the task to run a facility must understand their budget targets, performance target, and must be held accountable. There is a disconnect between management and authority," Tufton told The Gleaner.
He said the National Health Services Act does not give the permanent secretary the power to intervene in questionable situations. That, he said, has partly influenced how the Andrew Holness-led administration is approaching the situation.
"From this administration's perspective, we have said the institutions have to take more responsibility. When there's a an issue, if you notice under my watch, I don't jump to the front of the line to start justifying or explaining things. If there's an issue, the first point of contact must be the SMO and the CEO of that institution because, frankly, they are responsible for that institution and should be accountable."
The Inter-American Development Bank and the World Bank are helping with the work on the 10-year strategic plan.