Mon | Sep 25, 2017

Tested Patience ...Doctors regret strain on health service

Published:Thursday | December 15, 2016 | 12:00 AMJodi-Ann Gilpin
Dr Natalie Whylie, senior medical officer at the Kingston Public Hospital.
Dr Karen Phillips, head of the department of medicine.
Dr Hugh Wong, head of accident and emergency at Kingston Public Hospital.

With the Government's free health-care policy, which was intended to deliver equal treatment and service to all citizens, backfiring, placing a crippling strain on staff and resources, one doctor, echoing the sentiments of her colleagues, says it's a reality that they regret.

The Kingston Public Hospital (KPH), celebrating 240 years of existence, like every public health institution in the country, battles daily with limited staff, dwindling medical supplies, and a swell in patients seeking treatment.

Senior medical officer at the KPH Dr Natalie Whylie said as she reflected on the institution's 240th year anniversary that it is a reality with which they struggle, but one that was inevitable due to limited human resource.

"In the last 10 to 15 years, we have had a doubling of patients who come to the emergency room alone, without an expansion of the physical infrastructure. It is a very challenging place to work, and so that translates sometimes into difficulties in recruiting and retaining staff. If you have an increased demand for services and you have not matched that with a proportional increase in infrastructural support and manpower, it's going to translate itself into waiting time," she told The Gleaner during an interview on Monday.

The senior medical officer, in giving a glimpse into the severity of cases that they encounter, said close to 90,000 surgical procedures are done per year. She further stated that every single day, almost 2,000 patients pass through the emergency room and the outpatient clinics.

Similarly, Dr Hugh Wong, head of the Accidents and Emergency unit, said that there has been a rapid increase in the number of persons wanting treatment, noting that last year, he and his colleagues saw up to 84,000 patients, up from 45,000 when he started 20 years ago.

"I want to say that this is not a situation that is unique to KPH. When you look even in the international sphere, if you go to an emergency room in the UK (United Kingdom), you are going to wait for service. Here at KPH, we address the urgency of the situation, and if it is a life and death situation, you are going to be attended to immediately. The urgent cases are also given some priority," Whylie explained.

Whylie added: "The challenge we have sometimes is with the non-urgent emergencies and the non-urgent cases that come to either our surgical or medical clinic, for example, patients who might have a hernia, which is not necessarily an emergency."

The senior medical officer said that issues of customer service and patient care would be pertinent going forward - issues, she said, that have been recognised at the institutional level.

"Having said that, I'm not going to skirt around the issue. Yes, we have challenges. It's not an easy place to work, and so sometimes, that translates itself into issues of communication. A perception sometimes is that we don't have the passion that we should have, and I say perception because it is a perception," she declared.

She was quick to point out, however, that there are times when situations are exaggerated and taken out of context.

"A lot of times when we investigate, those issues are not true. People will come and they will wait a little bit, and then they will start to make noise that they have been waiting for eight hours, and when we check, they have been waiting in the emergency room 15-20 minutes before," she said.

"Monitoring and evaluating the process is part of my job as a senior medical officer, to see where the deficits are and to make technical recommendations, which then can be actioned with the administrative support, and, hopefully, the budgetary support as well," she continued.

Dr Karen Phillips, head of the department of medicine at the institution, said a lot would have to be done to change people's attitude towards primary care facilities such as health centres and clinics.

"I think the Government and the ministry have recognised that (hurdles) because one of their mandates is to build primary care, but even so, you still have patients who refuse to go to primary care, and so that is one of our challenges as it relates to the burden of care and the limited human resource," she said.

"In relation to the time period that persons may complain about, a lot of it sometimes happens in the clinic setting. They will get an appointment to come at 8 o'clock (a.m.), but they will be here from 4 o'clock (a.m.), and they may not see a doctor until 11 o'clock because sometimes the dockets don't get here until 10 o'clock, and sometimes that is a little hard to influence. No matter how you tell them they don't need to be here so early, they insist," she declared.