–concerned over too many referrals
Health Minister Dr Leslie Ramsammy says de-centralized health care has strengthened within the past year with the addition of two new hospitals, but challenges still persist including the issue of too many referrals.
Guyana, he said, like many other countries, lacks the financial capacity to “upgrade service in every region”, which means that hospitals in areas such as Mabaruma and Lethem can only deliver limited services, beyond which it would mean referrals to the city. He stressed that this “is not a question of the readiness of the hospital”, but how the system is currently functioning, people with more serious medical needs are being referred.
But Ramsammy has concerns about the referral system, which he said existed for some time and remains among the issues being debated. Ministry of Health audits conducted in the sector have revealed that referrals are still high across the country and according to him, questions continue to surround how many of them are genuine referrals.
The Health Minister is of the opinion that many of the hospitals which refer patients can actually offer the service they refer patients to other facilities for. “…Most of the cases referred now are genuine cases, but there are still examples where we believe a better job could have been done at the facility,” he told Stabroek News in an interview last week.
Ramsammy said that a particular hospital refers too many patients to the Georgetown Public Hospital and this is a reflection on the management of that hospital and not the quality of care being offered at that facility. He said some of the cases referred “could be and should have been dealt with at the hospitals” which are referring patients to the city. He said the situation at Lethem has improved tremendously, which means that the medical personnel on staff are handling certain cases. Still, there are some concerns.
The accessing of medical services in neighbouring Brazil is something the health sector is currently addressing, Ramsammy said. He disclosed that questions have been raised about whether the Lethem Hospital might be doing enough at its own end given that it has the option of sending off patients to Boa Vista. Recently, an accident victim involved in a fatal crash in the area was treated in Brazil. Some of the other victims were sent to the Georgetown Hospital for treatment.
Ramsammy said the challenges facing the system affect the Lethem Hospital also because the care offered in the city is not accessible to residents in the area. However, he said the new hospital provides a superior service to what was offered at the old hospital. “The service is not at the level where we would like it to be and generally it is not perfect, but we are working within our constraints and are providing a service to the people at Lethem that is better than it was in years (previously),” he asserted.
The new hospital recently commissioned at Linden is facing similar challenges, Ramsammy said. But he went on to explain that the Linden hospital was functioning minus its theatre. He said the hospital is currently in a transition phase where equipment from the old structure had to be installed at the new facility.
The operating theatre at the old hospital was not decommissioned when the new facility was officially opened early in December. Ramsammy noted also that the maternity ward was also not relocated at the time because the theatre was still operational at the old hospital. He said a decision had to be taken at some point to decommission the old theatre and have it moved to the new building and according to him, that process was likely to take around three weeks.
Ramsammy explained that the equipment had to be sterilized in addition to certain tests being conducted before the theatre at the new facility is functioning. He said the relocation was set to end on Monday last “which was the timeline we set”, but at the time of the interview he was unable to confirm whether it had been completed.
In terms of readiness, he said the hospital is technically and physically ready and staffing is better than in previous years with the addition of several new doctors. However, he stressed that it is not prepared to deliver a service like the public hospital in the city, adding that people should not expect this. He was adamant the new hospital has better physical accommodations and technical capacity to serve persons in Linden. “…moving the patient from Linden to Georgetown cannot be an ideal situation”, Ramsammy said while underscoring that it is the situation which currently confronts the sector while the Linden hospital is in the transitional period. He said people need to be a bit understanding when the sector was confronted with such situations.
The hospital being in transition was raised following the death of thirty-five-year-old Tricia Winth and her full-term unborn baby. Her family has questioned the care she received at the Linden Hospital.