The increasing number of emergency incidents in the public health sector should be analysed against the background of inadequate human resources

Dear Editor,

It was instructive to see from SN’s December 18 edition, the management of the Linden Hospital Complex speaking up in relation to its referrals to the Georgetown Public Hospital Corporation.
The openness of that management is in far contrast to the loud silence which emanated from the counterpart management team at the latter corporation where recently medical incidents (or accidents) have also been reported.

This is the appropriate organisational communication responsibility that appears to be steadfastly eschewed by the GPHC management team.

Perhaps more importantly, however, is the observation of the LHC administration reported in SN’s article.  The latter highlighted that human resources is one of the main contributors to the referral of patients.  Explaining that statement it was pointed out “the LHC has one specialist doctor for some areas and none in others.”  Missing were: orthopaedic specialist, neonatal specialist, cardiac specialist.  There was one gynaecologist.  The Admin-istrator’s disclosure does not offer the prospect of confidence in the LHC’s services to Linden’s community of future clients.

Indeed the critical human resource situation at LHC is but a microcosm of the wider human resource situation in the public health sector.
The most recent available information shows the disposition of more than 100 doctors in Region 4/Georgetown, with an estimated population of just over 300,000 persons; while 5 doctors are allocated to Region 10, with an estimated population of some 40,000.  That same Region 10 is shown as having just 9 functional midwives.  The bulk of the medical staff is concentrated on nurses and nursing assistants, who make up a complement of approximately 90.  Region 10 is also served by 2 district hospitals and 17 health posts.

Nevertheless the wider perspective is that too high a proportion of doctors (perhaps close to 75%) are located in Georgetown.  In any one case the perception is that whatever the disposition of doctors, it is compounded by a shortage of nurses particularly in specialist areas like paediatrics and anaesthetics, for example.

The continuing reliance on overseas personnel, with attendant communication problems does not necessarily alleviate some medical issues.
Overall, however, the vacancy rate in the public health sector hardly ever seems to earn mention by the authorities, largely perhaps, in the perpetuation of the fiction of the efficacy of the health system.  But one observer noted that up to recently approximately 30% of the established positions across the various health programmes were vacant.  The nursing system was particularly vulnerable, with over two-thirds of the qualified nursing positions vacant; and even at the level of nursing assistants, more than one third vacancies occurred – about the same proportion as for midwives.

So far as can be ascertained the categories of nursing assistant, nurse aides and patient care assistant together outnumbered those of qualified nurses by nearly 4:1.  Hopefully the more recent situation would reflect some improvement.  But while there may be signs that the attrition rate is slowing, due partly to the disproportionate number of under-qualified nursing personnel being recruited, the overall migration of the nursing cadre since 2000 must average well over thirty annually. Not so long ago Region 6 was quoted as a rather troubled area.  With 1 national level hospital, 2 regional hospitals and 3 district hospitals, not to mention health centres,  the incidence of vacancies was determined to be uncomfortably high in the nursing category (qualified and unqualified), that is over 50%.

It is against the background of inadequate human resources that the apparent increasing number of emergency incidents in the public health sector must be analysed.

Yours faithfully,
(Name and address provided)

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