There are some people who still want a ‘specialty hospital’ to be built in Georgetown, who believe this is necessary and that such a facility will dramatically improve health in Guyana. There are two main arguments against this idea. The first is simply that hospitals actually have very little to do with health. In reality, hospitals are dedicated to dealing with sickness. Yes, these things are connected, but they are two fundamentally different states of being as anyone who has ever been sick will tell you; the way one feels when ill is dramatically and clearly different from the feeling of wellness.
The fact is that health is largely something that happens outside of the hospital or clinical setting. The environment in which one lives and rears a family, the societal structures that offer support, maintain safety, equity, and justice- these are the things which really ensure health. The amount of money in one’s pocket, the safety and cleanliness of the environments one lives, works, and plays in, the kind of education and employment available, the systems in place to assist the vulnerable and ensure equity, the opportunities for self-expression and advancement, the access to justice in society- these are the things necessary to ensure and maintain wellness. No specialty hospital in the world can provide these things; instead this is the work of all citizens, not just doctors and nurses.
This significant, non-semantic difference aside, the fact is that Guyana already has a specialty hospital. It is called the Georgetown Public Hospital Corporation (GPHC). ‘Public’, as the GPHC is commonly referred to, is the largest public healthcare facility in Guyana and the one that offers the largest variety of services. People are referred to the GPHC from all the ten regions of Guyana for care that ranges from physical to mental. This then, is the specialty hospital already in our midst. I remind readers of this fact to make the point that building another facility and establishing a parallel (and likely exclusive and inequitable) system of care is not at all what is needed in Guyana today, nor is it a smart way to spend already limited resources. I believe that strengthening the existing public health facilities and systems will achieve much more. Yes, there are serious failings at the GPHC and within the health sector nationwide. We must focus energy, attention, and resources into addressing those issues, not divert them into another unnecessary construction project.
It is also important to realize that, along with enough adequately trained staff and the right equipment/medicine, competent management is also key. A good manager ensures that resources are properly spent, that supplies and medicines are available in a timely manner, that staff are properly trained, that the environment is welcoming and hospitable to patients and visitors, and that everything goes as well as it possibly can. A good manager anticipates potential problems and establishes systems to prevent them from occurring if possible, or to mitigate negative effects otherwise. A good manager knows that the provision of healthcare is an essential public good and does all in their power to make sure it is always of the highest possible quality.
Much has been said about the GPHC in recent years, most of it uncomplimentary. There have been serious errors made by staff, many lives lost unnecessarily, and, in some instances, as much pain and suffering caused as alleviated. Of course, there are good things that can be said about GPHC as well. There are many caring, competent, and dedicated staff and many departments have improved significantly over time. However, one major failing is that too often, persons with concerns or complaints about the quality of care they or their family members received were not given an audience or adequate answers by those in charge. There is a perception by many, including too many GPHC staffers themselves unfortunately, that GPHC is a place for ‘poor people’- that people who have resources would access care privately elsewhere, and that what happens to poor people doesn’t really matter. As such, patient satisfaction has not been given sufficient attention. Many people are also unaware of their rights as patients, too sick to demand them, or families too traumatized.
This needs to change. It matters not if one is rich or poor- we are all human and all get sick at some point in our lives. All people are deserving of quality, respectful healthcare, no matter their tribe, skin color or hair texture, wealth, education, or connections they may have, whether they’re gay, straight, transgendered, bisexual, etc. The Guyanese public- in all our glorious diversity- must be put first and foremost by all those tasked as public servants. The recent decision to send the Chief Executive Officer of the GPHC on leave is a proper and necessary one, in this columnist’s opinion. Significant changes need to be made at the GPHC at all levels, from top down, in order to improve its functioning and the quality of care and services offered to the Guyanese public.
Staff at all levels must be formally evaluated regularly- both with regard to their technical knowledge as well as their skill in communicating and dealing effectively with patients. Evaluation is crucial to quality service delivery. It must be at the forefront of all management plans, not simply a forgettable footnote, as too often happens. Persons who truly care about providing the best quality care and services are not afraid of any evaluation process; instead they welcome it for it provides valuable information which can be used to improve one’s self as well as organizational services. Accepting constructive critiques, along with continuous learning and improvement must become a daily part of our lives and work, and public satisfaction with the public healthcare services given its due import. The GPHC must specialize in excellent management, honest and regular evaluation of staff and services, and a commitment to quality care and patient satisfaction. This would make it a truly special and useful facility for all Guyanese.
Sherlina can be contacted at firstname.lastname@example.org