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Healthcare services improving as govt confront certain chronic problems – MOH

A health fair at the Georgetown Public Hospital in April 2023

See below for a statement from the Ministry of Health on healthcare services in Guyana: 

The health sector performance has drastically improved over the last three years. While the Ministry of Health firmly stands behind this statement, we concede that there are some areas of concern that still plague the sector and the Ministry is making earnest efforts to address these concerns.

A number of sweeping statements condemning care overall in the health sector, giving the impression that health care has deteriorated in the last three years, were made in the Stabroek News in an editorial on September 25. We unequivocally reject this notion.

One of the repeated statements made in the editorial is that whenever complaints are made about alleged poor and inappropriate treatment in public sector hospitals, the Ministry of Health or other relevant health authorities completely ignore these complaints and repeatedly fail to respond. This is not accurate. While making this charge of non-responsiveness, the same editorial also opined that “the authorities are quite good at convening investigations”. Indeed, in every instance, the MOH and/or other relevant public health sector authorities investigate the cases. As far as possible, findings are made known to the public. Every case is investigated. Stabroek News is unfair in concluding that the authorities are guilty of “waiting the public out in the hope that the affected families settle or simply give up”.

One of the challenges the sector has been addressing over the years is the institutionalization of patient-friendly services. While significant improvement has been achieved, the sector continues to be challenged by inappropriate behaviour by a small number of staff members. For this reason, the MOH and the government have established a hotline which became operational in April 2023. The number is 227 4357. Since the inception of this national hotline, there have been 77 complaints, with 65 addressed and 12 pending. Similarly, the GPHC has several hotlines for complaints which operate 24 hours and complaints are immediately sent to the CEO, the Director of Medical and Professional Services and the Director of Nursing for action. The numbers at the GPHC are 226-6249, 227-8210, 227-8241, 227-8245 (Extension 1148) and 701-4742 (What’s App). We urge that persons utilize these numbers to let us know of problems they encounter in the health sector. In addition, the GPHC has an office by the entrance painted bright orange for in-person complaints concerns.

While we see some complaints in social media and sometimes in printed media, none of these has ever been the subject of a call to the hotline. The Minister of Health has instructed that a monthly report on hotline complaints and actions taken must be made public as of November 2023.

For the Skeldon Hospital, in terms of medication and medical supplies, the hospital’s reporting and the MOH’s monitoring show that the hospital maintains an availability rate of between 85 and 95%. Reports from all hospitals show a rate of availability of 82% (Pakera Hospital) to 99% (Mahdia Hospital). While we have to strive for 100% every time, the situation has improved dramatically since August 2020 when the hospital maintained an availability rate of less than 35%.

In the case of the staffing at Skeldon Hospital, the Region 6 Health Department and the Ministry of Health have been on record admitting that staff improvement is a priority for this hospital. In August 2020, the Skeldon Hospital had three doctors assigned, covering the hospital and nine health centres, including Orealla and Siparuta. There are presently seven doctors assigned to the Skeldon Hospital, including two Cuban doctors and five Guyanese GMOs. As of September 29, two additional doctors have been assigned to the Skeldon Hospital. In addition, a doctor has been assigned for resident duty in Orealla and Siparuta. The improvement in staffing has resulted in an increase in patient load from 17,800 in 2020 to 29,000 in 2022 and is estimated to surpass 30,000 in 2023. The ER department is estimated to see more than 12,000 in 2023, the highest number ever. From zero ultrasounds in 2020, the hospital now performs almost 3,000 ultrasounds per year. From less than 100,000 prescriptions filled in 2020, the hospital filled almost 116,000 prescriptions in 2022.

The MOH is working with the RHO of Region 6 and with the hospital management to ensure better rostering of doctors.

It is no secret that Skeldon Hospital is affected by the overall nursing shortage in Guyana, a challenge that every country appears to be enduring at this time. The 25 nurses that are assigned to the Skeldon Hospital needs to be increased and the MOH is presently addressing this matter. This matter is compounded by no-notice absenteeism, a problem we are trying to solve.

The incident reported at the West Demerara Hospital with an asthmatic child has been investigated by a high-level team and the CMO’s report has been presented to the Minister. This report, like others, will be released to the public as soon as the Ministry has reviewed it. The WDRH had issued a statement of clarification immediately after the complaints were made. It should be noted that in spite of continued challenges, improvements have been made. Medicine and medical supplies have improved from 32% availability in 2020 to 90% presently. Referrals from WDRH have reduced by 87% over the referrals from 2020. Since the beginning of 2023, the WDRH has been playing a positive role in assisting GPHC to manage critical care babies, given the heavy load that GPHC presently carries. Often the NICU at GPHC cannot accommodate additional critical care babies since the NICU is more than 100% occupied. Presently, the WDRH manages between 20 and 30 critical care neonates per month. WDRH has been ably assisting to take off the load from GPHC.

In the meanwhile, recognizing a number of shortcomings at the West Demerara Hospital, changes are being made to address the concerns. A number of practices that affect quality at the hospital have been discontinued.

The incident referred to at the GPHC was the subject of a public statement by the GPHC.A thorough investigation is being conducted and the report will be made public. In the meantime, closure monitoring is being implemented to patient-friendly service is experienced by all patients and their families.

While the Ministry stands by its statement that services have significantly improved, the MOH concedes that it has concerns about the poor attitudes of a small number of staff members. The MOH concedes that there is vast room for improvement in communication and steps have been taken to improve how we communicate with patients and their families. Our goal is to provide a patient-friendly service across the health sector. The MOH has prioritized patient and family experience in the sector for improvement.