I would like to add my personal solutions for resolving the problems at the Queen Elizabeth Hospital (QEH), where criticisms were recently highlighted.

The QEH was officially opened on 14th November 1964 to service an estimated population of 250,000. Because QEH remains Barbados’s only acute primary health care facility, attempts to continue service to the transient and permanent population has resulted in congestion when we continue to believe it will service our current population, estimated at more than 270,000, by transferring some of this heavier workload to our polyclinics. However, the 60-year-old facility has been upgraded repeatedly with placement of updated diagnostic equipment. Additional specialties (radiological, histological, ophthalmic, operating theatres, pharmacological, physiotherapy, etc.) have been added and require additional highly trained staff to operate this new sophisticated equipment at an increased cost. This makes the hospital more difficult to operate with its burgeoning expansion of increased equipment, patients and staff within the same area.

It is my opinion that we must ‘get real’ by reviewing our history and remembering the General Hospital which outgrew its ability to service our increasing population in the 1960’s. The addition of UWI Medical teaching and student fraternities along with the equipment operators have added to the personnel within the hospital. The QEH now suffers a similar syndrome that took place in the 1950’s. I feel the question must be asked, “Would it not be better to consider additional hospitals which act as fully equipped specialized satellite Centres? Examples would be A Children’s Hospital; An Orthopaedic/trauma centre; An Obs./Gynae Centre; etc. and allow QEH to remain the Acute Care Centre. Such will need to be debated. My next query would then be: Because this demand for service is by/for the population, who should pay for these newly structured services?

My suggestion may create an outcry among those who expect that such treatment(s) should be free; but in the same breath, it must be recognised that the cost to build a high-class hospital today that provides top quality service(s) will come at a cost to those who request it. The alternative will be to have it done overseas at a higher cost with foreign exchange. The cost will be dependent on the services and facilities being requested by/for patients who should therefore be the ones paying for what they are requesting. Payment(s) for locals will have to be decided by an independent governmental body (if being run as a government facility) or by an independent body if being run in a similar way to Bayview Hospital.

Another item that can be placed on this agenda is the use of Insurance Companies’ Health-Benefits that will assist with the cost of treatment, purchase of equipment and its maintenance all of which should be factored into this cost equation. Health service contract by an employer/employee contact or for the employee only, will assist in allaying the patients’ cost. The constant increases in equipment cost continues to increase with the addition of Artificial Intelligence (AI) being developed and integrated to improve and expedite diagnoses. However, if we structured these facilities to service a vibrant “Health-Tourism” product, it will greatly assist with offsetting the anticipated high costs but such matters will have to be decided with the executive bodies of the hospital, the medico/dental associations and ancillary personnel to ensure everyone is working with the same agenda to improve health service in Barbados.

I must now complement the newly appointed CEO of the QEH, Mr. Neil Clarke, whose suggestion for digitisation of records, as a starter, will reduce a lot of the time-wasting problems being experienced. It is however imperative that viruses are not enhanced and hacking reduced once the computer-literate staff are well trained and provided with continuing education. Personnel using the computer hospital programme, must be highly trained to avoid errors that could induce litigation and such staff will require an adequate salary. One benefit is the immediate access to patients’ records which will immediately reduce patients’ waiting time through inter-departmental communication.

This improved service can also transfer clinical notes to general practitioner(s) who may reside overseas with the proviso that the patient’s consent is obtained. The avoidance of discrepancies in the patients’ notes must be acknowledged if quality is to be achieved and maintained. This aspect of maintaining quality is done with the provision of continuing education and regular training of operators.

The only drawback I envisage would be that computer training may have to be added to the schools’ curriculum to assist our youth to remain in “The Digital Age” and increase national employment. Hospital staff must be aware that we now live in a computer environment where a company’s computers should only be used for their intended purpose and not for personal use (playing games etc.). I believe that some staff who now act as receptionists could be displaced with computer-literate staff to guarantee the proposed consistent quality. I must therefore advise Barbadians who did not have any such training to attend computer courses, educate themselves and be eligible for work.

Such reorganization of the Health Services will also place Barbados on a better footing for tourism with visitors understanding that their health will be in good hands while visiting our ‘Paradise’. If advertised properly, overseas patients will be referred in like manner to when 19-year-old George Washington brought his brother, Lawrence, to visit in 1751, at the referral of his doctor, to experience the healing effects within our wonderful country’s environment.