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Minister David Estwick Declares War On Forces Undermining The Queen Elizabeth Hospital

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Minister Estwick
Winston collymore-CEO QEH
CEO Collymore

Minister David Estwick in his contribution to the 2008 budget debate cited several difficulties which he has encountered since assuming the post of Minister of Health in January 2008. Since the halcyon days when Senator Branford Taitt was Minister of Health, the QEH stock has been diminishing at a concerning rate for Barbadians. In 2008 the problems at the QEH appear to be complex and will take the cooperation of all the players to ensure that the healthcare dispensed from that institution is not compromised. Minister Estwick from the House of Assembly has sent a clear warning to the several factions at the QEH that enough is enough and he will be taking decisions in the interest of the PEOPLE of Barbados.

At the centre of his frustration appears to be two core issues:

  1. The Queen Elizabeth Hospital Board is being undermined
  2. Some Doctors at the QEH appear to be shortchanging the PEOPLE of Barbados by ‘moonlighting’ on the job. Consequently the core medical pool which is required to ensure an above adequate healthcare delivery is under threat. He cited the example of Consultant Brian Charles who appear to be a jack of all trades if we are to judge by the number of hats he is currently wearing. Then there is the matter of the Human Resource practitioner whose contract was terminated.

The Minister Estwick has sent a strong message in a way only he can, he will not be tolerating any behaviour which seeks to undermine the authority of the QEH Board – see media release below written by QEH Board Chairman

QEH 1

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113 responses to “Minister David Estwick Declares War On Forces Undermining The Queen Elizabeth Hospital”

  1. Georgie Porgie Avatar
    Georgie Porgie

    Real Ting

    I blog also on a medical student/doctor forum that dont even come close to this forum in terms of the level of information shared, the level of licks shared or the level of debate.

    I have a healthy respect for our people, and this blog………….but it will be amiss of me if I dont put the occasional lash in Bush Tea now and again. You cant let cawmere boys get out of hand, you see LOL

  2. Georgie Porgie Avatar
    Georgie Porgie

    Trained economist

    You got some hard questions there on issues of governance for a little doctor like me Sir. People like David, Bush Tea and Yardbroom etc would have to answer you there. I definitely cant speak with authority on question 1.

    Your assessment of the performance of say a Minister is based it seems on senior employees sharing his vision, but how can they share a vision that a Minister does not have, or can not project?

    However, you will notice in my sketchy plan to fix the QEH emergency room and the peripheral emergency issues, including developing and testing and redeveloping systems for mass casualty situations, I don’t involve no permanent secretary or no “independent ” senior civil servants. These guys wont have any say in medical issues, because there are medical illiterates. How will they know, or understand?

    I would deal with the medical issues with the medics. And consult on other issues with those who are supposed to know. I will get second and third opinions from others also. And I wont ask the medics about economics either, because they are economic illiterates.

    The senior civil servants would do the things that civil servants are able to do according to their training or experience. Those who don’t share the vision will be transferred, or ignored. Simple.

    Why should we suffer fools gladly. I don’t. I have always had to be right or get punished all my life, from home, at church, in school, at work; everyone has been hard on me. I have even be punished for excelling. So I have not much times for twits.

    You may ask “How can they share a vision they don’t understand?” I will make it clear that in my watch they are not paid to understand , but to do. Great leaders are dictators, who earn respect because they lead by example and are themselves brilliant. The greatest will listen to the input of others and modify it to suit the needs of their plan. Sometimes understanding comes with the passage of time and with performance.

    Why do Bible scholars NOW understand Daniel’s prophesies? Because 80% of them have been fulfilled?
    Why do Bible scholars NOW make sense when they discuss the mark of the beast? Because we now know that there are bar codes, computer chips that can be placed in the body with information, there is GPS, there are techniques for scanning individuals and identifying them etc. It certainly makes more sense to me than it did 40 years ago when I first started to read it.

    Similarly, if the minister is so far ahead of his staff as he ought to be on medical matters, he should be in charge and large! For heaven’s sake, he is supposed to be a doctor!

    The problem with the Ministry of Health seems to be that the folk dont know what the problems are, how or when the problems started, where or how to start addressing the problems. They are old clueless!

    These guys like they playing against Mendis at one end and Murali at the other end.

  3. Adrian Hinds Avatar
    Adrian Hinds

    GP says:
    The problem with the Ministry of Health seems to be that the folk dont know what the problems are, how or when the problems started, where or how to start addressing the problems. They are old clueless!

    =================================

    I think we all know what the problem is, and further to this we know that there cannot be solved without serious dislocation. They are institutional, and at this point cultural.

    ….I remember a story about an American regional telephone company that changed it’s name several time as each one became associated with bad service. When it went into the cell phone business it deliberately kept that new company seperate in everyway down to empoloyees seperate, and was able to break the cycle. Maybe for no other reason than to break the institutional culture that i think is core to the problems at the QEH, a new hospital seperate in every way from the QEH is in fact the best approach.

  4. Georgie Porgie Avatar
    Georgie Porgie

    So you will hire new Consultants Adrian? Those don’t grow on trees? Also an additional cost. Also our Consultants are part UWI paid and part Government paid.

    To get the requisite number of junior staff you might have to train more doctors. This takes five years and is an additional cost right now.

    To build a completely new General hospital is unnecessary.

    Dislocate the institutional culture that you talk about Adrian.

    I still say that the guys don’t have a plan! I have not heard any health plan since these mendicants came into office except that they will build a polyclinic in St John at the wrong location. If they don’t like my suggestion of below the fork at Salters, it must be below the fork at Turnpike.

    It is written WHERE THERE IS NO VISION THE PEOPLE PERISH.

  5. Georgie Porgie Avatar
    Georgie Porgie

    I forgot the nurses.
    Right now we behind in training nurses even for QEH.

    Who would have thought it? Barbados importing nurses from Nigeria and the Philipines.

  6. Tell me Why Avatar
    Tell me Why

    But Estwick’s rants and braying like Balaam’s ass will not fix anything, I promise you. The men will close ranks and crush him
    …………………………………………………………………….
    Hi George Porgie. The words used “Balaam’s xxx, says that you attended St. Giles’ and traversed Belle Gully. What say you.

  7. Animal Farm Avatar
    Animal Farm

    @GP
    I am not sure which decade you refer to, but it hardly universal in 2008 for intensive care units for adults and premature babies alike to be run mostly by juniors who are barely trained in subspecialty care while consultants pop in and out. It is not about donkey or scut work….high level patients need high level trained care. How many of the junior doctors who work in the QEH are recently graduated interns as opposed to residents in various stages of specialty training?? I suggest you check before you answer from your rear…I suspect you will be surprised. In other parts of the world it is the training residents who ‘run the show’….not interns and there is a big difference.

  8. Georgie Porgie Avatar
    Georgie Porgie

    Animal Farm

    The junior doctors at QEH are supervised by Registrars (what you call Residents in the USA) as wel as Consultants.

    I can assure you that I know what I am talking about.
    I prefer a UWI trained intern to a US resident anyday.

    I have been teaching in US type schools. The doctors are trained to do donkey work in thier residencies- during which time they specialize in one area. They are not as roundly trained as a UWI or UK graduate.

    The US doctor cant fart unless he has done a battery of tests and xrays and MRI’s. THEN AND ONLY THEN HE CAN MAKE A MIS DIAGNOSIS

    Your fancy training residents cant match my UWI trained interns. Your fancy training resident is just an intern with less clinical acumen than our UWI trained doctors.

    THAT IS NOT WHAT I THINK
    THAT IS WHAT THE US CONSULTANTS THAT COME DOWN AS EXTERNAL EXAMINERS SAY ABOUT OUR DOCTORS.

    Our Junior doctors are able to do the work they have to do supervised firstly and aided by the Registrars.

  9. Georgie Porgie Avatar
    Georgie Porgie

    TMW
    No I went to Bay Primary.

  10. Georgie Porgie Avatar
    Georgie Porgie

    In British Medicine you are trained to make the CORRECT diagnosis, BEFORE you order tests, because funds are limited.

    In US medicine uneccessary tests are done and often the diagnosis is not made.

    Animal Farm it is obvious that you are shooting from your shelves of Houston. and you dont know what you are talking about.

    I have a colleague in Barbados – now a Consultant- who was doing ALL THE OPERATIONS IN GYNAECOLOGY & OBSTERICS WHEN HE WAS A JUNIOR HOUSE OFFICER.

    I wont call the name here, but that is no lie.

  11. Barnabas Collins Avatar
    Barnabas Collins

    Undergrounders

    Everything in this country can’t boil down to corrupt Bees and saviour Dems. That is a myopic partisan view. We were having problems with the QEH from “forever” and the problems were across both parties’ rule. And lest we forget, the QEH was not built in 1994 more like 1894 but I digress.

    The doctors run the hospital and the culture there is so engrained that it is almost impossible to fix. I don’t care if you bring in all the HR specialists known to us and placed them on the board.

    I contend that that is the reason why the former government PROBABLY wanted to build a new hospital so they could have rid themselves of some of these doctors. CULTURE is people.

    Therefore, please leave Mr. Estwick, Mr. Walcott et al alone. I don’t care who they bring, once they want to effect change they will be problems a plenty. Having said that though, I am not suggesting that we put our collective hands in the air and continue as it is ad infinitum but I think this needs thought, ingenuity and lots of prayers. I am not sure what can be done to effect change at the QEH to be honest.

    What I can tell you, shouting at people from the confines of parliament will not do it.

    BC

  12. ROBOT Avatar
    ROBOT

    wuh he so damn ugly
    ———
    i hold no brief for dr. estwick
    i find your comment distasteful
    and i think you should leave it alone
    it sounds really silly and harps back to a time that we could best forget.

    so ease on those type of comments -we can do without such comments-please !

  13. Yardbroom Avatar
    Yardbroom

    Tell me Why
    I am a St Giles boy, please do not hold that against the school, it is not the school’s fault.

  14. Georgie Porgie Avatar
    Georgie Porgie

    Animal Farm You started with

    From my personal experience with a relative there as a patient, I can say that certainly the ‘junior doctors’ run that place. I watched them work day into night and then day again. Up and down….worked to the bone, trying their best. When could they have time to have the private practices people suggest?

    =============================

    I assumed that you saw this going on in this decade? Right? So we are talking about this decade right?

    Has it occurred to you that these doctors have had three years of clinical experience, when they have been helping to manage patients BEFORE they became doctors?

    Do you know that in their training that they have had MORE clinical experience, more “hands on” training and MORE responsibility for patients, than the US resident in his first year?. In fact the US year 1 resident is really what we call an intern, but with much less experience than one of our interns.

    Furthermore in our system, one must finish internship BEFORE one can start training to be a specialist. In our system a junior doctor has had four years clinical experience before he can think of starting to do specialty training. That is two more years training than in the US. Do you know any of this?

    The US starting resident is not up to the standard of one of our interns in experience or clinical acumen. OK? I teach medical students in their system, so I know what I am talking about. OK?

    I hope that the above answer helps answer your question “How many of the junior doctors who work in the QEH are recently graduated interns as opposed to residents in various stages of specialty training.”

    Now you write in your abysmal ignorance
    In other parts of the world it is the training residents who ‘run the show’….not interns and there is a big difference. Good point ColumbUS- not Colombo.

    Now learn :.

    In our system it is the Registrars that run the show by supervising the interns. Many of our Registrars are to the level of Consultants in their training OK?. They are not consultants because they are no posts available. In our system we call these relatively senior doctors, junior staff also because they are not Consultants. It was probably them that you saw coming in and out briefly, because they are supervising work on a number of wards. Some of them are in effect “consultants who pop in and out” OK?.

    It is indeed universal for patients to be seen according to an HIERARCHY starting with medical students and well trained junior doctors in the British system or barely trained residents in initial or various stages of specialty training as in the US. Consultants are called when they are needed. OK?. This is the case all over the world.

    Re high level patients need high level trained care. What does that mean? What is a high level patient? The Governor General? The PM?

    Acutely ill patients are monitored more regularly, usually by highly trained nursing staff all over the world, under the supervision of doctors. You want a Consultant to come and watch over your momma, and hold her hand?. How will that help? What about the other patients. Doctor sees the patient. Hopefully he makes the correct diagnosis, orders the right treatment. Hopefully it is available. THEN YOU PRAY! GOD DOES THE HEALING! Not the doctors!

    Intensive care units for adults and premature babies are run by juniors (interns and registrars in our system) who are barely trained in subspecialty care. [ In the US it is done by barely trained residents in initial or various stages of specialty training OK? ]

    Do you know THAT COMMON THINGS ARE COMMON? Does that make sense to you?
    If it does it might just facilitate your ability to understand how juniors can perform well in caring for your so called ” high level patients” and give “high level care.” In training you see it over and over so you can do it in your sleep OK?

    This is possible in our system because in their training our doctors have had more exposure in time than US doctors get in their training. Oh by the way I teach at US offshore schools, and I have also seen the system work up here.

    Re It may be useful in the investigations and fixing of the QEH that a closer look at the ‘junior doctors’ and how they work relative to the Consultants. From where I sat next to my mother’s bed, something just is not right.

    What is it that you want fixed Mr/Ms Think you Know? How do you know the level of knowledge or competence the doctors you witnessed have? Did you examine them at finals? Being an obvious medical illiterate how would you know if something is right or wrong?

    I hope you have learned a bit today.

  15. David Avatar
    David

    On the very critical questions posed by Trained Economist we can partially say that the days of the ‘civil servant’ or the ‘government’ worker must come to an end. No longer can this mildew Human Resource practice be allowed to compromise the efficiency of how our government entities are run. Very applicable in the case of our statutory boards. This is especially true with the QEH which is not only charged with the burdensome responsibility of delivering healthcare in the modern era but MUST do so by being held to account for the enormous slice of the national budget which is consumed by health.

    The days of managing our QEH cannot now be done with the old management approaches. ACCOUNTABILITY must be the order of the day. It is against this background that the HR must be rewarded but they must also be held to account. The option to terminate employees at the hospital for non-performance or incompetence is expected. More relevant to the discussion is the importance to have competent skills on board at the QEH. In this regard when we examine the resume of the HR practitioner who is under fire we are forced to ask the question: What special competencies recommend this lady to the job?

  16. Georgie Porgie Avatar
    Georgie Porgie

    @Barnabas Collins
    The QEH was opened in 1964.
    The doctors do not run the hospital- at least not QEH. Doctors work at the hospital- but doctors don’t run QEH. Doctors run Bayview Hospital though.

    When I was an intern the Sisters were in charge of the wards. Unfortunately, these experienced nurses have retired or died; and those whom they trained have probably migrated. QEH is suffering because we have lost many of our nurses. I learned a lot from the nurses as an intern; especially in Labor Ward.

    I tell all my medical students, “ When you go on the wards respect and listen to the opinion of the nurses. They have seen a lot more than you have. They may just have something to teach you.”

    BC: A higher accountability must be expected of both Drs Estwick, and Walcott, because they should better be able to identify needs than those who are non medics. They ought to be ahead of the game.

    Change can indeed be effected without problems. That’s all I am hearing. Culture this and culture that. But I have not yet heard a plan to change anything. All I hearing bout is people being fired, new board, and lots of noise.

    Man if I am in charge of anything for five years and I have a free hand, it will change…… and as you rightly say with thought, ingenuity and lots of prayers.

  17. Bush tea Avatar
    Bush tea

    Man GP, you share licks enough in Bush tea!!!.. …thanks to ‘real thing’ for trying to pull yuh off o’ muh -yuh hear!!!
    …. the only other blogger that hurt the Bush tea so badly was MME with his twin otter analogy… I still taking a special brew to get over those licks…

    …but when all is said and done, you will discover, in one of your more reflective moments, that when it come to management analysis and effectiveness, Bush tea is is well brewed…

    Your error stems from your inherent good nature. As I have always said, apart from your propensity to attack graduates of the hallowed university at Waterford, you are obviously a good person and a good doctor.

    This anomaly on your part causes you to presume that most doctors are like you…

    The rest of us know that most doctors are doctors because -you get to drive a Benz, you hardly pay taxes, you live a life of luxury and you get lots of other fringe benefits….. OH, you may also save a life here and there…

    Now the QEH depends on doctors to operate at a high standard. HOWEVER, the QEH can never pay the kinds of salaries to match those that can be made in private practice. We therefore allow doctors to do both jobs simultaneously.
    Where do you think that their priorities will lie?

    From the Board’s point of view, its focus is on the doctors HOSPITAL duties, but it cannot compete with renumeration….

    Can you see difficulties brewing?

    Now you want to solve this by ‘listening to ideas’? By medical analysis?
    Do you think that any doctor will admit that he neglects his duties because ‘IT DOES NOT PAY HIM TO DO OTHERWISE?’ …..people are not like that, all kinds of distractions will arise… constant war and rumours of war.

    What we have is a systemic problem. Whoever the players, the problem will persist.

    Again, Bush tea’s solution – Radical systemic change.

    1 – Disincentive for highly profitable private medical services (High taxes in their behinds)

    2 -High pay for efficient and effective expertise in the public facilities – partly funded by these taxes

    3- …and an industrial court to ensure that when unions flex their muscles it is for legitimate causes.

    Trust me GP, this will work like a dream… but the Doctors (who own the clinics) won’t like it, and the Union don’t want no court to stop their bullying.

    The ONLY way that such change is possible will be through a personality such as the goodly Doc Estwick….. Committed, Strong, Fearless and more i’grant than the saboteurs…. a man after Bush tea’s own heart in terms of relevance and suitability for the task at hand.

    …now, can we get back to polyclinics – where you have an extremely strong case?

  18. ROBOT Avatar
    ROBOT

    when I heard that Estwick had been given the HEALTH portfolio , I said uhmnn !, david th-o-m-p-$ON really setting up this man to fail because Q E H and SSA gwine squeeze this man to failure.

    it is suspected that estwick is not a favorite of his leader so putting estwick in health was a strangletegic move.

  19. Georgie Porgie Avatar
    Georgie Porgie

    David

    You are absolutely correct when you opine that “On the very critical questions posed by Trained Economist we can partially say that the days of the ‘civil servant’ or the ‘government’ worker must come to an end. No longer can this mildew Human Resource practice be allowed to compromise the efficiency of how our government entities are run.”

    But remember that delivering healthcare does not only mean hospital care. We must seek to take care to the periphery. Too much stress is put on the hospital. I know that that is a big part of our culture and tradition- running to the hospital for everything.

    Re “being held to account for the enormous slice of the national budget which is consumed by health.”

    I have always thought that our very poor parents and the single mother who sold sweets long side the road were able to manage their budgets; but highly educated and trained politicians and civil servants can’t manage the public purse just because it is not their money. Ideally, all public servants should try not to waste and to treat the people’s money as it was theirs.

    I agree with you too when you write “In this regard when we examine the resume of the HR practitioner who is under fire we are forced to ask the question: What special competencies recommend this lady to the job?”

    Do you know it is easier to fire a doctor in the public service than a maid? All you have to do is not renew his one year contract. You cant easily get rid of an appointed civil servant. And I continually read the myth on this thread that doctors run the hospital. That is bovine excrement.

  20. Georgie Porgie Avatar
    Georgie Porgie

    Bush tea
    Thank you for your kind remarks and your magnanimity despite the licks I had to put in you in case you raise your cawmere head too much. LOL

    I agree that the QEH depends on doctors to operate at a high standard. And it does. But we do have good junior doctors and registrars i am sure!

    I agree too that the QEH can never pay the kinds of salaries to match those that can be made in private practice. Remember that doctors work in hospital and in private practice simultaneously elsewhere.

    The solution to the dilemma you are posing might be to bite the bullet, and promote the senior registrars with consultant qualifications and give them more pay for a five year contract, while you phase out the uncooperative Government Consultants. You cant touch the UWI consultants though.

    I don’t like no board of medical illiterates Bushtea.

    And I don’t think the focus should be on doctors. Other hospital workers are involved in hospital care. A lot more has to be fixed than the Senior doctors, man.

    Bushtea you got to listen to ideas, because you might got some bright sparks like me with good ideas to help you think!

    Bushtea you need to analyze to set up your game plan in every game. I want to get a century on the first day of a test in which I open the batting. I want to be 33-40 at least by lunch. 66-80 by tea.

    That’s why I said if Estwick devised the plan I gave JC last night, he would have a major plank of concern to the public covered- accident and emergency or casualty and without keeping noise. But every body missing that.

    All he had to do is set up bout 20 similar plans in January, and now he could most of his time on Burke’s beach or Browne’s beach!

    When I teaching and I know I have to give an exam every four weeks and one final exam. Before I go into lecture 1, I got 3-5 questions in a file called exam 1, and 2 questions in a file called FINAL EXAM complete with the key. If my lectures not prepared four weeks I advance I want to panic

    Back to your systemic problem with persistent problematic players. I don’t have no problem with radical systemic change, cause I am a rebel- always was .
    1 – Disincentive for highly profitable private medical services (High taxes in their behinds) That is counteractive. Highly profitable private medical services MIGHT indicate that good medicine is practiced there (or that the people think so) That is not undesirable. LET THESE GUYS STAY IN THEIR PRACTICES FULL TIME. AND HIRE MEN TO DO HOSPITAL WORK FULL TIME AS I MENTIONED ABOVE.

    Also fellas aint going to work to pay your taxes. They will migrate.

    2 -High pay for efficient and effective expertise in the public facilities – partly funded by these taxes NOT NECESSARILY THE ANSWER. WHO WILL MONITOR THE STANDARD? THE PATIENTS? WHAT DO THEY KNOW?
    3- …and an industrial court to ensure that when unions flex their muscles it is for legitimate causes. WELL THAT MIGHT WORK

    Bushtea, you can be committed, strong, fearless and more i’grant than the saboteurs, and beat them with out keeping noise.

    I planning right now to destroy a man medical school before he get off the ground cause he think I am a monkey. (He offering me peanuts). Here is a black man offering me half what the white man paid me and want me to do twice the work. I am not arguing with him. I see that his aim is not excellence, and I abhor bogus medical schools. I aint gwine pick my tooth.

  21. JC Avatar
    JC

    GP you have really brought a serious set of ideas that would work!

    I hope that Dr. Estwick listens to David, Bush Tea, and GPs’ advice.

    With my fingers crossed I really am hoping for my friend’s sake and all Barbadian’s sake……….

  22. ROBOT Avatar
    ROBOT

    That is bovine excrement.
    —————————
    w t f

    is bovine excrement.

    man speak to me in a lingo i understand

  23. Georgie Porgie Avatar
    Georgie Porgie

    bovine excrement = bull shit!

    bos, bovis = cow or bull in Latin

    bovine= pertaining to a cow

    now you can use it too LOL

  24. Barnabas Collins Avatar
    Barnabas Collins

    GP…….Thank you for the info. We will wait and see what happens at the QEH. I am not sold on “because you are a doctor that you can manage the QEH”. It reminds me of WI cricket “because a man played 116 tests, he can coach, manage or know about cricket”. But I will wait and see what happens!!!

    BC

  25. Georgie Porgie Avatar
    Georgie Porgie

    BC

    If you check earlier on I said that not all doctors can do anything else but do medicine. Some cant manage anything else. So I know that all doctors are NOT capable of managing the QEH.

    But technically doctors should BETTER KNOW what is involved.

  26. boredickey Avatar
    boredickey

    Having lived abroad for a considerable amount of time, I know that every hospital has its problems and one must wait a long time when seeking attention . However, this is Barbados the little rock on the map and most people can’t take a plane and seek medical attention elsewhere. We have to make things right at the QEH because its all we have. I am not interested in all the fancy talk and how much someone knows about the system.We live here and its up to us to get it right. The QEH is as unavoidable as death is inevitable. The institution should be a-political.You dont need to be a doctor to be Hospital Administrator, COW Williams is no Barbados scholar. It seems to me that the NUPW and others within the hospital want to do as they like and I’m opposed to that. I voted for the DLP for many reasons. One of them being to get this country – that I love more than the USA- back on track. Dr Estwick is the Health Minister and I therefore trust his judgement and give him my support as I feel all people who love this country should do. You might not like his style, but I remember living in NYC when former Mayor Rudolph Guliani was not liked either because he had to get rough and tough with New Yorkers. The city was over=run by the criminals; crime was rampant; 42nd street was where you could buy anything. Guliani cleaned it up using unpopular methods. Being a nice guy sometimes is not always good. Jerome Walcott seemed to be a nice guy, but he came across as being soft. This QEH case needs a new approach ruthless as it might be. Dr.Estwick needs all of us behind him, because it is for the benefit of all your family and mine. Georgie Porgie, you seem very brilliant but last Feb.15th we kicked out a bunch of brilliant guys from government whose brilliance have left a sea of debt. You do NOT live in Barbados;we have to deal with this. You stay there, make your money. I live here and care more about the country than hoarding more and more money. One illness can wipe you out, and furthermore, I have never seen anyone take a dollar with them into the grave. Urge those you know within your proffession to support Dr.Estwick and then give a critical assessment five years down the road, I implore you. Thank you.

  27. Avatar
    Anonymous

    what is the real problem at the hospital

    is it that people cant get rice and sugar to thief and carry home ?????

    is it that people have been restricted from using hospital equipment to do their private work and they get vexx ?????

    is it that people playing the yardfowl game and looking to punish non conformers ??????

    what is the real problem at the hospital ??????

  28. David Avatar
    David

    One of the planks upon which our friend GP seems to have built his argument, to his detriment we might add is his anticipation of Doctors closing rank.

    Now Doctors are suppose to be intelligent by the very nature of what they do, at some point in the history of the QEH Doctors must come to an understanding that they are part of the problem and therefore must become part of the solution.

    The Doctors have a responsibility to save lifes by delivering the best healthcare. part of that responsibility will be to work with government to dismantle the culture of inefficiency which is inbred at the QEH.

    On a side note GP we understand that it has become fashionable for Doctors nowadays to avoid the signing on to the Hippocratic Oath!

  29. Georgie Porgie Avatar
    Georgie Porgie

    Boredickey

    Your post is another emotional rant that does not address the issue at hand.
    In response
    1- I agree that every hospital has its problems and one must wait when seeking attention
    2- I have advanced a partial plausible solution to solve the problems on our little rock . No one has asked for amplification of my ideas or sought to modify my plans except David & BushTea. Everyone else has continued the emotional rant.

    Believe me. I do understand that sick folk can be very anxious while waiting- mainly because they don’t have any idea of their problem. I do understand too that sick folk often get angry when health care personnel seem a bit slow or not so in a rush to help them. BUT….

    Have you thought that having heard your initial complaint that they know the prognosis is not so serious? or not as serious as YOU THINK? Have you thought that since COMMON THINGS ARE COMMON that they have seen it all before?

    Have you thought that many folk in ER’s ought not to be there, but at a more suitable clinic for their situation? Do you realize that our folk often burden the QEH ER because that is our traditional response, even though we have a number of free peripheral clinics all over the island?

    The plank of my proposals is to improve and expand the service at the peripheral clinics, in order to reduce the load at the QEH to REAL medical emergencies; NOT WHAT THE PUBLIC THINK IS A MEDICAL EMERGENCY.

    3- Can I get it into the heads of my people that health care does not necessarily = care at QEH? Can I get it into the heads of my people that we have more than the QEH (although the Bee’s let the vandals tek over the revamped St Joseph Hospital.)

    Can I get it into the heads of my people that health care does not necessarily involve doctors only?

    4- Cant you understand that you have to understand our system, in order to fix it? For example do you understand that our tradition to run to the Casualty for every scrape and bruise is nonsense, when you can go to your nearby polyclinic for many things? Do you understand that this is one of the first and easy things the MOH and the people can address without spending one cent?

    5- IT IS NOT TRUE that the QEH is as unavoidable as death is inevitable.

    Do you know that UWI personnel have been seeking to carry heathcare to the mases since the 70’s?

    6- You may not need to be a doctor to be Hospital Administrator, but you need to be trained! Are any of the Board members trained? If so, how many?

    7-. COW Williams is no Barbados scholar, but he is in CHARGE OF HIS BUSINESS and he is focused. He does not have a lot of fools making decisions that matter.
    He is sucessful because HE HAS A PLAN!

    8- Neither the NUPW or others within the hospital should be able to do as they like

    9- Dr Estwick is the Health Minister and you trust his judgement. That is your right! I also have the right to say that I think he is a loud mouth failure. Unlike you I have brought ideas to the forum which you yourself consider to be very brilliant. And I only making sport pun de forum. Our highly paid minister that you voted for has done nothing in six months. Ah lie?

    10- Don’t you think that I love Barbados too?

    11- I don’t like the ministers style or his apparent ineptitude.He can not do the job.

    12 Mr Boredickey, you have insulted me big time by mentioning me in the same breath, on the same line, and in the same paragraph as the asses you call brilliant that you kicked out at the last election. If they were truly brilliant they would have done a good job with out the stealing.
    Truly brilliant folk know that you cant take more out of system than what is in the system. Hence the inordinate debt. My solutions will not incur any debt.

    13 Skipper I scrunting like every body else. I am now virtually a pauper because of the way the BLP treated me. But I still have my brain, and I have offered reasonable solutions. If you will forget the emotionalism and patriotism and read, mark, learn and inwardly digest what I have written, you will see.

    I do NOT live in Barbados because I am in exile!

    14- If you have read my post well, you will have seen that I went against my professional colleagues in 1985 when I made my proposals for the running of the NHS via the polyclinics, when the profession were fighting the BLP government on the implementation of the NHS.

    15 I cannot support Dr.Estwick until he presents a plausible plan.

    Why should I wait five years down the road to give a critical assessment? Do you know how many Bajans will be dead by then, because he is impotent?
    HE HAS DONE NOTHING IN SIX MONTHS EXCEPT KEEP NUFF NOISE.

  30. Georgie Porgie Avatar
    Georgie Porgie

    David
    You guys seem to not to be reading or comprehending.
    Please read my posts again with an open mind.

    One of the things that you do not understand is that I know some of the fellas in Barbados better than you do, and I KNOW they are capable of closing ranks. In mid 1985, I had men that I did not know calling me and advising me not to support the Government proposals on how the NHS should be implemented. The doctors voted then almost to a man not to support the Government proposals as written. With an election approaching, and having promised at the 1976 election to implement a National Health Service, the BLP government of the day partially adopted my ideas to run the NHS via a series of polyclinics.

    The planks upon which I build my argument is NOT that the doctors will close rank but THAT you must have a PROPER PLAN with
    1- immediate objectives
    2- short term objectives
    3- long term objectives

    For each project you must have such a plausible practical plan.

    I have also outlined ideas of how to overcome and outwit and replace PROBLEM PERSONNEL as needed.

    I agree with you that as part of their responsibility Doctors will individually attempt to deliver the best healthcare that they can give whether they work in the public or private sector. Doctors also have the responsibility to co-operate with government via the Public Health Department to help maintain certain standards e.g reporting communicable disease.But doctors don’t have no responsibility to work with government to dismantle the culture of inefficiency which is inbred at the QEH.

    What I discern is a lack of trust and respect for the local doctors, and the standard of health care by folk who know no medicine, and by folk who are emotional. I also discern that people are so biased that they are not LISTENING!

    I can not get you folk to understand that there is more to healthcare than the hospital doctors and the QEH.
    I can not get you folk to understand that doctors do not run the hospital or the polyclinics. They have to follow certain directives from the ministry of health

    I can not get you folk to understand that doctors don’t control the training or availability of nurses- a crucial plank for healthcare.

    I can not get you folk to understand that doctors don’t control the availability of radioiodine and a lot of things.

    I can not get you folk to understand that we cant have a proper health care system without a proper plan.

    I have failed miserably! I give up! But I tried to educate the forum.

    Re On a side note GP we understand that it has become fashionable for Doctors nowadays to avoid the signing on to the Hippocratic Oath!

    Why should anyone sign this nonsense -http://members.tripod.com/nktiuro/hippocra.htm

    What I agreed and swore to at UWI was much more meaningful and relevant.

  31. David Avatar
    David

    @GP

    We understand you too well don’t worry. But at the root of solving many of the problems is if BAMP shows leadership. As we write this comment the Doctors at the hospital have called on the CEO to resign and they have demanded explanation as to why the medical insurance was changed by the new board.

    The beat goes on!

  32. Georgie Porgie Avatar
    Georgie Porgie

    David

    I tell you man you cant depend on BAMP.
    I circumvented BAMP in 1985, and the BLP implemented the NHS from the polyclinics.

    Estwick has to find away of doing that again.

  33. David Avatar
    David

    GP we were waiting to hear you say that all the doctors need to join one union. We have the junior docs in NUPW we think. Some of the other docs in BAMP. The nurses in NUPW, and we believe there is a minority membership in the BWU.

    Boy the QEH is confusion. No wonder GP had to run!

  34. Georgie Porgie Avatar
    Georgie Porgie

    I agree with you that BAMP should show leadership.

    That is why in early 1985 when I wrote PM Adams and when I confronted Vic Johnson I said to them ” Why is GOB fighting with the doctors about the NHS? This is what must be done.”

    I guess I was a little young rebel then when I confronted the PM and told him what to do.

    BAMP should be able to tell GOB what should be done, and how they will participate. But that will not happen. They will close ranks I tell you.

    So as my mom will say YOU GOT TO EASE YOUR HAND OUT OF THE LIONS MOUTH fellas. You got to be as harmless as a dove and as wise as a serpent.

  35. Georgie Porgie Avatar
    Georgie Porgie

    David
    The docs used to be all in one union-BAMP.

    Is it really true that the junior docs in NUPW now? Very interesting. If that is true, that makes sense. Junior doctors (mainly interns) are in a unique situation. They must work because they must complete their internships to get full registration. Without full registration they cant enter post graduate training etc. Guess who determines if they get full registration? YEP YOU GOT IT! THE CONSULTANTS!

    GP’s and doctors in private practice WILL NOT STRIKE cause they will lose money. They are in BAMP for other reasons—like medical insurance better mal practice insurance rates etc..

    Being in BAMP does not help the junior docs. Consultants always urge juniors not to strike The consultants don’t want junior docs to strike. Who will look after the consultants’ patients in hospital during a strike?

    BAMP as you can now see is not really a homogeneous body. And I see that the QEH in more confusion than ever, it seems.

    That is why we need the MOH to have a great plan that will captivate the junior’s because they are essentially a captive set of workers. The fact that the doctors are more heterogeneous is in his favor.

    David the solution demands an understanding of the system. It is not as hard as you think! Honestly!

    From your post I see a wedge that the MOH can use. Very interesting.

  36. Avatar
    Anonymous

    We does take ourselves real seriously pun these blogs. You think estwick here reading BU to find out what to do next? If this GP fellow feel he got answers why he dont write estwick and tell him what to do? and this exile talk sound fishy. I hope GP ain’t on the run from the law.

  37. Gapp Avatar
    Gapp

    David Estwick I am behind you 100% and do not relent… We are depending on you to deal with the QEH.. Lizz made a mess of it.. Jarome well I not sure what he did while he held that post the only thing I can think of when i hear his name is that porn woman in the morgue… anyway The people on this island sometimes amaze me .. them complaining about the QEH and cant get abc done the A&E this and that but now its time to make wrong things right them getting in the way.. I am a man behind the Trade Union Movent.. I have even been the Union rep for my company at one point but this time i gottah brake ranck with the union.. the Hospital is too important too the well being of Barbados.. “Estwick do what you got to do”

  38. Georgie Porgie Avatar
    Georgie Porgie

    @ Anonymous

    I don’t give two hoots if Estwick reads BU or not. I read BU! And I have stating my view on BU!

    You think Estwick is Moses? Or his Antitype Christ?

    I don’t FEEL I have answers I KNOW that I have answers. I had answers in 1985 and my ideas are working up until today. I have ideas today too. I have revealed some. Do you have any?

    How do you know if I have written, who I have written or when I have written?

    If you cant understand what I have written, why do you suppose that Estwick will understand if I did write.

    Why do I have to write Estwick or anyone and tell him what to do? Is he not paid to know what to do.

    I have colleagues that will see my family for free? Do you?

    I am not going to bow or bend to beg Estwick to try to help . Why should I?

    I hope to go help run a new offshore medical school soon, God willing.

    I am trying to make a contribution hereon the forum, and trying to explain certain things and you talking bovine excrement because you have access to a PC and to the internet, and because you are not literate enough to understand what I have written.

    People of your ilk suspect every thing. Why cant you believe that I am in self exile. Why should I be running from the law? I had to run from the BLP oppression.

    I had my scholarship. I was not bonded. Yet I served my people faithfully for 20 years everytime I got the chance in many capacities, until the BLP felt I should not work in Bim! I don’t owe the Bajan public anything man.

    @Gapp
    You can stand behind Estwick100%.
    You can depend on him to deal with the QEH.
    You can engage in emotional rants.
    You can shout “Estwick do what you got to do”, “and do not relent” as much as you like, but when the fellas close ranks quietly as they are doing, his balls will get squeeze. Watch and see. If and when the men close ranks, Estwick cant do a thing.
    Estwick has to outfox and circumvent who ever the trouble trees are!
    Again in your statement “the Hospital is too important to the well being of Barbados” you demonstrate the myth that healthcare is all about the QEH..”.
    What happens if the men borrow money and build other private hospitals. We already have private ER’s.

    Estwick vs BAMP. That sounds like fun.
    The youngsters may not be like the lads in my day.
    They may engage in emotional rants like you guys and strike.

  39. David Avatar
    David

    GP don’t despair we know for a fact that the very important people read the blogs:-)

  40. boredickey Avatar
    boredickey

    @ Gapp. My feelings exactly.I’d like to know the relationship between Dennis Clarke and the HR woman involved.Hmmmmmm!GP. The current CEO Winston Collymore was recruited under the former hospital board, from London where he was involved in hospital administration there. This as far as I can remember. So the baker can’t run the bakery. The current board are well qualified men, I say give the board and Dr.Estwick a five=year chance please.Right now the Dr. is fighting an octupus against change the back of which must be broken. I voted for the DLP not NUPW or Dennis Clarke or BAMP.If I have any suggestions I will write the Minister.This one I’ll give him here though! “Kick Butt man!”, change must come.

  41. JC Avatar
    JC

    GP all your ideas are workable I think we need you back here amongst your own ‘we need persons like you more than ever’

    You make me feel proud to bajan and that is the truth!

    However, I still like Estwick’s style but if you combine the two of you, Lord have mercy, I would go to QEH smiling, happy knowing my friend is in capable hands!

    I agree with David importnat people read the blogs, they will send the message,

    I hope Estwick listens ……..

  42. Wishing In Vain Avatar
    Wishing In Vain

    David // July 12, 2008 at 10:42 pm

    GP don’t despair we know for a fact that the very important people read the blogs:-)

    Including the PM my friend.

  43. Winston Collymore Avatar
    Winston Collymore

    UNDER FIRE
    Published on: 7/13/08.

    The Queen Elizabeth Hospital’s chief executive officer Winston Collymore.

    by SANKA PRICE

    BAD MANAGEMENT is one of the major causes for the decay of patient care facilities at the Queen Elizabeth Hospital (QEH), say doctors.

    But they contend this rot can be stopped if the QEH’s chief executive officer Winston Collymore is removed.

    The Barbados Association of Medical Practitioners (BAMP) stated this yesterday in a Press release issued to set the record straight on the continuing industrial unrest at the QEH over the last two weeks.

    In the release, the doctors said they were committed to ensuring the well-being of the public and pledged they would redouble their efforts to remedy the QEH’s ills and restore confidence in the institution. But to achieve this, Collymore must go, they say.

    They stated that despite BAMP’s executive holding several meetings with Collymore there had been “no real measurable success in outcomes or noticeable improvement in the day-to-day function of the hospital”.

    “It remains our opinion that the CEO has been ineffective in his capacity to manage the affairs of the Queen Elizabeth Hospital and once more ask for his replacement,” said the statement which was signed by BAMP’s public relations officer Dr Abdon DaSilva.

    Unanimous opinion

    The release said this was the unanimous opinion of the BAMP meeting held at the Martindale’s Road institution on Friday, July 4, where “members expressed overwhelming dissatisfaction at the performance of the CEO of QEH”.

    BAMP also took issue with the “unilateral” manner in which the hospital’s management switched insurance coverage from the Medical Protection Society (MPS), the leading provider of comprehensive professional protection, indemnity insurance and expert advice to doctors, dentists and health professionals around the world.

    The association said it did not support the notion that doctors at the QEH or any other individual should, or must agree to the terms of an insurance policy because they consent to having their employer select their insurance coverage.

    “Furthermore, the exclusion of insurance coverage as it relates to HIV/AIDS regardless of the reason is particularly worrisome and bodes of institutional discrimination and stigmatisation of people living with HIV/AIDS, and individuals infected with non-Hepatitis A.

    “BAMP is not convinced that the board’s interest in containing costs justifies the compromise in insurance coverage for doctors such as the loss of help with ethical problems that arise from professional practice, complaints, medical council enquiries, legal and ethical dilemmas, disciplinary procedures, inquests and fatal accident enquiries.

    “These issues are particularly challenging given the continuing “stock-outs”, a persistent and long-standing depleted (X-ray) radiology department, a recent shortage of diagnostic equipment in the respiratory unit, and the excessive delays in the Accident & Emergency Department,” the release said.

  44. Georgie Porgie Avatar
    Georgie Porgie

    @David and Wishing In Vain
    I am glad that very important people read the blogs including David.

    @ JC
    Thanks for your kind remarks I would dearly like to be home amongst my own more than you know. But we don’t like rebels in Bim.
    I don’t think I could work with Estwick , cause he keeps too much noise. I wont be able to think.

    @ boredickey
    You seem to think that “The current CEO Winston Collymore was recruited under the former hospital board, from London where he was involved in hospital administration there…… The current board are well qualified men.”

    It seems that the doctors don’t agree with you sir.
    All of BAMP cant be wrong on this one.
    If he must go in the interest of the health of the people as BAMP thinks, seems to me there should be a compromise here. CEO Winston Collymore must go. He cant run the board and he cant doctor either. Bye.

    If we give the board and Dr.Estwick a five year chance, things will be worse at the rate it is going. The DLP comes and goes; BAMP will remain whether you vote for them or not.
    What suggestions of consequence you can have to send the minister what? What s “Kick Butt man!”, change must come what?.

    Note this Bible story and see if you can find sense in it.
    Wicked Pharisees brought a woman alleged to be an adulteress.
    They seem to have the Master on the horns of a dilemma, because they have the correct charge under the Law and she is indeed guilty..

    If he say don’t stone the woman; they will say “you don’t keep the law.”
    If he says stone the woman; they will say “ You don’t exhibit the grace and mercy you profess to have.”

    These guys are like some of you. You commit the fallacy of the unexcluded middle. You think its EITHER/ OR. Its this or that. Its not to be the old way; it has to be Estwick’s way. I’m saying that there might just be an alternative way. They might be other ways.

    What did Jesus do? He quickly get into position, and played a master shot that eventually caused the case to be thrown out for lack of witnesses, and didn’t condemn the woman because he knew he was going to the cross to take her condemnation.

    What must Estwick do. Quickly get into position, and QUIELY play a series of master shots like Chanderpaul. And he will get the job done.

    You guys must leave out the emotion.

    When the Ministry asks you to respond, then you must respond.

    You get worked up about the hospital, but do you dump irresponsibly in our beautiful gullies, and affect our water courses?

    You get worked up about the hospital casualty, but dont you clutter it up when you can often go to the polyclinics for the same service.

    If the Ministry should ask you to put out your garbage in different colured plastic bags or containers on different days so that we can help the recyclers help Sanitation reduce the garbage that goes to Mount Stinkerro, will you obey, heed and cooperate?

    Do you comply with the request of our Public Health Inspectors? Do you parents/ mothers cooperate with the instructions of the midwives and visiting public health nurses? Are you aware of the great job they do in child health care and obstetric health care?

    Will our school teachers help the MINISTRY OF HEALTH brain wash our people from tender ages in what are the nation’s goals for health care.

    These are just a few of the ways that the public at large can help the MINISTRY OF HEALTH and the Minister, instead of inciting a foolish sounding man to do foolishness.

  45. Georgie Porgie Avatar
    Georgie Porgie

    My Dear BU DAVID

    Re :UNDER FIRE
    Published on: 7/13/08.

    The Queen Elizabeth Hospital’s chief executive officer Winston Collymore.

    by SANKA PRICE

    Now I will help you whip my colleagues when they err, because to err is human.

    However, according to the details in the post from the public announcement in the newspaper by BAMP, I am forced to side with BAMP.

    If the guys want these few things sorted out to make them happy. compromise with them and do it. WHAT WILL THEY BE ABLE TO COMPLAI ABOUT AFTERWARDS? They requests as mentioned are reasonable.

  46. Georgie Porgie Avatar
    Georgie Porgie

    Oh I forgot in my comment on JOhn 8 above.

    Dont we Bajans still believe that THERE IS MORE THAN ONE WAY TO SKIN A CAT?

  47. JC Avatar
    JC

    I myself can considered to be a rebel and I am not going anywhere GP!

    Come back home WE LOVE REBELS!

  48. Georgie Porgie Avatar
    Georgie Porgie

    JC

    Have you ever took on Mia Owen or Liz?

  49. JC Avatar
    JC

    Nope not yet I assumed you have; and knowing by your syance you gabe them hell; actually I am now starting my career;

    As for Mia SHE nearly took me on lol

    A day I was walking by and that woman dropped a comment at me that I thought was DISGUSTING!

    she really wanted to take me on. lol

  50. David Avatar
    David

    Some members of the BU family would have heard resident health expert refer to the semblance of a plan for health Barbados. For those who would have wondered what he is talking about here is the link.

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