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The Queen Elizabeth Hospital’s View Of The Ishmael, Sparman, Inniss Blow-up

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The following was received from a BU Source:

Queen Elizabeth Hospital (QEH)
  • Dr Ishmael, as a senior member of the Consultant staff of over 30 years, is held in high regard by the Ministry and Board of Management of the QEH.
  • The decision to suspend Dr Ishmael was done only after consultation with a legal and industrial relations expert and in the best interest of both Dr Ishmael and the QEH. It is consistent with current practice where a serious breach of the Staff Rules is alleged. A full investigation into the matter is being conducted.
  • It is important to note that in June the Board was advised in writing by Dr Ishmael that he could not guarantee that he would be renewing his contract which expired in April of this year. Notwithstanding, the Board delayed advertising the post of paediatric cardiologist, given Dr Ishmael’s standing at the QEH and also to accommodate the personal and professional commitments that took him away from his duties for considerable periods. Notwithstanding these prolonged absences, the Board received no correspondence from the Department of Paediatrics on the “increased risk of adverse outcomes” similar to the one issued after only one day of suspension.

Related Link – Internal QEH Memo

  • As noted above, the QEH Board has made every effort to ensure that paediatric patient care is not compromised during this period. The actions taken includes dialogue with paediatric cardiologists abroad, one of whom is a Bajan, to either bring them to Barbados for consultations or using telemedicine to send data to access their consult services remotely. In addition, the support in the short-term is being provided to Department of Cardiology to assist Dr Moe.
  • While agitation by members of the medical profession locally and regionally for Dr Ishmael’s reinstatement was anticipated, given his strong personal and professional loyalties, it is important to reiterate that in the interest of patient-care, staff morale, and good governance that no employee at the QEH, regardless of profession, age, colour or political affiliation, can be placed above the law and beyond the staff rules.
  • One critical point that has arisen during this matter has been the realisation that in some areas of clinical speciality there are no back-up services available and during periods when specialist are away including on vacation there is an increased risk of adverse outcomes. To avert this situation in the future, the Board and Ministry have been communicating and the QEH will. move with haste to develop a register of those Barbadian physicians in the Diaspora who are willing to provide support to the QEH in the provision of services to the Barbadian public. This will be explored as a new thrust in the Medical Aide Scheme.
  • There is unwavering support for the Board of Management of the QEH by the Government.

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  1. Micro Mock Engineer Avatar
    Micro Mock Engineer

    “It is consistent with current practice where a serious breach of the Staff Rules is alleged”
    ……………………..

    I read elsewhere that the ‘Staff Rules’ which Dr. Ishmael is alleged to have breached are 5.2.1 and 5.2.5 of the Terms of Conditions of Service for the Employees of the Queen Elizabeth Hospital.

    Can anyone share what these rules actually say?

  2. Commander Avatar
    Commander

    Notice how the admins at the QEH have never ever cared about the well being of patients when the lone specialists in any of the specialities had to go on vacation or sick leave or left or even died!

    The average poor person going to the QEH or Polyclinic was simply told tough ……….. you cannot get such and such. But when they have the gall to suspend a man wrongfully they still put nothing in place as usual!! Then when Dr. Cave wrote in the paper and BAMP raised concerns, suddenly there were contingency plans and everyone was ever so caring enough to have a telemedicine service.

    Utterly disgusting.

    Where is the telemedicine service for all of the women awaiting mammograms for well over a year?

    Where was the telemdicine service for the EEGs when gov’t only had one trained technician to administer it and only one consultant who generally read them? Where was the telemedicine service when the technician left and for over a year (I’d like to say years but I am not 100% sure of the exact duration) no poor Barbadian could get an EEG no one could figure out what type of seizure you or your child was having or if it was indeed a seizure.

    Where was the telemedicine service for the poor people who could not afford barium meal and barium enema studies between 2003 and 2009 when successive QEH management administrations failed to order or install the equipment. Though patients and doctors begged for it. If any of you recall the big boxes that featured prominently in the QEH’s corridors for several years ……… well that was the equipment that sat down there until the warranty expired. Why it sat there so long is another matter just like the extremely expensive A/C equipment which was bought and never installed for years while sitting in a private lot at the cost of $2500 a month while rusting ………… it might still be there too. I could go on and on.

    I therefore have seen no moral authority or backbone by the Ministry, QEH management or board on this issue. How dare they then try to turn it on him. Because he is the only pediatric cardiologist here are you saying he should not get sick? He should not get professional or training leave? He should not get vacation?! It is the duty of the management and the board to see to it that they hire enough staff for the given services as the public has been asking for years and years and not continue to pretend to offer a service by hiring a single consultant and then expecting him to do all of the work himself with NO junior staff …………… ie no team. Then they have the gall to complain when he is out of BIM.

    What is the amount of time that the management team has been away from their posts?

    Notice as well that the telemedicine thing is a new attempt to use a crisis to bring in some of the same people that I believe they have already secretly lined up for posts in the QEH. Hence the list that was going around which contained the names of consultants that certain people wanted gone. The attempts to get rid of Rambarat, Jones and Emptage were merely testing the waters to see if they could accomplish their goal of firing doctors without any form of due process or performance appraisal. Ishmael has now caused them to attempt to speed up his removal. Thankfully it looks like they will fail. I sincerely hope that he does opt to renew his contract and mek them suck salt. Please Doc do not let this affair make you leave and allow them to succeed in getting rid of you via attrition like they did with a certain A+E consultant.

    Look at this nonsense article and the statements by the unnamed “source” regarding people who want to come back and work. I think it would also be good to have a look at the posts from the last responder in the comments on the article.
    http://www.nationnews.com/index.php/articles/view/time-for-change/

    Time for change

    By Wade Gibbons | Mon, June 28, 2010 – 12:00 AM

    THE QUEEN ELIZABETH HOSPITAL (QEH) cannot operate as it has done in the past.

    Nor will Government allow it to function to the disadvantage of average Barbadians.

    That was the pronouncement yesterday from a very senior QEH official who will be involved in emergency discussions with the Barbados Association of Medical Practitioners (BAMP) during the week.

    Speaking to the DAILY NATION on condition of anonymity, and in the wake of BAMP’s concerns over the public advertising for a consultant urologist and pathologist, the official said consultants had been “ruling the QEH” for too long.

    He said doctors in the public sector, including those at the QEH, were hired on three-year contracts and the hospital had the right to renew or not renew those contracts. He noted the attitude of some consultants left a lot to be desired.

    “Some of their attendance at public clinic is very rare. Some of them are more interested in doing private cases as opposed to public cases. Many of the public cases are pushed back all the time or cancelled, while private patients who pay large sums of money are given priority at the QEH. However, this occurs with a minority of them,” he said.

    He noted that one of the challenges faced was that there were only a few consultant positions at the hospital.

    “Consultants get about $15 000 per month and are required to work a minimum of 21 hours per week. They are allowed to have a private practice and are allowed to bring their private patients to the QEH and treat them there for a fee payable to the doctor.

    “The senior house officers who are next in line in terms of the clinical work are oftentimes doctors who are just as well trained as the consultants. But they are on a fixed salary. They are not allowed to have private practice,” he explained.

    The top official said if the hospital kept renewing the contracts of the consultants, senior house officers and registrars would never get the chance to move up the ladder to be consultants themselves.

    “What has been happening is that the QEH has been losing the skills of mid-managers on the clinical side. They are going out into private practice exclusively, or they are leaving Barbados altogether to work abroad,” he said.

    He explained that the hospital could not create more posts but could create the opportunity to see who else could fill the existing consultancy positions.

    He revealed consultants made a minimum of $350 000 annually when their private practice and public functions were taken into consideration.

    He said Barbados’ primary urologist was in his 60s and one could not wait “until he drops dead” to have other options. He indicated there were Barbadian urologists based overseas who would like to return home to be considered but were afraid of “the system” at the QEH.

    Referring to a situation last year with a pile-up of bodies at the mortuary because autopsies were not being done, the senior official said Barbados deserved better than that.

    Yesterday BAMP president Dr Carlos Chase said he had no comment to make “on anything”.

  3. David Avatar
    David

    Looks like the PR has gone into motion.

  4. Commander Avatar
    Commander

    @ David I see that you posted the article for the benefit of the readers but please also post the comments to it as the article by itself only further gives voice to some “unnamed” so-called official’s sidespin which the commenters showed in several cases to be full of inaccuracies due to either ignorance or purpose work.

  5. David Avatar
    David

    Here are the comments

    Posted by Carl 5 months, 3 weeks ago
    It is funny how miraculosly they ‘know’ how much $$$ a consultant makes at his/her private practice. Deal with the real issue of job security, the lack of objective appraisals which let an officer know that things are going good bad or indifferent and the fact that it is ONLY the doctors at the QEH, the same ones being dissed now who ever have anything to say about improving the conditions for patients.

    This statement is an attempt by some people to deflect from their breach of labor practices.

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    Comment LinkPosted by RN. Fort.Lauderdale. 5 months, 3 weeks ago
    The hosp. been in poor state for a long time. I’m hoping that the top brasses can come up with clear objectives for this facility. The pts. are always #1 & should be treated as such. Money always talk & the rest is history…but it shouldn’t be like that. The pt(s). that don’t have money should still be treated & shouldn’t have to wait for long periods of time. Very unfortunate & these are the ones that suffer the most in the long run. I really do agree with the 3rd paragraph fr. the bottom. Some of us would like to come home & make meaningful contributions to the hosp. & the place as a whole but always get stop in our tracks by stronger powers. Take care of the pts. esp. the elderly. Everybody is important.

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    Comment LinkPosted by Carl 5 months, 3 weeks ago
    Something I forgot to add is that the main people who need to go home would be people of the ilk of those in the QEH who work in admin posts and do not do their job(s).

    It is funny that for years and years doctors were the only staff there on contract and the only ones who could be fired easily for poor performance. (I know of several which were sent home). There are procedures to go through which unlike other levels of staff involve far less red tape. It therefore annoys me that an “official” could complain about doctors. As competent managers they should have the gumption and skill to assess staff and inform them of shortcomings long before contract renewal or promotion schedules. They would not then have to think it fit to reserve the right to send home people willy nilly and appoint people willy nilly. If the staff are no good tell them so early and get rid of them if they fail to pull up their socks.

    Due to the character limit I have to post this in several bits:(

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    Comment LinkPosted by Carl 5 months, 3 weeks ago
    Part 2

    Anytime an officer is allowed as this “official” claims to have poor attendance, then the fault is in admin for allowing it to happen unchecked and the law is behind me on this. It is called acquiescence. The problem here then is with admin staff not enforcing the rules and deciding instead to reserve the right to fire anyone without due process.

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    Comment LinkPosted by Carl 5 months, 3 weeks ago
    Part 3

    this quote alone is telling : “He indicated there were Barbadian urologists based overseas who would like to return home”
    How does he know that. Does he and these interested parties correspond?  How can we then trust the selection process??  Is the job being lined up for someone particular?? I think these are reasonable questions as the only reason given by this gentleman for replacement of the particular officer is his age!!! I hope our more senior public servants are taking notice as this may be the new way to hire people …………. send you home quick rather than wait “until he drops dead”. That is disturbing on many levels. I wonder if he as a “senior” officer realizes that he is a part of and likely a big part of “the system” at the QEH that doctors and patients alike are afraid of.

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    Comment LinkPosted by Carl 5 months, 3 weeks ago
    Part 4
    That my fellow Bajans is what this is really about. An attempt to have doctors who are too afraid for their jobs to agitate for better patient rights and staff conditions. The plan is to have a system where politics and nepotism can run riot while Bajans get ill.

    The “official” also shows himself to be lacking in knowledge, as a senior house officer (SHO) is far far far from being a consultant. A SHO is several rungs from consultant and extremely junior, in fact, there are 3 grades of registrar (the level below consultant) and at least 2 grades of consultant above a SHO. While there is only one rung between an SHO and a medical student. I hope that the “official” is willing to have any surgery for him or his family performed by a team of “well trained” SHOs.

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    Comment LinkPosted by Carl 5 months, 3 weeks ago
    Part 5

    Finally what is also lacking in this article
    (conveniently) is the fact that if the “official” is indeed a “top” one …….. he makes more money than almost all of the doctors and nurses in the institution while doing far less hours and with far less qualifications!!! In fact, docs at the QEH are still tied to the old public service salary scales and consultants range from S2 to S5. But these new fangled senior officials being part of the newer statutory structure are not tied to such and therefore make much much more money as they have no ceiling like the healthcare workers do.

    So who is the villain?

  6. Commander Avatar
    Commander

    @ David

    Thanks.

  7. Crusoe Avatar
    Crusoe

    @CH”Christopher Halsall | December 22, 2010 at 5:17 PM | @Question et al… To share…

    I’m asthmatic.

    I get a prescription from my Doctor. I fill it at my Doctor’s pharmacy. “That will be $17 sir”.

    I then go back to the same pharmacy and buy the same drug “over the counter”. “That will be $15 sir”.

    I then go to Knights Pharmacy and buy the same drug over the counter. “That will be $10 sir”.

    WTF???

    ——————————-

    Chris, glad you raised this. THAT is where the government should have focused on healthcare costs and pharmacies. I too have purchased medication previously , where over the counter was one price, but the charge to the government service on the invoice was much more.

    Therefore, the government did not need to remove subsidy to ill patients including aged, by charging fees, but merely audit the charging of medicine, by pharmacies, to the government service!!! Why would pharmacy charge the Government more for a medcine than over the counter?

    A case of not understanding the issue and the source of leakage.

  8. My Name Is Not Sylvan Avatar
    My Name Is Not Sylvan

    Ahh yes the damage control has begun….

    Reverend Hewitt no doubt is aware that a Cardiologist is not the same thing as a Paediatric Cardiologist.

    Notice in this memo there is no mention of if Dr. Ishmeal’s charges of the DMS calling on behalf of the Minister of Health is in fact true.

    It would seem that this is once again the tried and true method of the DLP and its supporters of drawing an irrelevant red herring across the trail to distract people.

    This is not about a battle between the hospital administration and the consultants.

    This is about the question of Dr. Ishmeal’s letter alleging that the Minister of Health was intervening on behalf of a person with apparently questionable qualifications with complete disregard for patient care.

    “Circling the wagons” indeed!

  9. Commander Avatar
    Commander

    @ Crusoe

    Government i not charging the patient $$ for the prescription. It is the pharmacy which is charging a prescription dispensing fee or the handling fee which relates to formulary items.

    In fairness to Government and the minister, meetings were held with the pharmacies to ask for them to reduce the fees charged to government. It was explained that Government could not bear the costs much longer (some pharmacies can pull in up to $1 million a month from Gov’t). The pharmacies refused. So government decided that they would simply cease to pay any fees charged and expose the pharmacy fee markup to the general public. Pharmacies will have to decide if they want to keep jucking out people’e eyes or if they want to stay in business.

  10. mash up & buy back Avatar
    mash up & buy back

    To some of the charges being made by Commander above surely you are not accusing this new QEH board and new minister – of AC machines left to rust and not installed and other problems which existed when Jerome walcott was the minister of health and there was no board in place?

    This board has tried to clean up the mess that exists at the QEH,so I am giving them some rope.

  11. Enuff Avatar
    Enuff

    If it is true that Dr.Ishmael was suspended for using official QEH stationery, then to be consistent the person that wrote this memo should also be put on suspension.
    This ‘internal memo’, written on official QEH stationery, is certainly not internal as neither the Chairman nor other board members are STAFF and therefore cannot receive internal memos. Furthermore only the CEO/Director should be corresponding formally with the Chairman. As such, any staff member that chooses to write a Chairman would be doing so in a private capacity and should use personal stationery. To do otherwise is to usurp the authority of the CEO.
    Note that Dr.Ishmael’s letter was addressed to another staff member and cc to the Chairman, Minister etc

    @ My Name is……
    How can gov’t determine a private company’s administrative costs?

  12. Enuff Avatar
    Enuff

    “Traditional medicine was often illness-centred or cure-centred; the focus was on attacking and overcoming the disease. The patient – his comfort, mental status, wishes and desires – was secondary to defeating the medical enemy.
    “But that no longer needs to be the case. A patient-centred approach offers an add-on to the current care through a low-technology, systems-based approach to many of the problems and challenges that exist in the QEH.”
    __________________________________________

    I feel Rev Hewitt should just stop talking. I find the above attempt to define ‘patient-centred’ care incoherent and insulting to doctors and nurses.

  13. Random Thoughts Avatar
    Random Thoughts

    Quoting a BU Surce in regards to DEr. Ishmael “also to accommodate the personal and professional commitments that took him away from his duties for considerable periods.”

    Dear David:

    Please ask the BU source for us if Dr. Ishmael is being pounished because he had to be away frequently to assist with the late Prime Minister’s care.

    Also ask the BU source if he/she (nah it gotta be a he) thinks that the people of Barbados are complete idiots.

    Once we have the answer we will know how to vote in the next elections.

    And if the current Prime Minister is playing dead on this one.

    Somebody tell him that we the people ain’t dead (nor brain dead)

  14. Random Thoughts Avatar
    Random Thoughts

    Georgie Porgie claims that there is a priests with balls connectd to the QEH.

    But as I see it the only person with balls in this issue is Dr. Ishmael.

  15. Random Thoughts Avatar
    Random Thoughts

    David ask your BU source if they think that a jury of Dr. Ishmael’s peers would think it a serious breech of the staff rules if a QEH consultant writes a letter to QEH officials on QEH letterhead?

    Ask you source to sit down and stuudy ‘e head good, good and ask him if this came before a jury, or a sensible judge if Dr. Ishmael would be convicted?

    Tell your source that we the people believe that that thier unnamed legal and industrial relations expert is nothing else but a DLP yard fowl.

    And if writing a letter of QEH letterhead is a serious breech of the staff rules…what happens when a doctor through his or her carelessness or incompetence causes or hastens the death of a patient? Or has this never happened at the QEH? And if this has happened at the QEH howcome we the QEH patients have never heard of anybody being suspended for such.

    David please tell your source that we Bajans aint have nuff, nuff education for nothing. Tell your source that nuff ‘o we are better educated than the Minister, the Prime Minister, the QEH Board, and most doctors at th QEH. Ain’t so easy to fool we no more.

    Tell your source that there is no need to lie for high ranking officials.

    Tell your source that most high ranking officials can lie perfectly for themselves.

    Tell your source that we the people will punish the DLP for this.

  16. Commander Avatar
    Commander

    @ maksh up and buy back

    No, I am not pinning QEH’s past ills on the present management structure. I was showing that for years and across several administrations QEH has disregarded the risk posed to patients by having too little skilled staff in many areas. I was therefore trying to show the hypocrisy in their arguments vs Dr. Ishmael.

    And there is still quite a bit of anti-patient stuff going on under their watch.

    @ Enuff

    Rev. Hewitt is merely perpetuating the true nature of the QEH as an administration-centered institution. If it was as he accuses a Doctor/healthcare worker centered place :

    1/ Would Drs. go so often without pay?

    2/ Would Drs have problems getting their gratuity/pension/contracts in a timely fashion.

    3/ Would Drs in senior positions eg Dept heads have to be begging for yrs and yrs to have secretarial support.

    4/ Would Drs. be paid on the regular Gov’t salary scales at a statutory institution while admin has had theirs de-linked from such and make far more than the consultants?

    5/ Would Drs. do a 36hr shift without sleep twice or more a week rather than hire more staff?

    6/ Would Drs. perform their duties next to pigeon dung and fungus?

    7/ Would female doctors walk the wards at night alone while other staff are given security escort?

    8/ Would doctors perform a 36hr shift for less than a true overtime rate? $200 to $330 to be exact? What professional does an extra 16hrs of intense work for that?

    9/ Would Drs. run out of simple things like gloves.

    10/ Would Drs. be the only staff for years at the QEH that could be easily fired and not offered permanent appointment?

    11/ Would Drs. find out on maternity leave that no one paid the NIS that was being taken out of their salary monthly?

    12/ Would Drs. allow pencil pushers to overrule what things can be ordered for their department and patients?

    I could go on and on but when the administration with their big salaries, secretaries and big A/C offices say that the institution is focussed on serving doctors ………………… they must be right. We should have utmost confidence in their statements.

  17. Random Thoughts Avatar
    Random Thoughts

    Quotng David’s QEH source “It is consistent with current practice where a serious breach of the Staff Rules is alleged.”

    Staff rules my a*s.

    There is a certain secondary school in Barbados (and it is not for nothing that it is the most highly regarded secondary school) that has as it primary school rule:

    “a breech of commonsense is a breech of the school rules”

    David ask your source if common sence (and if I may add, common decency) hasn’t been breeched here.

    There is also a saying “that the law is the last refuge of scoundrels”

    David please ask the people of Barbados who is the scoundrel in this matter.

  18. Random Thoughts Avatar
    Random Thoughts

    Oh and in this matter Dr. Cve has balls too, as do Dr. Ishmael’s local and regional coleagues who have objected to this INJUSTICE.

    This is not about being “unfaired”

    This is about a QUH Board which is funded by OUR TAXES and which acts in OUR NAME committing an INJUSTICE.

    And we the tax paying citizens of Barbados object to this injustice.

    And if the DLP does not correct itself. We the tax paying voters of Barbados will do the correction for them.

    Tell the PM just wait and see.

  19. Random Thoughts Avatar
    Random Thoughts

    Oh and by the way somebody should tell Dr. Sparman that when a patient’s next of kin tell’s you “be off” as in “get lost” you should get out of the woman’s face. The nerve of calling your friend the Mnister of Health in an attempt to override the wife’s wishes.

    But then Dr. Sparman has never been able to keep a wife because clearly he has never had much regard for wive’s wishes.

    A lotta, lotta, men can bully their wives. That is real, real easy to do.

    But like hell when she is ready to leave you can’t make her stay.

    Tek dat.

  20. Charlie Avatar
    Charlie

    Let me say I read Dr. Ishmael’s letter on BFP and is astonished that Dr. Ishmael can be suspended for such.
    Dr. Sparman was out of place to be poaching patients from the QEH once they seem to be able to pay for his service.
    I am disappointed in Minister Donville Inniss for taking such a stance although I can understand that he would not want a visitor as patient dying in the A&E Stats room and not being able to get into the ICU for a lack of space.
    Until I get further information I do not see why the man was suspended. The internet will stop ministers and boards with getting away with foolishness. When will they learn that the main stream media cannot protect them any longer because of the libel laws? Wiki leaks should have taught them something

  21. Hants Avatar
    Hants

    @GP,
    The person who wrote this must be a cattle farmer. He had the material he wrote in the pen where they keep the bulls.

    From Nationnews.com
    “Traditional medicine was often illness-centred or cure-centred; the focus was on attacking and overcoming the disease. The patient – his comfort, mental status, wishes and desires – was secondary to defeating the medical enemy.

    “But that no longer needs to be the case. A patient-centred approach offers an add-on to the current care through a low-technology, systems-based approach to many of the problems and challenges that exist in the QEH.

  22. Georgie Porgie Avatar
    Georgie Porgie

    @ Random Thoughts
    Sir when I speak of the priest with balls, I am mockingly derisive and just quoting the title given to him early in the year by the BU know it all poster Bush Tea. Bush Tea said he was a priest with balls.

    I think that the man and the minister are betzpaenic- they have no real functioning brain cells.

    I really laud and applaud the posters above for seeing through the QEH admin’s spin on the issue.

    Richard Ishmael had every right to question whether what went on in the QEH A&E WAS TRUE OR NOT. He apparently did it out of a sense of duty, rather than a sense of malice. He ought to have been respected for this.

    Dr GP would have passed them by and sent the information directly to the blogs and any appropriate officials.

    It is sad that there is no opposition inBarbados to respond to this political tyranny.

    As for talk of doctors abroad wanting to come home to work under such conditions and to give back……..RUBBISH. MANY HAVE TRIED THAT BEFORE AND RETURNED FROM WHENCE THEY CAME, IN HASTE!

    ALL DOCTORS ABROAD SHOULD BE CAREFULLY OBSERVING QUIETLY HOW OUR IGNORANT OFFICIALS TREAT PHYSICIANS.

    BY THE WAY DO WE REALLY HAVE A PRIME MINISTER?

  23. EyeSpy Avatar
    EyeSpy

    @ Charlie
    Submitted on 2010/12/23 at 9:03 AM

    “Let me say I read Dr. Ishmael’s letter on BFP and is astonished that Dr. Ishmael can be suspended for such.”

    Isn’t the letter, etc not the same as what is posted here on BU? There is so much reinforcement that it becomes as clear as the nose on our face that the people of Bim needs to ask for a removal of suspension on behalf of Dr. Ishmael.

  24. David Avatar
    David

    @GP

    You maybe onto something regarding others looking on from the outside. People from all over the globe seem to find the QEH matter to be of interest.

  25. Jenny M Avatar
    Jenny M

    I must say at first I was pro-Sparman. Now I have seen this information, I must conclude that the Minister and the Chairman should also remove themselves or be removed. The Minister’s name has been called. He has been accused of serious infelicities. Prime Minister Stuart must show that he has balls and act now. Even the fact that the Minister is taking legal action against a staff member merits removal since he is compromised. As for The QEH official who found herself in the centre of this saga, she should do the honourable thing. Don’t wait!

  26. Jenny M Avatar
    Jenny M

    You may ask why the chairman should go. He is the Minister’s appointee, doing the Minister’s bidding. He should go too!!!

  27. My Name Is Not Sylvan Avatar
    My Name Is Not Sylvan

    Once again we see the DLP try to shift the blame….

    “…..it’s those damn doctors again” “Consultants are circling the wagons”

    Anything but accept responsibility for the mess they are making of things.

    Perhaps the goodly Reverend Hewitt would tell us what the Professor Cardiologist who consulted via telemedicine is being paid? How does that relate to the scale doctors are paid in Barbados? If it was “pro bono” what inducement was offered to him?

    How can you question if Dr. Ishmael should have used QEH stationery in a letter to the Director of Medical Services? It is essentially an internal letter to the QEH. Yet it seems Dr. Ishmael has been suspended on this point.

    Did the Director respond to any of the points raised? It would be interesting to see that memo if it exists.

    All of the Board sophistry of telemedicine etc. evades the central question as to if the Director of Medical Services was working on behalf of the Minister in moving a critically ill patient from the QEH to a private facility. And doing so against the wishes of the patient’s doctor and relatives.

    Yes there needs to be an investigation but not of Dr. Ishmael.

  28. Georgie Porgie Avatar
    Georgie Porgie

    David
    Doctors in the diaspora will come home and take a drastic cut in pay, and lifestyle to some extent. They will do this for love of BIM. ………BEAUTIFUL BEAUTIFUL BARBADOS.

    BUT NO ONE IS COMING HOME TO BE TREATED LIKE CHILDREN OR DOGS!

    NO ONE IS COMING HOME TO WORK WITHOUT THE TOOLS AND UNDER THE CONDITIONS WITH WHICH THEY CURRENTLY WORK

    DONT LET THEM FOOL YOU WITH THIER TALK ABOUT FOLK IN THE DIASPORA STRAINING AT THE LEASH TO RETURN. return to the dynamic dunces delores donville and dexter with thier side kick the equally medical illiterate the sacerdote with the dermoid cyst in his brain containing testicular tissues?

    I doubt it.

  29. Georgie Porgie Avatar
    Georgie Porgie

    my name is not sylvan
    You have asked a poignant pertient and practica point of the pay of the telemedine professor
    re
    Perhaps the goodly Reverend Hewitt would tell us what the Professor Cardiologist who consulted via telemedicine is being paid? How does that relate to the scale doctors are paid in Barbados? If it was “pro bono” what inducement was offered to him?

    can the dumb duncy dynamic dummies dexter donville and delores dump any doo doo in response to this question?

  30. Enuff Avatar
    Enuff

    @GP
    alliteration for the illiterates. lmao

  31. Random Thoughts Avatar
    Random Thoughts

    Dear GP: Even an orphaned child or a stray dog deserves better than is being dished out to Dr. Ishmael.

  32. Georgie Porgie Avatar
    Georgie Porgie

    Random Thoughts
    trute you a tell sa lol
    but the intention is to humilite him and put him in has place and let others know that they sit in the heavenlies and only judgement comes from them

  33. Sapidillo Avatar
    Sapidillo

    @ac, Bonny Peppa, GP et al:

    Wishing you and yours a very merry Xmas; may it be bright and best wishes for a healthy and prosperous year ahead.

    God bless.

  34. Georgie Porgie Avatar
    Georgie Porgie

    Thanks Sir Sappy
    Same to you Sir

  35. Weeping Avatar
    Weeping

    Quite interesting that Sparman is in the news 6 years later, around the same time that his appeal expired, according to a headline in the Nation News, Friday 24, December-2004.

    “GOVERNMENT can no longer appeal the decision handed down by High Court Judge Madame Justice Elneth Kentish on October 15 in the case against cardiologist Dr Alfred Sparman. That’s because the six-week period to give notice of appeal against the ruling had elapsed, said Shadow Attorney-General, Senator Freundel Stuart.”

    What an interesting world we live in.

  36. David Avatar
    David

    Commonsense suggests that telemedicine is an add-on service to be used in situations to provide 2nd, 3rd opinions or in an emergency!

    Certainly not to replace a doctor who is heavily ‘credentialed’.

  37. David Avatar
    David

    @MME

    I read elsewhere that the ‘Staff Rules’ which Dr. Ishmael is alleged to have breached are 5.2.1 and 5.2.5 of the Terms of Conditions of Service for the Employees of the Queen Elizabeth Hospital.

    Can anyone share what these rules actually say?

    Tried to get the pertinent QEH Staff Rules with no success to date.

  38. Straight talk Avatar
    Straight talk

    All the above accepted, we should consider this conundrum.
    As the QEH charges non-nationals for treatment provided, is it not strange, when we need all the FX we can lay our hands on, that the MoH intervenes to remove him from the government facility to a private concern.

  39. Georgie Porgie Avatar
    Georgie Porgie

    David | December 23, 2010 at 4:49 PM | Commonsense suggests that telemedicine is an add-on service to be used in situations to provide 2nd, 3rd opinions or in an emergency!
    Certainly not to replace a doctor who is heavily ‘credentialed’.

    ============================
    Not really David. ….or not fully. Telemedicine is used to provide consulting opinions to remote medical facilities or to facilities without the relevant cedentialed doctors. Consequently this highly touted add on by the priest wih balls for a brain is really oxymoronic………and moronic.

    On one hand the minister is bioasting that we have open heart surgery, and on the other hand the ignorant priest is saying lets have telemedicine to present a service for which we have had the services for 30 years of a highly qualified and respected doctor. Hilarious! or so it would be if this was not such a serious matter.

    Prime minister Stuart must intervene These two idiots are contradicting each other and themselves and making our nation look extremely stupid in the eyes of the world .

    I am sure if MIA was still the LOO she would have had much more to say than FREUNDEL OR OSA have said.
    what is wrong with the people’s elected representatives.

    TIME TO SET UP THE BU PARTY. AND A VIABLE TEA PARTY .

  40. Enuff Avatar
    Enuff

    Owen gathering the dynamite I am sure.

  41. alpha Avatar
    alpha

    Actuall i quite like what the QEH is attempting to do. The circumstances are not ideal, but when is it ever.
    It is about time that the hegemony of these arrogant consultants is broken. These guys like Ishmael, Goddard, Emptage and others of that ilk have been treating QEH like their personal playthings for years and average Bajans have been suffering in silence.

    Bajans are really an interesting lot. In one breath there is a shout and cry for a change at the QEH but when the opportunity for change presents itself bajans are defending the same people who have been mistreating them for years. I fully understand and agree with what the Board of QEH is apttempting to do. Time for a change of guard at the hospital and let these greedy consultants go and enjoy some of the monies that the have been accumulating for all these years

  42. KISSMYA Avatar
    KISSMYA

    Sapillo ?
    what is the meaning of -Merry Xmas ???

    cut the crap

  43. John Public Avatar
    John Public

    @Commander
    @Chris Halsall

    Let me try to explain how it works- Pharmacies buy a drug and then sell it to the patient on prescription at cost plus a prescription dispensing. This fee is on a sliding scale which changes depending on the cost of the drug (e.g. if a drug costs between $2.00- $5.00 the fee could be $5.00- so if the drug cost the pharmacy $2.10 the patient would pay $7.10 , and then between a cost of $ 5.01 – $10.00 the fee might be $7.00 etc.
    This fee is regulated by goverment for drugs that are on the BDS Drug Formulary. However it is not regulated for all other drugs. The non formulary dispensing fee tends to be higher than the formulary fee. So for Drugs on the formulary the prices should be the same at all pharmacies. Others drugs it can vary from pharmacy to pharmacy.

    Drugs sold over the counter work on a percentage markup, and do not use a prescription dispensing fee- however most pharmacies will charge the patient the same price for both prescriptions and over the counter sales where a drug is also normally sold legally over the counter or in the front store and this is usually the over the counter price as it is usually cheaper. If your pharmacy is not….well you have a choice.

    @Crusoe- I can tell you that whoever is giving you your figures has no idea–there is no single pharmacy in this island even filling 1 million dollars in prescriptions a month far less charging the goverment that in fees.- in fact the total fees for all 86 pharmacies to gov’t is about 1 million dollars a month.

    The pharmacies have shown that they are making next to nothing on prescriptions that they bill to govrnment after expenses, so reducing these fees would have made them lose money on these prescriptions.

    I always smile when I hear someone talk about Pharmacies juking out the patients eyes as I would be willing to go out on a limb and bet that out of all proffesionals in this island Pharmacist charge the lowest fees.

    And you are right the government has decided it does not want to pay the dispensing fees anymore so the patient will have to go to the polyclinics or pay the fees to the private pharmacies themselves- however this is only half of the story the other half of the story is that when the patients go to the polyclinics to avoid paying these fees they are going to shocked to find out a significant number of the drugs they have been getting free, especially in the case of anti hypertensives, have been removed from the formulary so they will not be available to the patient at the polyclinics

  44. John Public Avatar
    John Public

    My comments above are in response to posts in the “Is Dr. Richard Ishmael Being Silenced? article which is now closed.

  45. ac Avatar
    ac

    @Sapidillo
    Thanks alot and enjoy yours. Still looking forward to another one of your funny submissions on BU

  46. Micro Mock Engineer Avatar
    Micro Mock Engineer

    Thanks David. I wanted to verify the Nation report that Dr. Ishmael was suspended for writing to his employer using his employer’s letterhead. This seemed unusual and led me to question whether the newspaper had misinterpreted the clauses or the suspension letter they were quoting from. This is the Nation article containing the information… http://www.nationnews.com/articles/view/heart-care-risk/

  47. Commander Avatar
    Commander

    @ John Public the sliding scale you mention creates quite large fees when applied to an entire prescription. When one is talking about 1 or 2 items it is not so bad but Government cannot continue to pay the present rates. Some chronic care patients require 6 drugs per script when some of these are expensive what do you expect Gov’t to do. Many patients are on more than 6 drugs, 9 and 10 are not uncommon figures, we cannot continue to afford the pharmacy costs. (Unless we massively raise taxes or decrease who is eligible for ‘free’ drugs and healthcare)

    It is clear that many businesses in Bim including pharmacies are too often basing their viability on profit margins that are too large. Expenses quickly mount up to correspond with income and then before you know it you cannot survive with a lower margin anymore.

    That is one of the reasons that pharmacies are allegedly breaking even only. Not to mention that there are probably more of them than the island can sustain at this time (even though we all like convenience of a pharmacy next door).

    It would be instructive for you to let us know what sort of markups are placed on products in the Bajan pharmacies after getting them from the distributors.

    I maintain that the default markup is so high that one pharmacy executive at a minuted meeting complained basically that the draft plan by the minister and Barbados Drug Service would not be good because patients would see how much they add on. I kid you not. He then proceeded to explain that that would be unfair and would make them look bad to the public.

    The BDS changes are however worthy of a whole blog and should not further distract this discussion.

    Incidentally I am also against the changes to the actual formulary. I find them to be backward and a definite retrograde step for a country trying to offer first world or near first world pharmaceutical care. Patients will have adverse outcomes. Some not immediately but down the road for sure. The removal of combination medications is probably the most retrograde step of all as more than enough studies show these to significantly improve patient care by reducing how many pills they have to take and the times. Patient compliance is extremely important because no matter how good a drug is it cannot help if the patient does not take it!! So while the world is moving towards seeing how much they can decrease pill count we are increasing ours and while the world moves to make more and more drugs available as combos we are cutting them out …………… bravo to the bright sparks.

    It is also farcical that changes have been made which will basically cause the vast number of private patients to run to the polyclinic pharmacies for their medicine and BDS to my knowledge is looking to bring on only 2 staff members …….. ROFL. It will be federation and bedlam up in there. Not to mention the fact that I don’t think that their individual budgets have been increased to handle the extra load in 2011. All now on regular load they are still out of nuff things ……………………….. oops I’m still talking bout BDS…….. ok I am finished with that for now.

  48. David Avatar
    David

    @Commander

    If we missed your view on this apology offered, what is your view on the below?

    Thanks David. I wanted to verify the Nation report that Dr. Ishmael was suspended for writing to his employer using his employer’s letterhead. This seemed unusual and led me to question whether the newspaper had misinterpreted the clauses or the suspension letter they were quoting from. This is the Nation article containing the information… http://www.nationnews.com/articles/view/heart-care-risk/

  49. Sapidillo Avatar
    Sapidillo

    @ ac | December 23, 2010 at 11:14 PM |
    @Sapidillo
    … Still looking forward to another one of your funny submissions on BU

    I’ve been working on a project that takes up most of my time, so I hop in and out of BU. Don’t have the time like before. Anyway, I’d add to my to-do list.

    Blessings

  50. Commander Avatar
    Commander

    @ David

    I’m not sure i get what you are asking. I believe that the letterhead issue is one where the QEH is trying to grasp at straws in order to punish the Dr. It is a very tenuous and fragile argument they have against him as many courts would likely consider his use of a letterhead in this matter justified. But ………. I do not have the QEH’s rules in my possession to confirm my views. I do however suspect that these dudes on a daily basis break the very rule that Ishmael is being pilloried for.

    I am not sure if I have answered your question.

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