Doctors On The Take

Barbadian expectations were raised when the Queen Elizabeth Hospital (QEH) switched from being a department of government in 2002 to being run by a statutory board. We were convinced by the then government that the autonomy of a board was just what the doctor ordered for the QEH.

Successive governments have had to battle many challenges when asked to manage our premiere health institution.   To read the full-page ad which was placed by BAMP in the weekend newspapers detailing yet another conflict with the Board of the QEH would not have registered on the cognitive index of the vast majority of Barbadians. We have come to expect it. One is left to wonder why the industrial relations climate at the QEH always seem to ring of a discordant note.

Based on what BU has observed over the years the problems at the QEH are many and solutions difficult. The question which has to be asked is whether healthcare delivery is now being compromised as a result of unresolved issues between doctors and Board which have been outstanding for too long. BU’s sense is that there is a hardening of positions at the QEH. According to our sources the junior doctors especially are being asked to work extremely long hours which means there is no work life balance and a 12 hour day is not uncommon.  A spirit of cooperation which was part of a now distant culture has reversed to the detriment of the patient. As if this isn’t enough some in the know believe the quality of Interns entering the QEH in recent times is inferior compared to that of old.

Barbados has always prided itself on its standard of healthcare delivery, the unsettled industrial climate at the QEH over time is beginning to undermine it all.

It seems the problems affecting our healthcare system are not limited to the QEH. It must be said that while the vast majority of medical practitioners in Barbados in the private sector do a good job delivering healthcare, the adage one bad apple will spoil the barrel rings true. BU has it on good authority that there is a small band of doctors who are being significantly rewarded for referring unsuspecting patients to  specialist doctors, laboratories and others. Not only is this practice unethical but borders on illegal. BU must be fair and ‘defend’ those doctors who manipulate  insurance claims to ensure their patients benefit even if there is a mismatch between the claim and service delivered. In one case the patient pays more and in the other the patient saves!

We are often quick to call on politicians and public officials to demonstrate transparency and integrity in the execution of duties but what about our doctors in the private sector?

0 thoughts on “Doctors On The Take

  1. I member under the last administration when some significant bits of equipment broke down, it appeared that the hospital administration was in no hurry to fix and replace as there were a few private practitioners that stood to benefit from the resulting referrals .. Thought the whole thing was odd back then, but these things are above me so I moved on

  2. Well…BU…continue to do the good work on exposing the nonsense that goes on on this little island of ours…I never thought the day would come when media would be brave enough to openly make a statement…not even ask a question but to make a statement that addresses a serious situation. Bless.

  3. DO YOU know that the Industrial climate in Barbados will ring a discordant note simply because people are not treating other people nice ?
    DO YOU know that there is a certain hatred that seems to be present in people working in Service oriented areas of our country Barbados?
    WHY do people who lived in England etc complain about poor service from various shop attendants and other workers who interact with the public both private sector and public sector employees all over Barbados ?
    HAVE you noticed that one seems to bother these people when one walks into the store Supermarket or gas station at which these people work even though you are spending money,they make you feel as though you are begging?

  4. DO YOU that most of the culprits in this regard are of my gender ?
    WHEN will the Schools in Barbados teach and prepare individuals how to live as citizens in a developing country like Barbados ?
    DO YOU THAT the bad treatment starts right there in the schools ?
    DO YOU KNOW which gender form the biggest culprits in this regard ?
    Why is the cursor jumping around when comments advance down the page ?
    Is this an indication that I SHOULD NOT GO PAST A CERTAIN amount of words ?

  5. Do you know that certain senior doctors at the QEH don’t have patient care at heart, simply how much money they can make out of the patient before s/he dies?

    • Remember when BU kept harping about the need for the judiciary to get its act together and we had the mainstream media and apologists talking crap about how wonderful everything seemed to be?

      Today what do we read in the Nation attributed to Elliot Mottley QC?

      A couple years from now the same conversation will unfold about the scams in the medical fraternity.

      We seem to be ahead of the game bloggers.

  6. Dr. Carlos Chase is one of the worst leaders BAMP has seen, his motive is very political and his ojective is to cause discomfort to the Minister of Health. He has no leadership skills and he is very confrontational and in the blind man kingdom, the one eye man is king,

    I agree that junior doctors are called to work long hours, even though they are compensated for doing so, that seems to be the culture and they dare not complain else they will be discriminated against.

    There needs to be a computer system to track cost, income received and expenditure. What has the systems analysist achieved since being at that institution.

    Something drastic must happen, it is now nine years a Board has been existence and the only thing i can glean that is occuring is constant rise in the cost of doing business.

    The Minister of Health must be preapred to set policies to be implement at the instituion for the Board and set bench marks and a time table for the achievement of same.

    Nurses and doctors who dont turn up for work, but are known to work elsewhere while calling in sick should not be paid.

    Some consultants are interested in doing as little work as possible for the handsome reward for doing little to nothing.

    The CEO and his managment team need to deliver for the big pay packets they receive. The long talk must stop and performance measurments must be introduced. The Chief of Medical Staff or whatever he is called must lay out his plan for dealing with medical issues plaguing the hospital.

  7. There is a degree of disappointment that I feel when I read of the atmosphere at the QEH. It suggests that the leading sickness care facility suffers from much of the same conditions that exist in the larger society. There is a disregard for those without power and money. There is also impunity for those who, in spite of oath/vow to the contrary openly exploit whatever power they are imagined to have in the sickness care industry.
    Mr Commissiong, in a recent interview, raised some issues which should be of interest to those who see a need for correction in that small segment of the industry referred to as “doctors”. It is larger than that but it is not a bad place to put down a marker. Are we behaving like the colonizers of a different era and ethnicity? Are we choosing our healthcare professionals from the most desireable group of graduating highschoolers? Should prior undergraduate exposure, social awareness and sensitivity be as important as similar academic measures of math and science? When we try to change the self serving habits of grown people, are we involved in futility? Do we ever get to the point where we grease the skids and wish many malcontents goodbye? Then, who lubricates the slide? The lawyers and polititians, executives and board members from the same schools, families and towns as those deemed to be disruptive?

    As we seek to imitate the sickness care structure of the USA and minimize those of countries whose healthcare indices support the value of a wider based approach, let us pause. Even a casual review of news about the sickness care industry in the United States reveals objectively identified fraud and abuse (see recent and others). These involve physicians, pharmaceutical companies, hospitals, medical schools and personnel at all levels. Patients, communities and similarly trusting people are the ones that predictably suffer. Others whom also suffer are those, whom because of a professional or personal oath, really adhere to “first, do no harm”. Those well meaning and ethical care givers are often shouted down and demeaned by their garrulous and self serving “colleagues”.

  8. Where is the leadership to take on these rogue doctors? Any patient who goes to QEH know that their specialist will never have the time for them under the QEH, but will make the time if the patient pulls his pocket. Imagine heart patients are given appointments a year later for serious heart conditions. Is it that we have too few specialists at the QEH to meet the demand? Or is it that the specialists’ time at the QEH is so limited that it affects the level of care for patients? Why can’t the board of the QEH deliver a decent level of health care to citizens? Why is it they have to posture and brag about services they can’t deliver? Is it that they feel that it sounds good? I remember they announced in the media just before the World Cup that they were ready for any emergencies during that period. Yet the local population had to wait long hours for care. Nothing has changed whether it was BLP or DLP. THIS COUNTRY NEEDS STRONG LEADERSHIP AND IS PREPARED TO STEP ON SOME TOES TO GET THINGS FIXED! And you know what? I can’t see anyone from either political parties taking the lead. Corruption is rife and no one has the guts to confront it!

  9. David | September 8, 2011 at 6:16 AM |
    “Today what do we read in the Nation attributed to Elliot Mottley QC?”

    Anon Legal and/or Amused said that in the Commonwealth a QC could be brought in to act as a Justice in order to clear the backlog of cases in the courts. I wonder, with all the advise that Mr Mottley has provided to the four past CJ’s, did he ever include a suggestion like this? … Doubt it …

  10. BAFBFP:
    Are suggesting putting Elliot Mottley on a judicial bench in Barbados. Yes, he was in all those places, but did he go to say how and in what circumstance he left especially from Bermuda and Belize? He may your friend but don’t do this to us.

  11. In my humble opinion, if Mottley, QC did not offer help to Sir David Simmons why would any other CJ accept his help now!!!

    Regarding the QEH, an appraisal system with timely follow through, and monitoring of labour, welfare, awards, compensation, coaching, will bring the human resources under control and transparency will be seen among consultants and resident doctors plus all other staff members. Is that why BAMP does not want to hear about an appraisal (monitoring of human behaviour and attitude) system?

    You don’t talk compensation of duties before you look at job description and how it will be monitored. What are the doctors doing? how many hours are they on the job? who knows when they come and go? What is the quality of their work? to whom do they report? how can they improve as individuals? What training is required to enhance their general or specialized practice? ALL HR management queries.

    BAMP can get to this century as soon as the anaesthetics wears off and get up and start where employees are to start with employers. Doctors don’t employ the QEH the QEH employs the Doctors.

  12. @David. The existing system made a lot of lawyers rich. THINK!

    and do you know any “Poor” Doctors?

    Barbados sweeeeeeet fuh a whole lot a people.

  13. To david;
    As I understand it, the junior doctors are not members of BAMP; they are represented by the NUPW. It seems as if they have special problems with the consultants and the manner in which they are handled.

  14. @lemuel

    you are correct, the junior doctors had broken rank with Bamp for the reasons stated by you. Can anyone tell me how many doctors BAMP represent.

    Can the ceo of the qeh tell us how many patients doctors/consultant see a day?

    Is there a system in place to monitor doctors/consultants attendance at work,

    To harness the doctors barbadians need to support any lagal and legitimate action taken. They have no way to run to, it is difficult for them to go run to the mother country. They receive their basic training and sometimes specialist training at the taxpayer’s expense. They are employees of the hospital, dr. Chase motive is frustrate the health plan of barbados pure and simple. watch him over the next few months.

  15. “Can the ceo of the qeh tell us how many patients doctors/consultant see a day?”

    Many times the patient will arrive on the day of the appointment and be told that the consultant is away and will have to reschedule the appointment. Mind you the patients had been waiting months for this appointment. The new appointment might be six months to a year later. This has been going on for years and the poor who cannot afford to pull their pockets must accept their fate. Their life is not worth much to the physician who works for the Government., yet it is the same poor people who have helped pay for his/her education. The poor is scorned and treated in the most despicable manner by the staff at the QEH. They have the patients waiting like sheep in a pen. Just go an take a look at the waiting rooms. The workers walk around as if they own the place snarling orders to the patients who question them.

  16. @islandgal246 et al…

    Just wondering how much RFID is being used at the QEH.

    You know, Radio-Frequency Identification chips which can be embedded in passports, drivers licences and patient wrist bands.

    A rather old technology now a-days.

  17. I have a friend who had an appointment to see a consultant today, when she arrived she was told he is on vacation. What happens if this patient runs out of medication, since most of what she was using has been discontinued and the consultant was suppose to change the perscription today. Funny thing she was told to go and make a new appointment to see him, but the closest one is five months away.

  18. @David

    They might have preceded him as chaor of bamp, but you are forgetting one thing he benefits from the system and would not want any meaninful change to measure output, he is one of the consultants.

  19. @islandgal et al…

    Have you considered the possibility that is within in the rights of the employer to monitor the behaviour of the employees?

    Have you considered the possibility that perhaps the employees would perform better if they knew they were being constantly measured?

  20. Chris you want the unions to cripple this island? Great idea to have big brother watching that is why cameras in the workplace should be implemented. The unions don’t even want that to happen.

  21. What we need persons to secretly record public servants abuse and make it public. But then these public servants will probably take it further to ban cell phones with cameras in their vicinity. Boy we ain’t easy to deal with.

  22. Here is how to sort this darn affair:
    (1)Offer them a contract to work so many hours a day each month in the hospital.
    (2)Provide a way of monitoring their work ethic,time keeping.
    (3)Ensure ALL attend refresser courses every year.
    (4)Once qualified, a minimum and maximum amount of hours a week for senior and Juniors.

  23. @Just only asking

    The QEH went to a Board under the BLP and the Baord was supposed to have improved the operaton since 2003 higher salaries were paid to the ceo, director of support services which was created as well as nursing serivices adn what ahs happened, the doctors,particularly the consultants continue to do as they please. The thiefing continues, the high incidence of absenteeism sill is a problem, the poor accouning system is there, the problem of stock out has not gone away, the accident and emergncy department has not improved and the woes continue even though there has been an increased in stafff at all levels.

  24. @DAVID


  25. Obediant:

    Here is what the web shows on Napoleon-Ramsay:-

    From Barbados Advocate 5/29/2009
    Small business owners need to be aware of how the legislation surrounding employment rights will affect them. That is according to Industrial Relations Officer at the Barbados Employers’ Confederation, Charmaine Napoleon-Ramsay,

    From Zoom Info
    While at the Confederation, Mrs. Napoleon-Ramsay restructured the BEC’s biannual “Stepping into Supervision and Management” course which equipped managers and supervisors with the necessary tools for managing in diverse environments andalso facilitated the BEC’s Strategic Planning exercise.
    As part of her training at the BEC, she attended several overseas training courses including a visit to Washington DC where the Inter-American Development Bank (IADB), in Washington DC through its INDES programme, sponsored the course Design and Management of Social Policies and Programmes. In addition to this she visited the UK’s Advisory, Conciliation and Arbitration Service (ACAS) which aims to improve organisations and working life through better employment relations.

  26. @Just Asking

    She should be bringing a wealth of knowledge in performance management accumulated during her time at the National Productivity Council.

  27. Minister Donville Inniss’ concern about absenteeism by nurses in todays press lines up with BU’s concern about the hardening of the culture at the QEH

  28. Relationship among nurses + relationship between nurses and doctors + relationship between nurses and management should be of greater concern to Minister of Health before he reached absenteeism which is a result of ‘relationships.’

    The HR Management of QEH should apprise the Minister of relationships and how to improve them. Had that been done I believe the Minister would mention relationship and not give us the impression that Nurses are staying away from work in some cases due to moonlighting.

  29. It is a fact a number of nurses are moonlighting, some as much as three seperate institutions, and pay little attention to their main job at the QEH, but the same thing is happening with policemen at the RBPF. Maybe it is because of small salaries and low level of motivation to their staunch job.
    Barbadians must take some of the blame for the congestion at the A&E Dept, too many patients go that dept, for simple things like headache etc when they could attend a polyclinic; the A&E should be for serious cases only.

  30. @David

    Since she should be bringing a wealth of knowledge to the insitution, what has she reformed since she has been there? Why are people getting pay after they retire, is there a system in place to measure attendance etc?

  31. @ David
    BU David, you are one UNREASONABLE man. Did Bushie not BEG you to post at least ONE article which highlights something that make us Bajans look at least sane.
    Cuhdear, there MUST BE SOMETHING…..?!? ….Somewhere…?!
    …Just for INDEPENDENCE?

    But no you come with the doctors……
    These fellows worst than the lawyers. While the lawyers will rob you blind, blindfold justice, and laugh at the rest of us, the doctors have managed to keep a low profile …. They BURY their mistakes and dirty linen.

    This is a massive problem David. BIG!

  32. RE BAFBFP | September 10, 2011 at 11:08 AM |
    Georgie Porgie does a Google every so often to see if his handle is mentioned on a recent web page … let’s see if this is true …!


The blogmaster dares you to join the discussion.