Role of medical consultants to be assessed, says Tufton

BY KIMONE FRANCIS
Senior staff reporter
francisk@jamaicaobserver.com

Wednesday, August 14, 2019

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Health and Wellness Minister Dr Christopher Tufton says the role consultants play at the island's public health facilities is to be assessed.

Tufton was responding to a raft of complaints from junior doctors alleging abuse on the job and reported by the Jamaica Observer yesterday and Monday.

“There is that issue of the lack of supervision and that's something the system needs to tighten up on. The reality is that the senior medical officers (SMOs), within the hospital context, should play a greater role, I believe, in coordinating that type of arrangement for the support,” Dr Tufton told the Observer yesterday.

“We have gotten complaints periodically around consultants not being as available as they ought to be, and at times it is a function of the strengths of the SMOs within the hospitals and their capacity to try and oversee that process. It's something that I think we need to look at more closely and manage,” the minister said.

The doctors have complained about long, tiresome hours on the job, stemming from the reported absence of consultants. They have also said that they do so without compensation.

But Dr Tufton explained that the doctors are paid for a 40-hour work week and are compensated for overtime worked. Doctors on call are also paid, he said.

“So normally, a doctor will earn a fairly substantial allowance from the on-call or overtime and therefore it is not that they are asked to work without being compensated. Having said that, there are concerns about working beyond a certain number of hours per week and the potential impact that could have on both the doctor's own state of alertness as well as on the quality of care to the patient,” the minister said.

He added that the pressure felt by junior doctors, in most cases, is a function of where they are employed. A doctor, he explained, who is employed at a rural hospital will likely better be able to cope with extended hours versus a doctor working in an urban space.

The minister is proposing that a cap be placed on the number of hours worked by a junior doctor, and said it is a policy he wants the system to work towards.

“My own view is that there should be a relationship between the hours worked and there should be a cap on the number of hours worked. It's something I think the system needs to work towards, as is the case in other jurisdictions, because it is a case where you can find, I believe, a state of diminishing returns and the doctor's capacity to function. So that's something again that requires some rethink and examination,” he said.

In the meantime, Dr Tufton reiterated his position, that while the health system falls short in some areas, it is burdened with non-communicable lifestyle diseases.

He said the ministry is working to expand services and infrastructure at the island's primary health-care facilities, with a view to assigning more doctors there.

He also said that already, the ministry has overseen extended hours at some primary health-care facilities, a move that should reduce the influx of patients at secondary facilities and especially accident and emergency departments.

“So those reforms are coming, which will see an easing of that burden. In addition to that, at the level of hospitals there are major expansion plans. So Spanish Town [Hospital], for example, is slated for a major expansion plan. St Ann's Bay, May Pen [hospitals], a number of health centres in and around those hospitals, and so on.

“The challenges of equipment are there but it is something that we've recognised and we are working towards [fixing]. Having said all of that, I am prepared to say that the system has many challenges but it should not be described as being broken. The system works,” Dr Tufton said.

He disclosed that the health system responds to approximately three million visits per year — approximately 1.7 million to health centres and 1.2 million to hospitals. Inpatient care was over 190,000 last year.

“It conducts a range of other supporting services that see life expectancy, many of those international indicators, being at a relatively high level... So when you look at infant mortality and so on, these are indicators that show that as a country we have made progress, but the reality is that we still have some way to go. What I would want not to happen is that we condemn the system as a total failure when the truth is the system and those who work in it have been responsive to the challenges. We just have to keep working to improve what we have,” said Tufton.


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