WITH the Kingston Public Hospital (KPH) seeing up to 1.7 million patients in a year, both the critically ill and those with less life-threatening illnesses accessing services at the institution are often forced to wait for an entire day before receiving medical attention.

    Persons with broken limbs and gushing wounds, for example, are forced to sit for hours in the same crowded waiting room as persons seeking a prescription for their regular supply of diabetic medication.

    For many who are unable to afford the $2,500 that most private doctors charge for a visit, they either have to endure the day-long wait – sitting on hard, wooden benches in a smelly hospital corridor – or forfeit some necessities, like food, to receive more urgent medical care.

    Others, with less life-threatening illnesses, often leave the facility and return the following day in the hope that they will make it past the registration process.

    Tanny Shirley, chairman of the Board of the South East Regional Health Authority (SERHA) with responsibility for the Kingston Public Hospital, blames this inadequacy in the system on a shortage of medical staff and inadequate use of health centres by patients opting instead to seek service at the hospitals.

    Responding to questions posed by this reporter, who tested the system by waiting at the hospital for more than six hours without seeing a doctor, Shirley justified the long wait by saying persons are seen based on the severity of their illness.

    He, however, had no explanation as to why some obviously very sick patients had to wait even longer for medical attention.

    A lot of the health care problems, he said, could be solved at the point of admittance, but this was not always done due to a shortage of staff.

    “There should be at least a trained registered nurse walking around, observing patients’ behaviours to identify those deemed as critical,” he said.

    Patients to KPH, he explained, were categorised depending on the nature of their illness, with the more serious

    cases seen first.

    He, however, admitted that his did not always happen, as was evident when the Sunday Observer visited the institution last Thursday.

    Making reference to a child who died at the Bustamante Hospital for Children last month, Shirley said although the full information had not yet been gathered, it would appear that ‘categorising’ failed in this instance.

    The child, two-year-old Ashley Lindo, died on October 16 while waiting for medical attention at the hospital. Her mother was told to sit and wait her turn although the child had a fever. The mother, who had made two earlier visits to the hospital, was told to take the child home and give her a sponge bath.

    An autopsy later revealed the child died of dengue fever.

    “That shows how important it is to categorise the illness to give preference to those more critical,” Shirley acknowledged.

    He noted that with the advent of free health care for minors, there had been an influx of patients to the hospital, coupled with the fact that there was always a shortage of staff.

    “There is always the case of under staff, which is an ongoing cry because of migration of the profession,” he said. This was even more so in specialised areas.

    As such, he said, there was a constant struggle to have patients seen in a reasonable time. He, however, added that reasonable time had to be looked at in the context of the situation.

    Asked if a patient having to wait seven hours and more to see a doctor was considered reasonable, Shirley said it depended on the amount of persons to be seen.

    “For instance, on a busy day at KPH some 300 to 400 patients are seen,” he added.

    He said that KPH received referrals from all other hospitals, not only from Jamaica but all over the Caribbean.

    “While we may never want to accept that you need to wait there for seven hours, the fact is that during that period all the doctors and nurses are constantly engaged,” he insisted.

    The long wait at the KPH was made even worse, Shirley said, because of the large extend the services of emergency and accident cases to separate them from regular cases.

    ” We will also be going on a massive education drive to educate the public as to where the health centres are so they can use them,” he said.

    Shirley was unable to say what the ratio of medical staff to patients was on a day when the hospital had 300 to 400 patients, but suggested that this was determined by the chief medical officer (CMO) on the ground.

    “Usually the CMO makes the decision on how to structure the routine and there are matrons to help in co-ordinating all these activities,” he said, adding that they sometimes called upon medical consultants to come in to help.

    The issue of quality customer service at hospitals like KPH, according to Shirley, was an ongoing problem.

    “It is an ongoing problem, not at KPH alone, but all hospitals and it is our wish that patients be seen in the most friendly and courteous manner,” he said.

    He added, however, that this was being addressed as hospital staff was being sensitised in this regard.

    “To say we are near there, I think there is a lot of work that needs to be done, but it is something on the agenda which we are very sensitive to and which we need to achieve,” Shirley said.