EDITORIAL - SERHA accountable, too

We agree with the South East Regional Health Authority (SERHA) that the management of the Kingston Public Hospital (KPH) should be held to account for the sorry state of the institution and how crudely its patients are being looked after, as was recently reported on by this newspaper.

But there is the flip side to that coin.

While the managers of KPH oversee the day-to-day operations, they, ultimately, are accountable to SERHA, whose chairman is the respected businessman, Mr Lyttleton 'Tanny' Shirley. Boards are not mere backdrops to organisations; they have real responsibility.

Indeed, as Mr Shirley would know about those in the private sector, the legislation setting out the rules of how companies should structure themselves and manage their affairs provides stiff penalties for governors who breach their fiduciary responsibilities.

It is not enough for directors, whether of private- or public-sector organisations, to merely assert, when things go bad, that "we didn't know". Which, of course, is not the claim we make of the SERHA board.

However, they appear not to have known enough. For if they did, things would not have been allowed to reach so desperately low without the KPH's management being called to account.

Health-care hindrances

This is not to suggest that we are not sympathetic to the resource constraints faced by Jamaica's health sector and the specific problems of KPH, perhaps the largest, and most utilised, trauma hospital in the English-speaking Caribbean.

We know that on its staff are many skilled doctors and nurses, who annually attend to thousands of victims of motor vehicle crashes and gunshot and knife wounds. Thousands more, with a plethora of other ailments, pass through its doors.

The hospital is located near to communities that are prone to outbreaks of violence and most of whose residents, like the vast majority of the KPH's patients, are poor. These factors have helped perceptions, if not the character, of the hospital and the public's attitude towards it.

Then there are the economic issues, such as the $2.1-billion, or 6.3 per cent cut, in nominal terms, in the Government's health budget. The real reduction is significantly larger when inflation is taken into account. SERHA's own budget, already inadequate, we know, was cut by approximately eight per cent.

Greater efficiency

In such circumstances, the drive has to be for greater efficiency, squeezing as much value as possible out of each taxpayer dollar. Conceivably, some services may be cut back.

Some things, however, are intolerable in a hospital. Like the stench in a ward being so bad that the place is referred to as 'dung a gully gully', a metaphor, in an urban Jamaican context, for going to a watercourse clogged with garbage.

That, in our view, is beyond the inadequacy of resources to buy fancy equipment or repair wheelchairs or having enough trained nurses to offer specialised care. It has to do with a lack of basic organisation, an absence of focus, a misplacement of priorities, and a misapprehension of the hospital's role in providing patient care.

If we are right, the management of KPH should consider their future at the institution. And if the SERHA governors were unaware, they, too, should consider whether their situation is tenable.

The opinions on this page, except for the above, do not necessarily reflect the views of The Gleaner. To respond to a Gleaner editorial, email us: editor@gleanerjm.com or fax: 922-6223. Responses should be no longer than 400 words. Not all responses will be published.