As the overcrowding continues unabated at the San Fernando General Hospital, Medical Director Dr Anand Chatoorgoon has given errant consultants an ultimatum to "shape up or ship out."Charging that some doctors are not giving value for the money they are earning, Chatoorgoon said he would meet with all clinical heads this morning to read the riot act to them.
"I intend to tell the doctors, who will soon be getting an increase in salary that we love them and want them to work with us, but if they do not wish to work properly, in the way we want them to work and do not care about the organisation which employs them, then they have an option," he said."I have already told my CEO (Anil Gosine CEO of the South West Regional Health Authority) that this year, doctors have to shape up or ship out...Those who do not wish to work with us and serve the poor people, then leave us and go.
"This hospital belongs to the poor people, we are here to help them, and if you (doctors) don't care about the poor people, leave us and go. I am reading the riot act to them, whether they like it or not, because I am distressed about the level of care patients are getting from some doctors."The situation is not new, but the proverbial feather which broke the camel's back arose last Thursday night, when attempts by Chatoorgoon to reach an on-call consultant to deal with an alarming overcrowding situation failed.
This caused Chatoorgoon to write a stinging letter to the consultant in question, in which he questioned the compassion for the ailing public seeking his service, as well as unjustified overtime on-call claims.In a copy of a letter, made available to the Guardian, Chatoorgoon described the overcrowding at the hospital as "a crisis."
In the letter, reference is made to a situation last Thursday night, when close to 50 patients were kept in wheelchairs and gurneys under tents, because of the unavailability of bed space in the hospital, while the senior doctor was celebrating, at a restaurant, the earlier opening of the San Fernando Teaching Hospital. The situation proved too much for the junior doctors and an inexperienced registrar on duty to handle.
According to the letter, Chatoorgoon made several attempts to contact the consultant to come to the hospital and assess the patients, in an effort to determine who needed to be warded and who could have been administered medication and sent home.Chatoorgoon advised the consultant of his tardiness and suggested that he consider alternative employment if he no longer felt compassion for the patients he had taken an oath to care for.Contacted by telephone, Chatoorgoon confirmed the situation.
"The overcrowding situation at the hospital is pretty bad and until Chancery Lane (the hospital extension which Prime Minister Kamla Persad-Bissessar handed over last Thursday) is opened, we have to be discriminating in who we admit because we do not have endless number of beds," he said.
"But some doctors are playing the fool and, at this point in time, I am prepared to speak out because we are not being given value for money. I was in tears when I saw all those people suffering and was unable to reach the consultant to have him come and do an assessment."He said he was not satisfied with the level of supervision given to junior doctors when the consultants are not around.
"Juniors, too frequently, are left on their own without supervision and that, therefore, translates into patients not getting the best possible care," Chatoorgoon said."I have made ward rounds with Director of Health Dr Shevenand Gopeesingh, during the day and there are very few consultants during that time."On evenings and at night, he said, the same thing occurs."So why are we paying them an on-call allowance?"He said he is also having problems with consultant radiologists who are lagging behind in their CT and MRI reports.
216 more beds added
Over the weekend, patients continued to be treated under the tent pitched outside the Accident and Emergency Department.The hospital, originally called the Colonial Hospital, which was built in the 1950s, at present caters for at least half of the 1.3 million population of T&T, way above the figure it was first intended to serve.
At the opening of the Teaching Hospital, which will add 216 more beds, bringing the number of available beds to 866, Housing Minister Dr Roodal Moonilal said overcrowding at the SFGH would be a thing of the past.Also at that opening, last Thursday, SWRHA chairman Dr Lackram Bodoe, who received the building and echoed Moonilal's sentiments, stressed the need for improved bedside manner of his staff.Speaking about the treatment of patients in the tents, he said, the teaching hospital could not have come sooner.
"I encourage staff to cherish this facility and to use this as an opportunity for transforming the culture in which patient-staff interactions occur," he said."We must endeavour to treat our patients even nicer, in this very nice facility."