The lengthy waiting list for cataract surgery at the Ophthalmology Department of the Eric Williams Medical Sciences Complex, Mt Hope, is a consequence of 30 years of mismanagement, says North Central Regional Health Authority (NCRHA) board chairman, Dr Ashvin Sharma.
Sharma made these statements in light of reports that 5,000 people are on the waiting list for cataract surgery at the complex and allegations that doctors in the department are extracting double salaries by referring patients to their private practices. He said multiple factors contributed to the length of the waiting list, including the need for additional medical and clerical staff.
"The human resources and finance departments had been in shambles for years, and for a long time the board could not figure out how much funding we had or how much debt we were in. All these infrastructural problems have an impact on clinical delivery." In December 2011, an audit of NCRHA human resources and finance departments exposed some $40 million in debt and $2 million in overpayments to one employee.
Sharma said within the past two to three months new human resources and financial teams were hired. However, Sharma said it could take as much as 18 months for the NCRHA to reconcile its budget and become "financially compliant." An audit of the Ophthalmology Department, carried out by the Ministry of Health, will begin on Monday to determine financial needs and to investigate claims of misconduct.
Sharma said there are no laws restricting doctors from working in both government and private facilities. Doctors who work in both arenas cannot allow their working hours to conflict, however, and "cannot use the hospital as a referral base for private practice."
Addressing the waiting list
Senior doctors in the Ophthalmology Department met with the board recently to discuss the waiting list, Sharma said. He said doctors reported a high number of patients suffered diabetes-related eye problems. These cases required prolonged management and therefore were not easily removed from the list.
"It has been explained to us (the board) that we don't have the manpower for the high number of complicated diabetes-related cases. And as these cases tend to be more severe, they are prioritised, as are cases where there is an imminent danger of losing eyesight." He added that the board instructed NCRHA CEO Collin Bissessar to set up a hotline and make public requests through advertisements that patients on the list update the clinic on their treatment status.
This exercise should begin next week. The call-in system will allow for patients who have been on the list for three years or more to verify whether they have received treatment or not, he said. Sharma also said he supported Health Minister Dr Fuad Khan's proposal to erect a national ophthalmology centre. "The ideal situation would be the creation of one central centre where all RHA resources could be pooled. The turnover rate would be higher and there would be a decrease in costs."
