7 News Belize

Doctors at KHMH Still on 'Go Slow'
posted (June 18, 2009)

The crisis at the KHMH was supposed to have been resolved yesterday – but this morning doctors were back on go-slow at the country’s national referral hospital. That meant the cancellation of specialist clinics and elective surgeries – with the hospital running on skeleton staff for a second day. And so there was another emergency meeting between the Board of Directors and the Medical and Dental Union this morning. Still though, there was no resolution and before 5:00 this evening, an exasperated board of directors told us that it’s unacceptable and bewildering.

Dr. Francis Gary Longsworth, CEO – KHMH
“The union opted to continue with actions which they had initiated the day before. That is withholding of some services. Because they felt that some other issues had not been addressed, despite the fact that they had signed an MOU, the President had signed an MOU, the President of the Union, and the Minister of Health had signed an MOU to say that we will proceed from that point over a period of a month and carry out due process in resolving these issues and normalizing services at the hospital. Now as I said earlier the reason for this press conference is that we have serious concerns that the actions taken since yesterday are detrimental to the care of the patients coming to the KHMH and we feel that withholding of service or slowing of service to patients in fact constitute a danger to the welfare of our patients and we see it as a deviation from the agreement that was made the day before.

The medical officers who are members of the union as well have taken the position that they will continue their ‘go slow, ’ I think is the term that they are using, even though in our opinion it really speaks to a removal of some of the services. They are maintaining emergency services within the hospital. I don’t know about the timelines of the response of those emergency services but they have indicated that they will provide emergency services within the hospital throughout this period. Following on that we do not know what other actions they have taken or they plan to take as we have not received any communication from them since this morning when I was in a meeting with members of the union. The result of that meeting was that they said they would continue their action until their demands were met.”

Jules Vasquez,
Which specific demands?

Dr. Francis Gary Longsworth,
“Well the demands that had been put to us initially and was for reinstatement of Dr. Ghazy and which has been accomplished. He’s been written to today to say that he has been reinstated in his position. The other demands have to do with the allegations, the broad allegations, unsubstantiated to say that the Minister must remove the Director of Finance, myself, the Chairman, and members of the Board. But we maintain that to make such demands without evidence of any wrongdoing or malfeasance on the part of any of these persons should be subject to due process.”

Maria Elena Sylvestre, Board Member
"The greatest concern of the board is the reduction and in some cases the withholding of essential services that could jeopardize the life of our Belizean citizens. In the opinion of this board, the issues do not warrant the withholding or the reduction of health services to the population. At this time it is our grave disappointment and it is our understanding that the situation persists and up to this moment, there has been no specific written or verbal allegations directed to the management or to the Board of any type of misconduct or behavior. We’ve heard of perception and we’ve heard allegations but there has been no specific directive given to us about anybody who is sitting on this board.

We have gladly agreed to be audited by an outside independent auditor selected by the union. But I think we should go even further. I think we should expand the audit to the delivery of health services. We need to evaluate the quality of care that is being given to our people. We need to look at every corner of the operation of KHMH. We need to shine the light everywhere, not only directed at the board or management.”

Laura Longsworth, Board Member
“Every time we fail to give the kind of care to patients that they need, we run the risk of increased illness and perhaps even death and I thinkthat that is a very serious thing. We need to hold ourselves accountable. The board is very much aware of the implications and we are not taking it lightly at all. I think the signal went out that we are not taking it lightly when not only the Minister of Health worked with us yesterday but also the Prime Minister of this country. That was a clear signal of the importance that we place on healthcare delivery and I think that that is the way to go.

Healthcare is delivered on a basis of evidence. You must have evidence to provide service. You have to justify actions by producing data and good data. And so I echo Miss Sylvestre’s concern that to date we do not have that information.”

And while the administration says the doctors have not provided specifics, the doctors say there are plenty of them – particularly in the acquisition. Financial Controller Carlos Perrera says that there shouldn’t be any because they have instated plenty of management controls to repair irregularities since they come in ten months ago.

Carlos Perrera, Director of Finance – KHMH
“We implemented not only three quotations on large capital expenditures but on all purchases. The purchasing officer that was newly appointed in that area reviews the prices and quotations ensures cost and quality is the priority with the many suppliers that we purchase from and I can list the very amount of suppliers. We inherited where the purchase of supplies were being done with doctors who are employees of KHMH and who own and operate companies outside KHMH. This created unnecessary conflict at the institution and at the same significantly disrupted supple chain management. We initiated the policy that procurement of supplies and equipment will no longer be sourced by an employee that is with Karl Heusner Memorial Hospital. This by itself strengthens the supply chain management.

We inherited where there was no documentation to show for international purchases, the respective quotations of those international purchases acquired to illustrate accountability and transparency. We initiated that 100% of all checks disbursement be signed that has the requisitions, the invoices, the purchase orders, any additional quotations for the purchases of those particular equipment. No matter where the supplies came from at the end of the day we were looking after the interest of the tax payers and the people from that end. We therefore initiated an internal auditor that is fully on fulltime employment at Karl Heusner to perform inventory management functions that supplies issued are being used and accounted for. It was a norm that the requests for tax exemptions for supplies was being manipulated where goods were being imported and times only 50% of what was on those entries was for the KHMH. Therefore goods were being imported under KHMH.”

And while the administration met the press in the boardroom, the doctors were meeting two doors down in the library. They declined comment until tomorrow but told us they do have very specific complaints and documentation to back it up. 7News has also received invoices which shows the KHMH purchasing pharmaceutical products from the De La Fuente Pharmacy – owned by the family of Orange Walk Mayor Phillip de la Fuente for prices which do not compare favorably at all with prices available from other suppliers. In some cases the prices difference is as much as two thousand percent. In the case of dopamine there are invoices which show the drug dopamine for $71 each compared to $25 each from another supplier. We’ll have more on these documents in tomorrow’s newscast.

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