The Tribune

By ADRIAN GIBSON

ajbahama@hotmail.com

BAHAMIANS have generally felt that the powers that be do not truly have a healthcare agenda and, frankly, do not care about the public healthcare system. If one was to visit the Princess Margaret Hospital or some of the polyclinics on any given day or night, one would encounter throngs of frustrated Bahamians, irritated by the “don’t care” attitudes of medical personnel, angry about the slothfulness of staff in catering to their needs and exasperated by what appears to be an overall lack of user-friendliness in accessing decent healthcare without either having to bleed out in the waiting room, display their anger through uncontrollable outbursts, call a physician who they might know or are connected to some politician. That is the horrendous state of public healthcare and yet when the single largest investment in the history of healthcare in the Bahamas is made — that is, in the public sphere — the potential that would’ve been realized with the introduction of the critical care block will likely not be achieved as a design-built step-down unit has been excluded from the block in preference to glossy office spaces.

Indeed, any poll of Bahamians and medical professionals alike would yield the opinion that the vast majority of them believe that the public healthcare system must be fundamentally revamped and/or completely rebuilt.

Relative to the vitally important step-down unit — which I understand was supposed to be situated on the second floor of the newly constructed critical care block — its intent, in hospitals across the globe, is to serve as an intermediate, semi-critical unit in which patients who are no longer critically ill (that is, in the Intensive Care Unit), who may be on a monitor or generally interactive, but who aren’t well enough to go to the medical-surgical units. One should also note that not all patients who come out of ICU must go to a step-down unit or a general ward as some of them have a marked improvement in their conditions, so much so, that they could be discharged.

Cardiovascular Surgeon Dr Duane Sands told me:

“I don’t know what the premise is in changing from the step-down unit, but there’s a concept that is well held which is that the accommodations of administration are, and must be, significantly better than the accommodations for patients or the professionals who must care for patients. There’s a real disconnect as to what priorities are! The question Bahamians should be asking is how should their scarce healthcare dollars be spent — is it better spent on clinical equipment, critical care space or air conditioned offices? A step-down unit would allow for the treatment of seriously ill patients who need more than open or general ward care. So, the exclusion of such a unit, for whatever reason, is an error in healthcare planning. This will need to be revisited in the near future.”

Indeed, the evolution of the critical care block from one initially intended to better care for critically ill patients to one that would partially offer facilities for patients and partially offer posh, high-rise offices for hospital big-wigs is demonstrative of what the Public Hospital Authority (PHA) and the powers that be view as priority! As Dr Sands said, “The view that is widely held in the administration of healthcare is that ‘if it wasn’t for them doctors and them nurses, we (the administrators) would be fine taking care of patients.’”

“They do not listen. And so, despite the single largest investment in healthcare, the potential of the new critical care block could possibly be lost and never come to fruition. Up to Thursday (November 14th), surgeons—who will be the primary users of this space (critical care block)—have not had a chance to view the facility. As a matter of fact, I still haven’t seen inside and they simply won’t let you in. We would have to go on a tour and they have not allowed us to go on this tour—bear in mind that it’s November! The viewing of the critical care block is by appointment only and we have not been given an appointment. “

When one looks at the critical care block and thinks about how a vital floor—originally dedicated to medical care—was designated to serve as office spaces for the hospital’s administration (who, obviously, must already have offices in their current capacities), we Bahamians find ourselves yet again disappointed with another promise that has not been delivered.

According to reliable sources, the critical care block is behind schedule and the funding — which was recently raised by the PHA’s recent public offering, is delayed. Frankly, though the share offering was oversubscribed, the PHA had to publicly seek funding as it is virtually insolvent. Moreover, the opening of the critical care block is further delayed since the staffing levels are not yet adequate to meet the needs of the new block. By all accounts, as it stands, the anticipated move-in date has been indefinitely postponed.

In summing up his take on the delayed critical care block and the PHA, Dr Sands said:

“The PHA is a tool of devolution and, despite the efforts of those involved, it has not been set free to function as originally conceived. It continues to be micromanaged by the MOH and is therefore another layer of bureaucracy. It is metaphoric of the inability of politicians to avoid meddling in the so-called quasi-government entity. It is far too enticing to be able to manage so many jobs, so much money and so many resources that the politicians simply can’t let go! For this same reason, political interference in the PHA will forever keep it on the brink of fiscal insolvency, just like the Mortgage Corporation, Bahamasair, BEC and Water and Sewerage.”

I couldn’t agree more.

THE POLICE AND THE 12 HOUR SHIFT

I supported the implementation of the 12 hour shift for police officers. Frankly, I still do. When it was launched and I noted a dip in violent crime, I thought it was a commendable move on the part of the Ministry of National Security, the Commissioner of Police and all parties involved. That said, I also understood the complaints of the Police Staff Association (PSA) and felt that the Ministry of National Security could curb their fervent protests by merely offering extra compensation or—if the monies could not be paid—giving them the time off, for example, if an officer works four days on a 12-hour shift each day, give that officer three days off. If the PSA was sincere in its protests, I have no doubt that they would’ve agreed to such an understanding and this, by extension, would have averted claims that the government violated the Employment Act by slavishly overworking officers without compensation, claims of fatigue and, as it finally turned out, the threat of legal action.

Indeed, now that the 12-hour shift rotation has been terminated, I’m quite disappointed that an amicable resolution could not be arrived at. Even more, the question most people want answered is whether the purpose of the 12-hour shifts was merely to demonstrate that there could be a dramatic reduction in crime, particularly since the timing seemed contemporaneous with a spike in violent crime.

Police officers have told me that they are no longer on the 12-hour shift rotation. So, why was it stopped? Could an agreeable understanding be arrived at? Was the threat of legal action the basis for the shift from the newly adopted 12-hour shift policy to the usual 8-hour shift? Was it theatre for the public’s consumption or was it a detailed plan? If this is the case, why were the shifts started in the first place without paying attention to the details—e.g. compensation, police welfare, etc?

With the Christmas season fast approaching, this is the time for police officers to be on the 12-hour shift rotation, as police data would show that crime historically increases around this time of year. Frankly, the authorities that be and the PSA must come to an harmonious understanding—in the interest of the Bahamian people—relative to the 12-hour shift being reinstituted during the Yuletide season.

Since the general public and the media have yet to be officially and forthrightly informed by the Minister as to cessation or continuation of the 12-hour shift—though rank and file police officers are telling us all and spreading the news like wild fire— one wonders about the reason for the secrecy (the officers have not kept the secret). I think that generally, the Ministry of National Security has been working overtime in seeking to implement new approaches to crime and, when one considers the recent operations and 12 hour shift scheme, has offered a more idea-oriented, better approach to crime than when the Ministry was headed by former minister Tommy Turnquest.

Unfortunately though, this country is not one of transparency at this time and so the answers relative to the whispered withdrawal of police officers from the 12-hour shift are not likely to be forthcoming.

ATROCIOUS SERVICE AT PREMIER IMPORTERS

On two occasions I have had to endure the most dreadful, woefully inadequate service offered by Premier Importers—a company that sells construction materials and situated on St Albans Drive. Quite honestly, based upon my experience with Premier Importers, there is nothing premier about its service quality.

A few months ago, I purchased four doors from this company. The doors were to be shipped to Long Island. They sent two of the doors and did not send the other two nor did they have the decency or the courtesy to call me to inform me of the same. I discovered that my doors weren’t sent and were suddenly out-of-stock (they weren’t when I made my purchase), after I received a call from the folks in Long Island telling me that only two of the doors had come on the mail boat, I immediately called the company and, among a plethora of excuses for why I was never called and informed and why my doors were sold though they were to be set aside for shipping, they finally told me that they were out of stock and would send the doors the following week. Frankly, the lady who I initially spoke to on the phone that day (her name escapes me) had an attitude. What’s more, there were persons—the contractor and his workers—who were on the job site and waiting for those doors, among other things.

Here’s the kicker, I have done business with City Lumber, FYP, JBR, Tops, Twenty Century and a number of different construction/material outlets and none of these entities have ever sold me items and not sent them to the island as agreed. At no time have I ever had to hear that anything purchased from these companies wasn’t purchased.

After much ado, someone at Premier got it right, even offering an apology.

I soon decided that I would patronise them once more and so two weeks ago, I purchased 27 cases of tiles and a several bags of grout and thinset. This time, they delivered. However, I was informed by the tile layer that he needed seven more boxes of tile and a bag of thinset (I should also note that I purchased a different set of tiles from Global Tile for another part of the building and they delivered, in both instances, without fail). Unlike Global, Premier Importers did not deliver my tiles or thinset to the boat and once again, they failed to call and inform me of the same.

Once my folks in Long Island retrieved the building materials sent on the boat, they noticed that the items expected to be sent from Premier wasn’t on the shipping manifest. Once I received the call, I was irate. Why? Because upon making this follow-up purchase, I personally went to the so-called delivery manager who I informed of my past issues with Premier (re the doors) and asked him to set aside my items to avoid a recurrence of the same. I also showed him my invoice and he faithfully promised me that he would do so. He did not and, upon calling them—since they didn’t call me—I once again found out that they had sold my items to another customer and—whilst those tiles were in stock when I purchased them and spoke to the delivery manager—they were sold thereafter. How unethical!

What makes it worse is that they lacked the professional decorum, the ethical dispensation to even call me. Once more, I had to angrily call them and chide them about their unprofessional behaviour, their contribution to the delay of that aspect of my job, etcetera. Fortunately, Premier Importers has at least one very professional and diligent employee, that is, Mrs Margaux Taylor-Major (the company’s buyer), who worked tirelessly to locate a few boxes of tiles and maintained a line of communication that was open and honest. I appreciate her level of professionalism and though I was upset, I could not be angry with someone expressing that level of diligence and care for rectifying a situation that she had nothing to do with.

The owner and administration of Premier Importers must ensure that it takes a greater interest in Family Island customers and those persons who are sending material to the Family Islands for active construction projects. Time is money and no one likes to have their time wasted, nor does anyone want to hear that they have purchased an item whilst in stock only to have it resold to another person before it could be packaged and shipped out. That, as I said earlier, is simply unethical!