The Tribune

By EARYEL BOWLEG

Tribune Staff Reporter

ebowleg@tribunemedia.net

HEALTH and Wellness Minister Dr Michael Darville announced yesterday an agreement that allows the transfer of Princess Margaret Hospital patients to Doctors Hospital West.

Effective today, some patients will be moved to the facility on Blake Road for approximately 14 weeks. It is estimated this will cost the government between $2 million to $2.5 million.

“This is not the first time Doctors Hospital has come to the public facility’s aid,” Dr Darville said at a press conference.

“It happened in COVID-19 and I am pleased to say that we are finalising all of the necessary negotiations so that we will be able to provide the necessary care for our patients here at the Princess Margaret Hospital. With respect to the care of patients transferred to Doctors Hospital West, I commend the PHA, the doctors for coming into agreement with these essential discounted rates for public patients at Doctor’s Hospital West.

“It is a collaborative effort with clinicians, healthcare executives, legal advisors, EMS leadership, and financial officers in order for this particular initiative to be successful. With this agreement, the Public Hospitals Authority will be in a position to address critical existing infrastructure challenges including replacement of elevators – remediation work, mechanical, electrical, plumbing — all that is necessary in order for the hospital to function effectively,” the minister explained.

“We are also installing modular infectious units here at the Princess Margaret Hospital. And we need this facilitative move in order to do the necessary repairs without the disruption of essential services.”

Asked about the discounted rate for patients, he noted it “fluctuates”.

“In some instances, it can go as high as 50 percent in some instances of 30 percent because while the patient is at Doctors Hospital, we will have to be able to do lab tests, diagnostic tests, and a variety of other tests and so the overall package we felt was very reasonable.”

He added: “When we compare what we pay for the services here at the Princess Margaret Hospital and during the initial opening at the press conference, I made it very clear that I do appreciate Doctors Hospital working very closely with the Princess Margaret Hospital in the PHA. We are satisfied with the rates that we currently have. The details fluctuate so it's difficult for me to tell you exactly every detail, but the rates are discounted.”

PHA Managing Director Dr Aubynette Rolle explained that the PHA’s agreement with Doctors Hospital allows for full usage of the Blake Road facility amounting to some 51 beds.

“Medical chiefs of staff, Internal Medicine Department, and the Emergency Room Department created the criteria of medical patients who will be transferred with stringent screening and admission of non-critical patients with an average length of stay between five to seven days depending on the acuity level and bed availability for transfer at Princess Margaret Hospital. Monitoring and evaluation of the referral process will be carried out to ensure that only public patients are transferred and strengthened case management to ensure a smooth transition of patients,” she said.

“The Emergency Medical Services will be included in the transfer process and the EMS leadership has been fully engaged in the planning process and making the necessary preparations to ensure patient transfers are conducted safely, efficiently and without (disruption) to the agency's emergency response functions. PMH’s internal medicine team will manage patients with the support of Doctors Hospitals health system physicians and allied health staff.”

Patients who will not be transferred to the Blake Road facility are those in paediatrics, obstetrics and gynaecology, surgical patients and patients requiring intensive care, and also those with infectious diseases.

Dr Caroline Burnett-Garaway, medical chief of staff, said the Doctors Hospital facility will function almost as an “annex” of Princess Margaret Hospital.

She continued: “So it will be like a ward at PMH and so it's going to be internal medicine patients. So as the managing director said, diabetics out of control, congestive heart failure, hypertensive emergencies that will be transferred over to that hospital. So the process is that all patients will be admitted through the emergency department and reviewed by the medical specialists who decide that they require admission.

“If they're stable enough to go straight to Doctors Hospital, they'll be transferred from the emergency department to Doctors Hospital West. However, usually internal medicine patients when they come to hospital are quite ill. So we may opt to keep them at Princess Margaret for about three days to five days to stabilise them and then they could be transferred over from one of our wards to Doctors Hospital west to complete their management.

"There are 51 beds at Doctors Hospital that we can utilise for the management of our patients. So we're not sending anyone who's unstable that may require intensive care, ventilation. The heart is unstable. So those will stay at the Princess Margaret Hospital and then we will send more stable patients over to Doctor’s Hospital West.”

The government's proposed plan to outsource care was previously met with concerns from consultants from PMH’s Department of Internal Medicine. In a document dated October 20, the doctors criticised the plan, saying there is no justification for it.

The doctors alleged there has already been a death in the pilot of this process when a patient who had been moved to the other health facility became unstable and could not be revived on arrival at PMH.

When asked about the claim and addressing the consultants’ concerns, Dr Rolle indicated she was “unfamiliar” with the alleged death during the pilot phase.

“What I do know is a patient decompensated as usual and unfortunately the patient died. What I am prepared to address, though, is that yes, there were challenges. Anytime any organisation is about to make changes, all parties will not be on the same page, I call it,” she said.

“But we have had multiple consultative efforts and I'm happy to say that they came to the room, they appreciated the quality of care.”