I REFER to the letter “Hospital in urgent need for help”, (The Star, Nov 19).
I too am a medical officer and the issues that were raised in the letter are not foreign to me but in fact have been faced since my medical student years.
As a medical student, I was attached to a teaching hospital in the Klang Valley whilst two years of house officer training was completed in Kota Kinabalu, Sabah.
Even in the city center, we still ran out of basic items such as gauze, intravenous cannulas and disposable gloves.
In Sabah, similar issues were faced. Throughout the two years, we seemed to have a constant lack of A4 paper.
Certain departments were sending disposable items for sterilization to be reused.
Basic items such as medical tape, needles, disposable gloves would run out on a regular basis.
During my posting in the accident and emergency department, I remember running out of oxygen supply during one of the shifts as all our tanks were running low.
When I brought it up, the answer to all this was the usual: “in the process of working on it” and “no budget allocation”.
After two years, I was sent to another hospital in Lahad Datu. Sabah. In the last four months, I have experienced hospital (and housing area) wide blackouts at least once a month.
Operating theaters break down frequently in all three main hospitals on the east coast of Sabah and patients sometimes have to be sent 400km away to Kota Kinabalu for operations.
Mobile phone networks are poor and pathetic, whilst mobile internet is something available only in certain parts of the town.
The lack of staff in many departments makes administration and paperwork even slower. Clinical waste from the whole state of Sabah has to be sent out for disposal as the incinerator has not been functioning for a significant period.
Facilities and infrastructure aside, at the national level, the house officer distribution system nationwide needs a proper revamp.
Stark discrepancies between the numbers of house officers in hospitals force some hospitals to apply the shift system and others the on-call system.
This disrupts the constant supply of house officers to hospitals, resulting in certain house officers having enough time for breakfast, lunch, tea, and early dinner after a 10 hour shift; whilst others work 40 hours non-stop, clocking 120 hours a week without a rest day. Enough of figuring out whether house officers should work on shifts or on call system but focus on distributing them evenly instead.
Our primary, secondary and tertiary education systems lack adequate training of leadership and management skills which are sorely needed by a doctor.
The recent move to place nurses and ward sisters to help in monitoring of the attendance and performance house officers worsens the situation as house officers are sometimes required to manage district hospitals/health clinics single-handedly after two years of housemanship. How are they going to rise to this after being ordered around for the better part of two years?
Given all the above conditions, it’s no surprise that young doctors hop across the Causeway to Singapore for housemanship and post-graduate training. It may seem like a whole lot of whining and griping but it is necessary for the benefit of the community at large, for those that we call patients, those that come to hospitals to seek comfort and cure. There is no excuse for suboptimal patient care.
The general answer to most issues are one of dismissal such as that other hospitals are also suffering the same predicament.
We need to get rid of this habit of using comparison with others as an excuse for substandard performance. Nationwide standards need to be set and worked towards together. We must learn to adapt to substandard working environment and make the best of what we have to deliver optimal patient care.
To those in the corridors of power, please heed the situation of the healthcare system in this nation. Do away with unnecessary bureaucracy and protocol.
Empower and allow autonomy wherever possible to distribute the burden of management whilst honing leadership skills in the periphery.
For example, hospital directors need to be given more autonomy to handle finances. If they see the need to transfer funds to a different unit/division of the hospital, they should be able to do so without time consuming bureaucracy.
There needs to be an avenue for whistle blowing not only in the socio-political scene but also in the healthcare system.
Set up a proper feedback channel for accountability and transparency purposes. Forget about corporate and social visits; instead make surprise or incognito appearances to hospitals nationwide to assess the situation yourselves. Only by getting your hands dirty, can you clean up the mess in our healthcare system.