Health Minister Tandin Wangchuk has instructed the health secretary and the presidents of the national referral hospital and the Khesar Gyalpo University of Medical Sciences of Bhutan (KGUMS) to form a high-level committee to deliberate on the proposal to make the national referral hospital a corporation.

As a way to retain specialists, improve services and to provide a financial benefit to the hospital, the government has directed the hospital to come up with a strategy to make the hospital a corporate entity. A total of seven doctors and 11 specialists left the health sector in the last six years.

This proposal came after the cabinet discussed the specialist retention strategy submitted to the cabinet for endorsement by the health ministry through the Royal Civil Service Commission earlier this year. The Cabinet and the ministry support the idea.

However, the second pay commission had pointed out that the government cannot raise allowance for the specialist category alone. If the government raised the allowance for the specialists, then it has to do the same for other health workers.

Lyonpo said that the prime minister during the annual performance agreement signing with the Jigme Dorji Wangchuck National Referral Hospital (JDWNRH) asked the hospital and the ministry to explore the possibility of providing financial benefits to the specialists to retain them.

“Specialists are civil servant and we cannot differentiate their salaries from other civil servants based on their profession. We have to follow the RCSC rules and regulations,” Lyonpo said. “Making the hospital a corporate entity is the best solution for now.”

However, Lyonpo said that to change the status of the hospital into a corporate entity will depend on the proposal that will be submitted.

The health minister’s letter to the health secretary and the presidents of JDWNRH and KGUMS of August 14 states that the health system in Bhutan has grown remarkably in the past five and a half decades.

However, the ever growing and ageing Bhutanese populations have caused a surge in demand for health human resource capacity in the country, which to date has been managed comfortably and successfully, it stated. “It is therefore imperative that the characteristics of the future health care system and changing demographics, changing government policies and other trends on the future adequacy of medical doctor supply needs to be considered carefully and diligently.”

Lyonpo pointed out that there is a number of specialists who have to work only from 9AM to 3PM while others are regularly required to be accessible and available at all times to provide continuous care to patients during emergencies. “There is shortage of specialist whose services are required after 3PM.”

“The number of medical specialist in the country has not gone down. It is increasing every year,” Lyonpo said. “The shortages are there because many specialised health services are being introduced in the country. As more specialised health services are introduced, more specialists will be required in the health sector.”

As per plan, the health sector requires 169 specialists. Currently, there are 81 specialists, including the 10 super specialists in the country.

Of the 88 required specialists, 33 are general specialists.

Lyonpo said all health workers are important but the proposal that was submitted was only for the specialist because they are limited in numbers. “It is important that we look into the proposal holistically.”

Lyonpo said that if the hospital becomes a corporation, it could raise the financial benefits of its staff according to their service rules without having to follow the RCSC rules. “Service will improve and depending on their efficiency, they can provide allowances to the health workers according to their entitlement.”

Lyonpo said people are concerned that they will be required to pay for health services once the hospital becomes a corporation. “Constitutional requirement states the state shall provide free access to basic public health services in both modern and traditional medicines. The ministry will at any time protect this right of the citizens.”

If the hospital becomes a corporation, it would not only help in retaining the specialist but the pool of specialist will grow and the work pressure will be reduced in the long run, Lyonpo said. “Attractive pay and allowances will encourage people to take up the course that has demand in the health sector including the specialist.”

Lyonpo said studies to make the hospital a corporate entity have been carried out in the past.

Dechen Tshomo