Asks GNHC to continue studying the possibility of corporatising JDWNRH, among others
The health ministry has written to the Gross National Happiness Commission (GNHC) to continue the study on assessing the possibility of corporatising Jigme Dorji Wangchuck National Referral Hospital (JDWNRH).
The December 11 letter was sent in response to a letter from the commission that sought the ministry’s directives on whether to continue or hold the work after the National Assembly (NA) decided to stop the corporatisation of JDWNRH on November 23.
However, the Director of GNHC, Rinchen Wangdi, said the commission is yet to receive the response from the health ministry and that work is on hold after the NA’s decision.
Besides providing an in-depth analysis considering policy, legal, management and financial implications of corporatising the hospital vis-à-vis maintaining status quo, the committee led by GNHC will also study the functioning of JDWNRH as an autonomous agency and determine areas for improvement.
The committee was reconstituted on September 18. Health secretary Dr Ugen Dophu said the committee would continue with the study and submit the report to health minister by the end of this month.
“Although the NA has decided not to corporatise the hospital, it is better to have the study completed as the committee had already started the work,” he said. “It’s good to have a report with findings and recommendations, which can be used for reference in future.”
The strategy to explore corporatising the hospital arose after a specialist retention strategy was proposed to the cabinet. A committee comprising specialists from the JDWNRH and human resource officials from the health ministry prepared the proposal.
Now, Dr Ugen Dophu said that activating the specialist retention strategy seems to be the ultimate solution to retain specialists.
He said the cabinet deliberated the proposals and made some recommendations on the strategy. “We have to proactively follow up.”
One of the proposals in the strategy is to provide an allowance of Nu 25,000 to clinical medical doctors and a sub-specialist allowance of 20 percent. On this, the response from the cabinet states that granting pay and allowance is the mandate of the pay commission and that government is not in the condition to consider it.
It also states that the proposal has to be considered holistically and take into account the emoluments of the other civil servants, which includes general duties medical officers (GDMO) and technicians.
The committee also proposed providing on-call allowance of Nu 500 an hour for calls beyond regular duty hour to specialists and to attend one SAARC conference annually and one international conference bi-annually for specialists.
In terms of on-call allowances, the cabinet has directed that the proposal be put up to the finance ministry.
On availing continuing medical education or professional development of specialist, the cabinet directed JDWNRH and the health ministry to submit a project proposal to GNHC and the Royal Civil Service Commission (RCSC) for financial support.
The proposal also recommended recruiting on contract those specialists who have resigned, superannuated or completed their service bond.
The cabinet’s response states that, doctors who have left the system may be recruited on contract only if there is an acute shortage and until the shortage is addressed. They may be paid 80 percent of the salary paid to expatriate specialists at the time of appointment.
Dr Ugen Dophu said the committee has proposed more than 80 percent of what is paid to expatriate doctors.
Currently, depending on their seniority, the payment to expatriate specialist ranges between USD 2,000 and 3,500 a month
On this, the cabinet directed the hospital and the ministry to discuss the matter with RCSC. The cabinet has also suggested making a slab system. For instance, those who superannuate after 60 years may be provided USD 3,000 while those who resigned after 50 years may be given USD 2,500 and those who resign before 50 years could be given USD 2,000.
Dr Ugen Dophu said they are yet to disuses this up with the RCSC.
Increasing slots for MBBS and post-graduates, increasing the cost of service bond and providing personal assistant and duty vehicle for specialists are some of the other proposals made to the cabinet. The health secretary said the RCSC already has a system in place in terms of service bond.
The cabinet also directed the ministry to revisit the cost of referrals from regional referral hospitals to JDWNRH. The Department of Medical Services is working on it.
The cabinet suggested the ministry to study why doctors preferred working at the headquarters and to assess the impact of doctors leaving hospitals to join the ministry. It also suggested to study how critical is it for a specialist to have a personal assistant, housing nearby hospitals and their proposal to RCSC to recognise specialist training duration as active service.
Dr Ugen Dophu said if the training is in Bhutan, the RCSC considers the duration as active service. But if the training is outside Bhutan, until 18 months, the duration is considered active service.
He said currently, all specialists get 40 percent scarcity allowance. A clinical specialist is entitled to other allowances that other civil servants are entitled to.
Dr Ugen Dophu said except for the pay and allowances, which could be discussed in the next pay commission, the proposal needs to be activated through discussions with the finance ministry and RCSC.
Meanwhile, the national referral hospital, Gelephu and Mongar regional referral hospitals will soon receive 28 expatriate specialists. Of the 17 that will be placed in JDWNRH, the ministry has already hired four from Myanmar and other places. The rest will be hired from Cuba.
“This is expected to address the shortage of specialists in the country. The specialists will be hired on contract for two years and by then we will have our specialists,” Dr Ugen Dophu said.
As per the requirement and plan, the country needs 88 more specialists.
Dechen Tshomo