Plan to merge referral hospitals underway

To provide timely care and health services to patients, the government is planning to merge the three-referral hospitals in the country.

Health minister Dechen Wangmo said the country doesn’t have many specialist and surgeons and having the referral hospitals are under one management would allow the health workers to work in these hospitals on rotation.

“We will consolidate, merge and form a teaching hospital,” she said.

By doing this, the health sector, she said, would be able to provide timey services to the patients.

For instance, if Monger referral hospital sees many ENT (ear, nose and throat) cases that require surgeries, the hospital can compile a list and ask the patients to come on a certain date. An ENT specialist from JDWNRH could visit Mongar hospital for a week and conduct the surgeries.

By circulating the limited human resources, lyonpo said there would be efficient and effective utilisation of the limited resources.

“Sharing of knowledge and skills would also be enhanced because medicine is not about only treating patients,” she said. “Ultimately we build the standard so that all three referral hospitals have the required human resources.”

Today, the doctors of JDWNRH cannot go to the regional referral hospitals. JDWNRH is a semi-autonomous body while the two regional referral hospitals in Gelephu and Mongar have no autonomy.

Of the three-referral hospitals, lyonpo said JDWNRH has the highest number of medical specialists. “But the question is if the specialists are seeing the cases they were supposed to? No, because things are not as they were supposed to be.”

If these three hospitals are merged, then they can rotate as a teaching hospital and doctors from Khesar Gyalpo University of Medical Sciences of Bhutan can practice in any of the regional referral hospitals and do their residency there, which cannot be done today, lyonpo said.

Merging would also enhance a performance-based management system, she said. “Being a teaching hospital, they all have to perform and they are all one unit, an autonomous agency.”

One of the drivers of an autonomous agency, she said was that they have to perform. “If you are not performing then you could be fired.”

The ministry will play a role in oversight, quality, regulation, and standard. “We want to regulate standard, set standards and say you are not performing if you are not. This is the idea for the merger so that all our resources are pooled.”

During the APA (annual performance agreement) signing last month, the health minister had assured that all referral hospitals would be de-linked from the Royal Civil Service Commission (RCSC)

Prime Minister Dr Lotay Tshering told Kuensel that representatives from stakeholders including the president of the university, and the national referral hospital had a first round of meeting with the RCSC.

The prime minister has also issued an executive note asking the concerned agencies to formulate a concept note.

Lyonchhen said that while it is at an early stage and many consultative meetings has to be followed, the hospitals would be first de-linked and then a decision on the merging or keeping them autonomous would be made.

Meanwhile, Lyonpo Dechen Wangmo said that the health ministry’s current vision is the nation with the best health. “What is the best health? The best should be the quality of care.

What happens today is that patients from all parts of the country flow to the hospitals, she said. With a triage system in place, diarrhea and cough and cold cases should be taken care at the Basic Health Units (BHUs).

Dechen Tshomo

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