Much of what Bhutan has achieved in health care services is because of our health workers. While there is little appreciation to their service, there is uproar when healthcare facilities run short of health workers.
In what was a desperate attempt, the national referral hospital last week issued a notification freezing extraordinary leave (EOL) for nurses and technicians. The move has not gone well with the employees even though they are aware that the management’s decision was taken in the interest of service delivery. We are aware that the shortage of heath workers cripples the delivery of healthcare and understood this way; the management cannot be blamed for taking an extraordinary decision.
But questions remain. The country’s apex referral hospital is short of 120 nurses today and perhaps, as many technicians. With many on EOL, the hospital is not sure if they would return home to resume work. This has disrupted planning and recruitment and therefore service delivery.
However, this is not a new trend we are seeing. The hospital has been short of drugs, doctors, specialists, equipment and even parking spaces. The hospital was politicised and became a tool to gain political mileage. But these discussions did not help the staff at the hospital nor improved service delivery. Many left and many more are planning to leave. The decision to place female health workers in the BHUs failed miserably when the transfer orders were revoked. The same is happening with doctors.
Now, with employment opportunities for skilled workforce available beyond the country’s boarders, many are leaving altogether. EOLs are now facilitating our skilled workforce to work abroad. While this may be good, the organisations are aware that many would not return. Freezing EOL for selected professions may work for a short period but could trigger more resignations. It would be naïve to assume that such a move would help retain critical employees.
This calls for the civil service and other organisations to revisit their rules and to keep pace with change. It calls for a holistic understanding and diagnosis of issues plaguing our health sector.
We now have medical professionals at the helm of governance, who know best the issues at the national referral hospital. Against its claim that the party was given the mandate to govern because of its health pledges, we are still waiting for visible change in the health sector. Human resources are critical for the government to implement its pledges, but what it has today is a hollowed health sector whose grievances are rarely heard.
The government has announced, without much detail, that it would delink the national referral hospital. While the hospital has been mooting this move for years now, our policy makers have to assess how this would improve the state of health workers and service delivery.
A cabinet member recently observed that the standards of service at the national referral hospital are at par with a district hospital.
The question is why and what would the government do about it?