Over the years the cash-strapped Queen Elizabeth Hospital (QEH) has become notorious for long waiting periods, especially in the Accident & Emergency Department, out-of-date equipment, missing files and stock shortages. And while much of this has been attributed to the Martindale’s Road, St Michael facility’s management, some of the hospital’s challenges can be seen as purely financial. One suggested capital-raising measure has been the introduction of user fees but the hospital’s administration seems more focused on recovering monies owed.
Back in 2006, then chief executive officer Winston Collymore conceded that the hospital was underfunded in its day-to-day operations but noted that with a tighter accounting system, including the vigorous collection of debt and an increase in service fees, they should be able to steady the situation. At that time the QEH was getting an $8.3 million financial injection from Government. In the June 25, 2006 SUNDAY SUN, Collymore said this additional money was due to a $21 million shortfall in the funds allocated to the hospital and their expected needs. He estimated that before recouping outstanding debt, the QEH needed $134 million, having originally been given $113.75 million. Collymore said the hospital intended to collect at least $7 million owed to it that financial year, and would appoint a debt-collection agency to collect these funds. It would also be going after about $3.5 million from former patients who received loans from the Medical Aid Scheme.
He also said increased service fees would greatly help the QEH’s finances. “We have fees here that are 50 cents for particular tests. By the time you do the particular paperwork, you might as well not charge them,” said Collymore, who noted that some of these fees had not changed in more than 20 years. He dismissed suggestions that an increase in fees could be interpreted as an intention to privatise the hospital, noting: “You are just increasing the amount to reflect the value of the treatment and the actual cost of providing that treatment.”More recently, the May 22 SUN ON SATURDAY reported that more than $4.5 million was owed to the QEH and that health care institution was taking steps to encourage people in arrears to settle their debts.
Senator Irene Sandiford-Garner, Parliamentary secretary in the Ministry of Health, said, “Barbadians who know that they owe the Queen Elizabeth Hospital money . . . we will be actively and aggressively pursuing the debt owed.” “I think it is unconscionable that our people would have the benefit of one of the best, if not the best, general hospital in the Eastern Caribbean, and leave that institution and not pay their debt. I know there have been reports that some people have attempted to pay and their money has not been accepted. That is debatable. But if that is the case, we would wish you to come back and pay the QEH the money owed.” She said systems would be put in place in the not-too-distant future to ensure that people pay before they receive certain services. “Just as you cannot check into a hotel and check out without paying, the QEH is moving to the stage where we will have a revenue-generation system which indicates that when you come, you pay for the services rendered,” Sandiford-Garner said. The following month CEO Dexter James said people who owe the hospital money have a three-month grace period to pay up.
According to the June 2, 2010 DAILY NATION, he said people could call the finance department to clear or make satisfactory arrangements to settle their debt. James stated that after the grace period, the QEH would take legal action to get its money. The CEO further added that patients who do not require immediate and emergency health care will not be admitted to the QEH if they have not honoured their financial commitment. Minister of Health Donville Inniss went a step further and said the time had come for the QEH to be reimbursed for treating the victims of vehicular accidents. “It is expected that those responsible for such accidents and their insurers will find this to be a fair policy and will not delay in settling such claims,” he said in the April 8, 2010 DAILY NATION. Inniss also said a similar policy for victims of violent crime involving the attention of the police was currently being fine-tuned.
However, the minister made it clear that health care remained free. “It is simply a case that those who are involved in personal injury claims, that the QEH be reimbursed by the carriers and whoever is responsible for causing the accidents. “We cannot continue a situation where we have such a large number of accidents on the roads of Barbados putting such a major toll on our public heath care facilities and [not] do something about it. “I am not asking individuals who turn up at the QEH to be treated to pull their pocket and pay, butI think people ought to know what is the cost of the treatment they got.” Prior to this, James said the hospital would crack down on delinquent patients in order to recover more than $1 million owed in arrears for private treatment.
In the March 24, 2010 DAILY NATION, James said the QEH receives only 60 cents of every dollar paid by private care users. “Potentially, the QEH could collect $3 million to $4 million per year, so $1.5 to $2 million could be outstanding in any given year – which is very high. We have to address what I consider to be [the] less than acceptable collection performance of the hospital,” he said. James, in a statement reminiscent of that attributed to Collymore above, said: “Rest assured, we will be taking some aggressive steps not only to change our policies and procedures for admissions, billings and collections, but we will also be taking whatever appropriate action is required to [get] the funds and fees that are legally due to us . . . which may involve going to the court.“Health care is free to all Barbadians at the point of delivery, so what we are speaking to is for patients who have exercised the right to private care. They are the ones who will be required to pay the fees at the hospital,” he said.
