The Bhutanese Leading the way.
The National Referral Hospital in Thimphu is exploring possibilities of expanding the fee based special consultation services it provides in the evening, to cut waiting time, improve service delivery and also incentivise health care work.
The new services include endoscopy, echocardiography, physiotherapy, eye and gynecological procedures, ENT and surgical procedures.
As of now the special consultation services, started in October 2012 as a pilot project, is limited to medical certification, medical consultation with specialist/general medical officers, radiological investigation and electrocardiography (ECG).
The fee ranges from Nu 150 for x-ray diagnostic to Nu 4,500 for MRI with contrast, and is to cover services of the health care workers who provide the special consultation during their free time. The fee does not include the cost of using government infrastructure, equipment and drugs and laboratory services. (This needs to be cross checked)
“At the time of starting the special consultation services, it was decided that only those services which can be provided on an outpatient basis should be included in the pilot project,” said the superintendent of the hospital, Dr. Gosar Pemba adding that new services were to be added later on.
On the new special services, Dr Pemba said extensive consultations were done before drawing up the list that will allow patients more convenience and reduce waiting time for certain procedures like endoscopy, surgery, echocardiography and ultrasonography.
“The new services would definitely bring about improvement in service delivery as patients will have more time with their doctors and this will improve diagnosis and treatment and result in fewer patients visiting the Out Patient Department,” he said.
He also said that the new services would clear the backlog in endoscopy, surgery and other services where the waiting list is long. The new services are also expected to involve more hospital staff and lead to equitable distribution of fee money and improve staff morale.
Dr Pemba said a new team would have to manage the expanded special consultation service since it would involve a large number of patients.
Health workers who run the service at present do not have adequate time during the day to give appointments, as they have to work in the hospital. Likewise, the supervisors who manage the service are tired by evening.
“The new team can start working from midday and give proper appointment, which is not being done at the present moment,” said Dr Pemba.
Even though some of the objectives have not been met the special service, which is in its fourth year of operation, did provide opportunity for the people to avail and choose their doctor of choice, said the medical superintendent. “It has also been self-sustaining and in fact contributed to the royal government exchequer even though this was not the objective.”
The hospital has been making a revenue (profit?) of Nu. 4 million annually (only from the special service ???) which is utilised in hospital maintenance and renovation according to Dr Pemba.
On when the new services would start Dr Pemba said that it is, “a long run plan and will entirely depend on demand of patients”.
