Health sector limping from ‘chronic’ overcrowding and dangerous understaffing, says JMDA

Hospital and healthcare services could face disruption today as the Jamaica Medical Doctors Association (JMDA) has called for doctors and supporters to wear blue as a visible sign of solidarity with interns who are planning to take protest action.

According to the association, the call is for urgent action to address long-standing concerns and comes on the heels of industrial action by nurses in the Accident and Emergency (A&E) Department of the University Hospital of the West Indies (UHWI).

In a release, the JMDA said it was bringing public awareness to an ongoing issue plaguing the health sector, namely, the “significant reduction in the number of interns who are working within the medical facilities islandwide”.

According to the JMDA: “This has created significant human resource and clinical challenges and has posed substantial challenges to service delivery. It has also increased the psychological and physical toll on medical teams. In many facilities our interns are working for 24-32 hour periods on alternate days. There are interns who are working up to 56 consecutive hours. These work schedules are inconsistent with the stipulations outlined in Policies and Procedures Manual for the Medical Internship and Senior House Officer Programme.”

The body said it was “calling for the immediate cessation of these exploitative hours of work which violate these guidelines. We have received reports of our interns experiencing motor vehicular accidents and falling ill from sheer exhaustion”.

In the release, under the signature of its president, Dr Rene Badroe, it stated that “the development of clinical acumen during the internship period is threatened as medical officers have identified that our interns are unable to adequately hone their key clinical skills because of the significant increase in workload associated with the decreased intern-to-service ratio”.

She said this has far-reaching implications for patient safety and the quality of clinical training.

She noted that in the most recent sitting of the MBBS Programme at The University of the West Indies (UWI), Mona, approximately 90 candidates successfully passed their examinations, some of whom will be returning to their home countries. She said, based on investigations, there is no expectation of a significant increase in the number of graduates from the university until 2029.

Without urgent intervention, the JMDA said, the shortage of interns will continue to pressure an already strained healthcare system and the medical professionals who serve within it.

“… Their absence places additional strain on existing staff and contributes to increased workloads, longer working hours, and challenges in maintaining efficient service delivery. Given the essential nature of interns to service delivery and the maintenance of a viable healthcare system, we are calling upon the Ministry of Health and Wellness and the Ministry of Finance and Public Service to urgently identify funding in the interest of patient care to support the following …” said the JMDA.

It is calling for the creation of additional internship posts, temporary task-shifting through the contracting of senior house officers and medical officers to do sessions to supplement intern coverage, and improvements in rest and overnight facilities.

It said that these facilities are entirely absent in some institutions, inadequate in others where interns are required to share beds, and in some locations, have experienced recurrent flooding, sewage issues, and inadequate sanitisation.

It said interns play a vital role on the medical team and the future sustainability of the healthcare system and that the JMDA stands ready to engage meaningfully with key stakeholders in identifying and implementing feasible solutions in the coming weeks.

Badroe, speaking on Beyond the Headlines on Radio Jamaica 94FM, said the situation across all hospitals was untenable.

Meanwhile, the UHWI, which was the scene of yesterday’s industrial action, also issued a statement stating that operations had returned to normal following action by nurses from the A&E Department after concerns were raised about overcrowding and other aspects of the work environment.

According to the UHWI, measures have been implemented to address immediate concerns, including the transfer of patients from the A&E Department to inpatient wards to reduce congestion and improve patient flow.

It said the UHWI remained focused on maintaining a safe and supportive environment for both patients and staff while ensuring the continued delivery of quality healthcare services. It thanked the nursing team for their continued commitment to patient care and service delivery, adding that “patient care remains our highest priority”.

“We want to reassure the public that the concerns raised have been addressed and UHWI is fully open and available to serve the public. Our team remains committed to delivering the high standard of care that patients expect and deserve," said the statement from the hospital’s management.

Nurses Association of Jamaica President Donna-Marie Richards said overcrowding in the department means a lack of basic privacy for patients and limited accessibility on a nurse-to-patient basis.

“So if you are to do the basic vital signs for a patient, manoeuvring the space to carry out these duties becomes compromised. You just don't have the room to manoeuvre,” she said, adding that the space was originally set up in cubicles with two to a cubicle.

“What is happening now, you have three people in a cubicle, and then the passages have people in them. And this is how you are filling the gap. This morning they had 102 persons, and 72 people were waiting for admission. And out of that 102, there were still another 10 persons outside who were waiting to be seen. So if that 10 had come in, you would be at 112.”

The hospital’s acting CEO said 50 patients were moved to wards on Tuesday morning, but this was disputed, and The Gleaner was told the number was 17. erica.virtue@gleanerjm.com