JDWNRH to be function as autonomous hospital

JDWNRH would function as an autonomous hospital governed by a board.

In enhancing effectiveness efficiency in health delivery system the government has decided to grant autonomy to the Jigme Dorji Wangchuck National Referral Hospital (JDWNRH). This was announced by the Prime Minister today while presenting the State of the Nation report.

“Under this new framework, the JDWNRH would function as an autonomous hospital governed by a board. The government is confident that the doctors and nurses will use the autonomy to improve the nation’s most important hospital. The JDWNRH is also expected to function as a teaching hospital for the University Of Medical Sciences Of Bhutan,” stated the Prime Minister.

The Prime Minister also said henceforth the monthly health contributions will also be donated to the health trust fund to procure essential drugs. The Bhutan Health Trust Fund was started in 2000 and the fund today stands at Nu. 1.2 billion.

“Last year (2012-2013) the government spent Nu. 168.3 million to treat 988 patients. I am happy to announce that the Health Trust Fund now stands at Nu. 1,241 million with annual income of Nu. 60.8 million accrued in 2012-13. Furthermore, to commemorate the 60^thBirth Anniversary of His Majesty the Fourth Druk Gyalpo’s, starting this fiscal year the procurement of all essential drugs – 367 of them from paracetamol to chemo- will be met from the Health Trust Fund. In addition, to keep the Health Trust Fund sustainable, the government will donate all monthly health contributions to the Trust Fund i.e. your contribution,” Prime Minister said.

The Prime Minister said for the good heath of the citizens the government will attempt to provide continuous flow of safe drinking water for all rural residents and then within three years to all urban residents.

Today, there are 29 hospitals, 205 Basic Health Units; 519 Out Reach Clinics; 193 doctors; 799 nurses and 455 health assistants across the country.

Work to change the status of Jigme Dorji Wangchuck National Referral Hospital (JDWNRH) into a corporation has begun, health minister Tandin Wangchuk said at the meet the press session.

Responding to a question on the status of the specialist retention strategy that the health ministry submitted to the cabinet, lyonpo said that making the hospital a corporate entity is the best solution, for now, to raise allowances for health workers especially the specialists.

Lyonpo said that once the hospital becomes a corporation, it could raise the financial benefits of its staff according to their service rules without having to follow the Royal Civil Service Commission rules

“The government will give them the budget per patient every year,” he said. “Depending on their efficiency, they can provide allowances to the health workers according to their entitlement.”

A committee comprising specialists from the national referral hospital and human resource officials from the health ministry prepared a specialist retention proposal and submitted to the cabinet for endorsement.

Lyonpo said that the prime minister during one of his visits to the hospital observed that besides other health workers, specialists are critical to provide specialised medical services to the patients. “Lyonchhen asked the hospital and the ministry to see the possibility of providing financial benefits to our specialists as given to those abroad and to work on a strategy to retain them.”

Not all specialists leave the service because of financial reasons, the minster said. He said they also leave because of work pressure while some quit because it’s time for them to superannuate. “There are not many specialists who retire to go and work abroad.”

In the proposal, besides the 40 percent specialist allowance, the committee proposed 20 percent sub-specialist allowance, MD (Doctor of Medicine) and MS (Master of Science) allowance of Nu 25,000 and on-call allowance of about Nu 800 an hour for specialists currently in service, Lyonpo added.

For those specialists who have resigned, the proposal recommends that they should be allowed to join the service again and be paid the same amount the expatriate specialists are paid.

Lyonpo said the proposal was discussed in the cabinet and has the support of the health ministry and the cabinet. “It is important to retain the specialists but we can only raise their allowances without changing their basic salary because they are civil servants. Moreover, the specialists are already getting 40 percent allowance.”

However, the second pay commission pointed out that the government cannot raise allowance for the specialist category alone. If the government raised the allowance for the specialists, then it has to do the same for other health workers.

“So we have recommended the proposal to be put to the next pay commission whenever it is to be held,” Lyonpo said.

He said it was not feasible to endorse the proposal immediately and other options to retain health workers were explored.

“We had a meeting and the only solution we could have for now is to make the national referral hospital a corporation,” Lyonpo said. “We feel the specialists should be given more allowances according to their entitlement as the number of specialist in the country is not many.”

Starting next year, there will be at least 18 specialists graduating every year, Lyonpo said.