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to get more personalised care as Sri Jayewardenepura General Hospital
turns 20 That is the view expressed by retired police officer Theo Dias, seated comfortably on his hospital bed with a beautiful view through the wide-open windows. And 72-year-old Mr. Dias, with a "weak heart" should know. For, he has been to many a hospital, both state and private, but keeps coming back here. "The staff makes the difference," says Mr. Dias citing instances when the nurses would help the patients to the toilet even if a minor staff member was busy elsewhere. He is in Ward 19 of the Cardiology Unit of the Sri Jayewardenepura General Hospital and has been warded here on and off eight times. But the Board of Management is not satisfied and is striving to improve and develop services, as the hospital prepares to celebrate its 20th anniversary in December. At the wheel of these ambitious development programmes of this General Hospital, a unique mix between a state and a private hospital, is former banker Sarath de Silva who has brought in a private sector touch with him. "The Sri Jayewardenepura Hospital is a wonderful asset and a vital community resource. Unfortunately, it seems to have lost its stature," says Mr. de Silva who took over as Chairman in May. He sees the root cause of this "loss" as a combination and interplay of several factors. The vision of the hospital's architects was a state-run facility but fully autonomous with freedom to take operational decisions on its own. "However, autonomy has been eroded over the years and successive governments have to bear the responsibility," explains Mr. de Silva dubbing the Sri Jayewardenepura Hospital a sleeping giant that has not reached its full potential. Presently, there is a high measure of autonomy, says Mr. de Silva, adding that however, he seems a virtual prisoner under the systems, procedures and practices entrenched in the hospital. Among his first tasks was to examine all documents and he came up with the diagnosis that the health of the hospital was poor. The balance sheets were all negative although it is at an excellent location in a conducive environment and has all the facilities. "The hospital has a dedicated workforce from the topmost consultant to the junior most minor employee," he says, but unfortunately there is a syndrome that "the hospital is too big to fall". That is what needs to be changed, according to him. The first few steps in this procedure have already been taken through decentralisation and delegation. "I prefer participatory management rather than power being concentrated at the top," he says. "The top should not be saddled with administrative matters. Decentralisation would also help democratise the processes." A new committee structure has been in place since August, a precursor to the wide ranging changes envisaged. A Joint Consultative Committee, headed by the hospital Board chairman, will promote an exchange of views among the different levels of staff through continuous dialogue while the Committee of Management has been divided into three for more effective input. They are the Senior Management Committee, headed by the hospital director and the Personnel Policy Committee and Technology, Equipment and Procurement Policy Committee, each headed by a senior consultant. A committee has also been set up to streamline and rationalise payments and settlements. Commenting on the "erratic" pricing policy, Mr. de Silva says, "The systems and procedures are too rigid and archaic, they are 20 years old. The hospital sends different signals to different people - we have the image of a general hospital but one that charges a fee." He feels that the Act of Parliament setting up the hospital should be changed to suit present conditions and aspirations. Detailing his ideas to make the hospital self-sustaining, he said the Board was hoping to establish a "service" as well as a "commercial" wing. "We need to work within the policy framework of the government but with a private sector orientation and management. We need to work hard and change our attitudes for our own survival." The wheels have already started turning and laundry, security and janitorial work have been outsourced for better service and cost effectiveness. The internal audit functions will soon go the same way. Linking health insurance to the hospital and forming a strategic alliance with an important hospital in the region are also being explored. The commercial sector will take care of the service sector. "Of course all this will be dependent on government approval. This is the way out of the heavy dependence on the government's grant to run the hospital," he says. The Sri Jayewardenepura Hospital, at present gets Rs. 340 million from the government annually. Why not use the outpatients department that is lying idle after 2 p.m. for a channelling service, he asks, adding that the lab facilities could also earn more revenue. "While keeping the social service character of the hospital intact like any other state hospital we are attempting to infuse business-like commercial practices and also improve facilities by establishing an MRI scanning and advanced radiology unit, a modern dental care unit to perform maxillo-facial surgery and a neurosurgical unit to name a few," he stresses. "On the medical side, though this is a multi-speciality hospital, there are gaps. The hospital could also be developed as a post-graduate centre of learning." Adds hospital Director Dr. D.L. de Lanerolle that the public is not aware of the facilities at Sri Jayewardenepura because they have not marketed them. "The big plus," he agrees, "is the staff that is fully qualified. The patients have easy access to top consultants because they are on our staff." He spells out the excellent "colour-coded filing" system for the patients as the only one in the country. "Anyone who seeks admission here would have his medical history on record which can be pulled out immediately even if he comes for a different ailment the next time. Patients' records go into an international classification system, which helps in research and data analysis." "We
will concentrate more on patients hereafter," assures the hospital
Chairman. "Now the focus is on the doctor-patient relationship
but we are changing that to the doctor's relationship with the immediate
family members of the patient as well. At least five people are
generally around the patient passing judgment." ONE
OF THE BEST GIFTS It was in September 1979, during then President J.R. Jayewardene's visit to Japan that he was asked what he would like in appreciation of his speech at the Conference for the Conclusion and Signature of the Treaty of Peace in San Francisco, USA in 1951, pleading Japan's cause following World War II. Recalling his response in 1979, President Jayewardene had said at the hospital’s foundation stone laying ceremony: "I thought about a conference hall, about a stadium, about a parliamentary complex but the words of Lord Buddha dawned in my mind. 'Whoever monk would tend me he should tend the sick.' I therefore requested a 1001-roomed hospital - one more than the largest capacity hospital built by the Japanese in Thailand." A unique feature of the Sri Jayewardenepura Hospital is the Presidential suite for VVIP patients. The two occupants so far have been the late Mrs. Sirimavo Bandaranaike and the late Lalith Athulathmudali. |
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