Outgoing President of the Vanuatu Medical and Dental Association (VMDA), Dr Basil Leodoro, says the Public Service Commission (PSC)’s transfer of directors to medical superintendent positions to move hospitals forward is unnecessary.

“If there are any delays in strategic planning, it is because of the failure of consultation, communication, timely recruitment, lack of accountability and scarce commitment from the government,” he said.

“We have had medical officers acting in the positions of medical superintendents for over four years without any formal appointments despite applications. Nursing Services Managers and General Services Manager of all hospitals were also acting for over five years with no permanent appointment.

“They have been dutifully carrying out hospital business as usual while instability has been occurring at the national executive level.

“The Ministry of Health (MoH) has had four different ministers in four years and four directors for hospital services each year.

“The health executive level has been ineffective due to changes every year, while the current hospital and provincial health managers have been on acting basis without any authority to plan, strategize or develop.

“PSC as employer and the national level executive are to be blamed for the delays in strategic planning, meeting outputs and NSDP KPI’s because it has not been recruiting, appointing and then holding those health leaders accountable.

“PSC has not been following its own performance appraisal process which VIPAM has stressed throughout the public service.”

Dr Leodoro said rearranging the health executive level is not the best solution to build stable hospitals and improve patients care.

“Acting officers should be recognized with promotion and appointments or the posts advertised,” Dr Leodoro said.

“With due respect to the transferred officers, the medical superintendents are medical doctor positions.

“Medical superintendents as the name implies are medical officers first and foremost; and no amount of justification or readjusting the selection criteria is going to cover the fact that medical superintendents should have a job criteria as a medical doctor with a background and experience in administration and leadership and more importantly, being able to work as a team with the nursing, clinical-support and allied services.

“I know that there are competent Ni-Vanuatu senior medical doctors, nurses and support officers who are more than capable to handle those positions.

“I think there is an element of trust and accountability that PSC should apply to the appointment of medical superintendents, nursing services managers, medical-allied-dental services managers; and general services managers.

“Those key leadership, planning and strategic posts for hospitals have been vacant for over four years.”

He said a Health Services Commission is ideal as PSC is clearly struggling to manage the human resource issues for 972 health workers, including specialists, who are all public servants.

“If the employer was to consult in order to better understand the development strategy of hospital specialist services, the medical and nursing workforce pathways, hospital structure and hospital processes; then it would lead to improved welfare of health workers and a higher quality of patient care,” he said.

“If you want to develop strategic plans for hospitals, you need strong hospital management teams authorized to make decisions based on patient needs.

“Good hospitals in Vanuatu do not function on individuals but on teamwork, respect and consultation.

“The PSC approved structure for hospital services is structured in a way that medical superintendents are team leaders who are then supported by nurses, clinical-support and allied officers.

“It needs to understand that clinicians will always speak up when they think that patient care is compromised.

“PSC needs to reconsider the hospital appointments and consult employees to better understand the realities of patient care and hospital services.”

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