Dominica’s Health Systems Transformation – PAHO/WHO

Dr Ruby Blanc, Hospital Medical Director at the Dominica China Friendship hospital, speaks to the current transition and its effectiveness.

“Previously the hospital which was then known as the Princess Margaret Hospital was governed by the Ministry of Health. We reported directly to persons in the Ministry, for example, the Medical Director to the Chief Medical Officer, the Hospital Services Coordinator to the Permanent Secretary and the Matron to the Nursing Head at the Ministry. As you can well imagine, in terms of running a hospital, making urgent decisions on a day-to-day basis, you really need that kind of control on site. We had some visionaries, there are some people who worked very hard on this, and the decision was made that we should fall under the Authority, a Board which would have direct control and more importantly there would be one person who would have overall responsibility and that person would be the Chief Executive Officer. With that, just over two years ago with the necessary legislation and laws passed and the Hospital Authority came into place and we’ve since moved into this new governing structure.”

Now, how does this new Authority gel with care delivered in other settings and at other levels?

Dr Blanc says the key is “focus and communication” which will ultimately yield the benefits.

“Previously, you had the Ministry of Health focusing on all the different areas of health, you now have one individual and a team focusing primarily on the running of the hospital. Obviously, the hospital does not function in isolation, we have to relay to primary health care and all of the other support areas. So within this new governing system we’ve had to find ways in which to keep the communication lines open, as well as when we introduce new things into the system or new systems. We note that it does not exist in isolation and that we have to involve primary health care and the other support services into those discussions as we plan and as we roll out.”