POMGH needs a clinician as CEO

THIS is to give the public a balanced view of the current debate over the appointment of a non-clinician as the chief executive officer of Port Moresby General Hospital (POMGH) for the first time.
POMGH is the premier hospital.
It is the teaching hospital for UPNG’s school of health science where all cadres of health professionals are trained. 
It is the only tertiary referral hospital in PNG.
It is a technical institution.
Health is a technical sector. 
The best people to run health are health professionals. 
One can never compromise this by bringing in non-health professionals.
A hospital’s performance is based on how well it fared in delivering health care to patients and technical support to delivery of health services.
This performance can and must be judged based on comparison of the performance of health indices of the hospital and the province prior to and during the incumbent’s tenure.
Important health indicators and activities used as yardstick as performance are:
* Total mortality rate (all deaths rate);
* Infant mortality rate (death rate in children under one year);
* Maternal mortality rate;
* Case fatality rate (death against those who recover from a particular
disease);
* Morbidity (duration the patient is ill) – a good indicator of the quality of care;
* Immunisation coverage;
* Rural health visits by doctors of the hospital; and
* In-service workshops conducted by the hospital (both for hospital and rural health staff).
Financial wizardry and structural management must never be used on their own in judging performance of a hospital and its managers.
Can a medical doctor run the State Solicitor’s office? 
Can an accountant run the Attorney-General’s office? 
Should not health be given equal respect?
POMGH should be given due respect, including appointment of its CEO.
It deserves premier care and handling.
It is a national disgrace for unfortunate Papua New Guineans to seek donations to receive treatment overseas when we could and should be able to provide such services in PNG. 
It is a national disgrace when decision makers seek medical treatment overseas when they can influence changes in health service provision by seeking treatment locally.
Internationally recognised programmes are conducted in POMGH annually. 
There are important collaborative programmes POMGH is involved with its overseas counterparts and donor agencies. 
The CEO must be someone with clinical acumen and management capability to effectively lead this hospital in its important functions and into the future.
A specialist doctor with management qualifications should be a requirement for POMGH. 
Having had experience in management situation in a major hospital or at higher health sector management level should be an added advantage.
The team leader of the health team has traditionally been and should always be the doctor. 
Training of all other category of health professions are geared towards carrying out orders of the doctor in delivering optimum available care to the patient and community. 
In the medical officer hierarchy, the specialist medical doctor is the head of that team. 
Get another professional in to head that team and you are asking for trouble.
The new CEO, without prejudice:
* Is not a clinician;
* Is currently CEO of Popondetta Hospital, a level three hospital, having previously served as director finance and administration at Wewak hospital, also a level three hospital; and
* Health indicators of Popondetta Hospital and Oro province have not improved during his tenure there.
POMGH has been neglected over the years by successive governments.
It needs more than K60 million annually to effectively run its basic services.
Successive governments’ budgetary support had been an abysmal allocation of less than 50% of its
budget submissions. 
In 2007, it was allocated K28.4 million, K29.8 million last year, and K32.5 million this year. 
Appreciation goes to the kind hearts of business houses, the public, donor agencies and overseas partners for their invaluable financial support.
The POMGH board and its chairman should know this. 
The Health Minister and Cabinet, which approves the underfunded budget, should know this. 
The nurses and doctors at POMGH know this.
Where does a non-health professional manager fit into this equation?
This is the crux of the National Doctors Association’s argument against the appointment of a non-health professional to head POMGH.

Dr Kauve Pomat
NDA president