During the latest round of Councillors’ Constituency Meetings in April 2018, a number of issues were raised by the public on different topics.

Over the next two weeks, each Council Committee will be providing responses to the issues raised during the meetings. This week the focus is on Health with responses provided by the Public Health Committee. 


Hospital Care

The Lift is at the wrong end of the Hospital

The location of the Lift is not changeable and it has been situated where it is based on engineering and building safety constraints. Nevertheless, we take privacy and dignity of our patients very seriously. We will work with the nursing staff and patients to ensure that all is done to make people feel comfortable while they are being transferred from the wards to theatre in hospital garments. This may include using wheelchairs and gurneys even though patients are ambulant and able to walk if this is preferred by the patient because of dignity issues. We will endeavour to discuss with each patient options regarding transfer between the wards and the theatre in order to uphold their preference and maintain dignity. This is the first we have heard of such a complaint and we will address this specifically with patients and enhance the current procedures in place by asking specifically about patient’s preference.

Privacy on the Wards

There was a delay in re-installing curtains on the wards because of poorly fitting fixtures after renovation. We had used mobile screens in the interim. It can now be affirmed that since 3 May 2018 all the beds now have curtains installed that can be drawn by the patient based on preference.

Complaints Management

All complaints are formally recorded and investigated irrespective of how these arrive to the Directorate. Feedback is formally given to complainants and necessary actions taken as identified following investigations. Recently, the Health Directorate has introduced a simple Friends & Family Test which helps collate feedback from patients.

Joint Replacement Surgery

Joint Replacement Surgery has now started on the Island as planned. All surgeries conducted so far have been successful and patients discharged home walking.

Visiting patients at meal times

We take due consideration for all patients on the ward and meal times is best managed in such a manner that everyone on the ward have their privacy maintained as much as possible. There are times that some patients require additional support during meal times from nurses and other healthcare professionals, or family members, we therefore politely ask other visiting family members to visit at other times.

Doctors’ Qualifications

All doctors at the Hospital are qualified.

Difficulty understanding doctors

This is a critical issue and it is important that if any patient has difficulties in understanding the advice or instructions given to them by the doctor they should immediately ask before leaving the Hospital for clarification. If there is still concern, then the Senior Medical Officer, Hospital Nursing Officer or the Health Director can be contacted via the receptionist for additional support. No patient should leave a consultation without understanding their care plan, advice given or instructions.

Hospital Information Board

An Information Board with all critical clinical information and staff names will be put in place once the renovation and re-arrangement of the facility is complete.

Mammogram Machine

The Mammogram Machine developed a fault because of a power surge. It has been repaired at a cost of £8000. We are awaiting a 100kg UPS to avoid repeated breakdown after which it will be back in regular use.

Hospital Appointments

A detailed public announcement was made available on the radio and in local newspapers in May outlining the appointments process. All appointments are available on a first come, first served basis for the approximately 200 appointments each week. Nevertheless, any urgent clinical need will be attended to at the Emergency Department in the Hospital so nobody will be left without urgent care when needed. We will ensure that patients who doctors would like to see for follow-up at specific times are able to get appointments as required.


Scheduled operations can be postponed if an urgent case arises that requires intervention to save life and limb. Such ‘emergency’ or urgent operations also require careful planning to ensure that it is safe to be undertaken. Sometimes, patients need to be stabilised before they can be operated upon and this can take a few hours to a few days. Efforts are made to reschedule postponed planned surgeries as quickly as practicable and convenient for the patients concerned. We understand the inconvenience and difficulties which may arise when people have put support plans in place for a scheduled surgery. We only disrupt planned surgeries when absolutely necessary.

Doctor’s Availability during Whale Watching Season

There is an on-call system and no emergencies have been unable to receive treatment because doctors are not at the Hospital during their leisure/private time.


Overseas Medical Referrals

Access to money, lunch and additional pastoral support

Access to money, lunch and additional pastoral support when referred overseas for treatment are the key concerns raised. There are known issues with setting up the mobile phone e-wallet payment for patients to access the subsistence allowance provided by SHG in the first few days of arrival in South Africa. In order to deal with this issue, patients sent overseas now receive a week’s subsistence on the Island to take along to South Africa.

While in South Africa, support to patients will come from MSO staff, JoAnne and Lance, who are available at Panorama Lodge. The pastoral support available from SHG is not one-to-one or 24/7 and is primarily based on needs. However, any patient in difficulty or in need of additional support should contact Lance and JoAnne directly in South Africa and all efforts will be made to provide support required within existing policy constraints.

Additional cost for Carers

Carers will receive an allowance if the Health Directorate is responsible for sending them with a patient. Carers travelling of their own accord will not receive an allowance.


Visiting Specialists

Plans for specialist visits will be completed in the second quarter of the financial year based on clinical needs and available funding. Patients who will need to be seen by specialists visiting the Island will be given advance notice as usual.


New Service Development

There are no immediate plans to commence additional clinics at other locations on the Island because of staff and budget constraints.

Harmful and hazardous alcohol use has been raised as concerns and the current treatment service will be expanded as required based on identified clinical needs and available funding. This will be explored as part of the Health Directorate’s operational plan for the next financial year.


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Public Health Committee

6 June 2018

St Helena Government Communications Hub

Telephone: 22470