With the purchase of two helicopters and the introduction of emergency medical evacuation service, the government has fulfilled its pledge to improve access to medical facilities.

This was one of People’s Democratic Party (PDP) pledges for the health sector in 2013.

Royal Bhutan Helicopter Services was launched on November 6, 2015 and the choppers remain one of the government’s major achievements.

Lyonchhen Tshering Tobgay in his State of the Nation report 2018 said the helicopter service has been extremely beneficial and so far, 368 medical evacuations have been carried out, some providing services to the most difficult and remotest of terrains.

Of the 18 pledges in the health sector, immediately addressing the issue of the doctor shortage in the hospitals was one of the pledges. The government then said that they would work towards ensuring that all hospitals have at least three doctors each including a specialist.

Lyonchhen reported that the total number of doctors increased from 203 in 2013 to 345 in 2018 and except for Gasa and Haa, all the district hospitals now have a minimum of three doctors each.

He claimed the total number of nurses and health assistants has also increased from 1,254 in 2013 to 2,364 in 2018 with most BHUs having at least one female health assistant.

While the government claims that it has brought about marked improvements in addressing the shortage of health workers, shortage of human resources in the specialists and community based female health workers remains a challenge in providing equitable access to quality healthcare.

The pledge to increase the number of health workers in gewogs with at least one female health worker in every BHU could not be fulfilled with the health ministry revoking the transfer of 21 female health assistants who were selected to be placed in grade II BHU this March after the prime minister asked the ministry to do so.

As of March 2, 51 BHUs in the country do not have female health workers.

Meanwhile, 118 ambulances cater to the people across the country today. Lyonchhen said half of these were acquired in the 11th Plan.

Director general of the medical services department, Dr Pandup Tshering, during the mid-year review of health ministry’s annual performance agreement 2017 – 18 in February this year, said nurse-to-bed ratio has also increased to 1:6 from 1:7. This means the government’s pledge to decrease nurse-to-bed ratio from 1:9 to 1:6 is met.

Lyonchhen said despite not being a rich country, the Bhutanese people continued to be provided with universal free healthcare without the burden of high taxation. “Infrastructure and services are necessary to take these health services to the people.”

Lyonchhen reported that the government during the 11th Plan expanded health services by building six new hospitals and 28 BHUs. Today, the country has 32 hospitals and 208 BHUs. Audit observations on Tsirang hospital’s number of beds and flaws in the tendering process of the mother and child hospital mar the expansion of infrastructure and health services.

While the government pledged that it would give autonomy to all hospitals particularly to Jigme Dorji Wangchuck National Referral Hospital (JDWNRH) and regional hospitals, autonomy was granted only to JDWNRH in July 2014.

Towards expanding and improving JDWNRH services, Lyonchhen said that the hospital was granted additional autonomy, which has led to improvement in the delivery of services despite the growing number of patients.

Several new services such as fertility clinic, renal clinic and epidural labour analgesia were introduced during the 11th Plan.

In its effort to retain specialists and as one of the retention strategies, the health minister had announced at a meet the press session that the ministry was working on corporatising JDWNRH.

“Besides bringing about better service delivery and autonomy, there was no policy intent of the government to commercialise or charge patients for their services,” Lyonchhen said referring to the issue of corporatising JDWNRH. “I must report to the Parliament that these are unfounded rumours.”

Lyonchhen said that a significant achievement that must be highlighted is the status of the health trust fund. “The fund has doubled from Nu 1.2B (billion) to Nu 2.3B and this increase ensures that current and future generations continue to receive free medicine.”

In terms of reducing the OPD waiting time at JDWNRH, which is one of the government’s pledge, the hospital rolled out appointment system for some of the departments like Ear, Nose, and Throat (ENT), medical and gynaecology/obstetric departments to reduce patient waiting time.

This was after the Royal Audit Authority’s performance audit of the hospital’s OPD services report on December last year revealed that the average waiting time for patients at the hospital’s medical OPD was observed at 1 hour 38 minutes and general OPD at 45 minutes against the target of 30 minutes.

Dechen Tshomo