Tufton stands firm in criticising procurement paralysis at Bellevue

Health and Wellness Minister Dr Christopher Tufton has doubled down on his criticism of Jamaica’s public procurement system, insisting that the prolonged delay in getting a proposed 100-bed psychiatric facility at Bellevue Hospital approved reflects a failure of government agencies to work together.

Tufton was responding to the Public Procurement Commission (PPC), which last week rejected his suggestion that it had contributed to delays in the project, saying it had never received a procurement submission for the facility and therefore could not have delayed its consideration.

However, Tufton claimed the PPC’s response was inaccurate and missed the wider issue.

“Because they did respond to a submission on the proposed 100-bed psychiatric facility at Bellevue Hospital. They responded with several objections to approval for the design of the new facility. Further, there were several delays including uploads to gGov website, that contributed to over two years of wait and still the project is yet to be approved,” he said.

“It is in this context that I said I am not sure where the delay is — PPC or MOHW (Ministry of Health and Wellness) procurement — and I stand by that,” he said.

The latest exchange follows an August 16 Sunday Gleaner report highlighting the severe strain on Bellevue’s emergency room, where patients in psychiatric crisis have sometimes been turned away because of inadequate space and limited bed capacity.

The emergency room has just three cubicles separated by partitions, while Bellevue’s acute-response areas have 19 female and 54 male beds. This is while Bellevue has reported a recent influx of new patients, some of whom administrators believe may have been impacted by COVID-19 and the effects of two devastating hurricanes in recent years.

broader problem

Tufton said his original comments were not intended to place responsibility solely on the PPC but to highlight the broader problem of a procurement process that takes too long.

“My point is that the system takes far too long,” he said, noting that the PPC should not view its role as ending when it approves or rejects a procurement submission. Rather, it should help government ministries and agencies find solutions to move forward.

“I get the impression that they feel their job is complete because they consider a document and offer an explanation of rejection and a call for additional information. That is not how the government should work,” he charged. “A rejection may be valid, but they must ask themselves why it is, if a ministry is having this ongoing and long list of rejection, and what is their role in helping those agencies or ministries to become more efficient.”

procurement process

The minister maintained that the Bellevue procurement process had involved several stages and delays, including problems with uploads to the Government’s gGov procurement platform. He said the PPC had responded to a submission concerning the proposed facility’s design and raised several objections.

The commission, however, said its records showed no submission relating to the procurement of a firm to design the proposed 100-bed facility had ever been submitted for its review or approval.

“I think the PPC in their rush to defend themselves is missing a more substantial point — that is their role in ensuring that projects are not just rejected but their role in seeing that projects are completed for the benefit of the Jamaican people,” he said while suggesting there were several other procurement issues involving the PPC that have ultimately resulted in inordinate public delays.

The same delay problems affect other areas of healthcare, including outsourcing and the provision of diagnostic services, he said.

At the same time, Bellevue’s chairman, Dr Diana Thorburn, described the need for expansion at the hospital as severely urgent.

“The main thing holding us up now from taking in more people is the emergency room situation, which is completely inadequate,” Thorburn said, noting that the problem extends beyond the ER’s condition.

“To get a sedated patient from there (ER) to the ward is a complete ordeal for everybody — the patient, the psychiatric nursing aide. Sometimes these are large people, they are sedated so they are heavy, and frankly, to me, it’s just inhumane,” she said.

Thorburn also cited the distance from the hospital’s entrance to the ER, which she said is unlike that of any other public health facility.

The solution is relatively straightforward if funding could be secured, she said.

“Fixing it is not hard. We have the space, there is not a whole lot to be done, we just need the money,” she said, reiterating that Bellevue does not have its own capital budget and depends on central government funding for major infrastructure improvements.

According to Thorburn, Bellevue sits on some 50 acres of land. Many of the buildings there are not in order and are not situated in the most convenient way, she explained.

The government announced plans in 2022 to reorganise Bellevue into two facilities, including a new 100-bed neuropsychiatric facility for patients requiring acute care and a separate facility for more than 400 long-stay residents. Four years later, the proposed expansion remains unrealised.

“We must stop feeling comfortable with applauding announcements and focus on implementation achievements. I’m obviously very frustrated,” charged Tufton.

corey.robinson@gleanerjm.com