All health care systems have patient safety issues, even the best. It is not so much that these problems exist which is of concern but how they are dealt with when they are identified. Like all health care systems, the GHA has its problems, but it is committed to identifying and addressing them.
The GHA in 2018 committed to transform itself into an organisation that provides safe, high quality, cost-effective and compassionate care. That programme has been unfortunately interrupted due to Covid when resources had to be focussed on mitigating the impact of Covid.
When the Chief Minister received the strategy from Professor Burke, he committed to using it as the basis of a transformation strategy for the GHA going forward. Following the end of the first wave of Covid there was a cabinet reshuffle and Minister Sacramento was appointed as the new health minister with the remit to implement the transformation programme.
Implementation of the transformation programme was put on hold during the second wave of Covid and planning commenced again once the second wave had passed. The projects that have now commenced as part of that programme include the electronic document management system (eDMS). This will be the cornerstone of the new GHA providing an electronic record, patient tracking system for cancer referrals, diabetes management, etc.
The transformation programme necessitates changes to the management structure to ensure that the GHA can continue daily operational management while the transformation projects are running. These changes will invariably be disruptive to the organisation for a period of time until the new structure is embedded, but the GHA is confident that the new structure will manage both the operational and transformational components going forward.
Professor Burke had health issues over the autumn and winter of 2020-21 and was on extended sickness leave from late March 2021 until shortly before his retirement in July 2021, coming out of hospital only days before his departure. As a result, he was not up to date with progress on the eDMS, cardiac catheter lab, or the mental health transformation projects amongst others. His concerns were based on his assumption that nothing was being done when in fact the opposite is true.
Professor Burke acknowledges that the planned projects, spearheaded by the eDMS project will significantly contribute to and facilitate the transformational needs of the organisation and make the GHA safer for patients. It has been pointed out to him that his disclosures were outside of the remit of his contract and breached his obligations to the GHA and its patients.
Professor Burke said: “With the commencement of the eDMS project the GHA has set its compass in the right direction and is now on a journey that will benefit the health and well-being of the people of Gibraltar. I am sad that due my ill health I have not been able to contribute to these projects, but I wish the GHA well on its journey. I believe that it would be wrong for the professional development aspects of the work that needs to be done in the GHA to become the subject of party-political witch-hunts which will impede progress. With the information I now have I am satisfied that, under the leadership of Minister Sacramento, with whom I enjoyed a very positive working relationship, progress will be made by the Health Ministry in addressing the issues I originally identified. Finally, I am sorry if any publication by me of my concerns has caused alarm to the public in Gibraltar and regret if anything I have said about the people of Gibraltar as a whole and their future caused offence; that was not my intention”
The Chief Minister said: “This is an exciting time for Gibraltar and in the GHA we can look forward to providing NHS standards of health care service to our population with many of the services we have previously had to send to Spain and the UK being repatriated to Gibraltar. A lot of work is being done in the GHA and a lot of more work will have to be done to achieve the year on year improvements we all expect in this key area of policy. In the very difficult Covid period the GHA has continued to build on the services it has provided to date.”