KEY POINTS:
A Nepalese eye hospital that treated 800 outpatients a day and employed just three management staff is an example of how New Zealand hospitals could run with less bureaucracy, says former Wanganui optometrist Mike Webber.
The Rose Charities New Zealand trustee visited the Lumbini Eye Institute in Nepal
with Napier ophthalmologist David Sabiston this year during a visit to a Cambodian eye clinic.
The eye hospital was a "self-sustaining" business run by eye surgeon Basant Sharma and drew from a catchment population of 100 million Indians and Nepalese, Mr Webber said.
The 220-bed hospital got no government funding and charged $35 (about two months' Nepalese wages) for cataract surgery.
Those too poor to pay received free treatment.
The hospital's 12 eye surgeons performed up to 200 cataract operations each day and saw 800 outpatients. The three operating theatres each contained four operating tables which were used simultaneously.
"Dr Sabiston and I were absolutely so impressed by the patient flow and the orderly way doctors were able to get this number of people done in a day - and all this was controlled by a CEO who had two clerics in his office," Mr Webber said.
"We were both blown away by the efficiency of the patient flow, given the small team that runs the place and how decisions were made by the medical staff."
The chief executive linked in to all parts of the hospital through his computer and knew what was going on in all theatres.
"Each individual section in the hospital is run by a senior doctor or senior nurse who at the end of the day analyses their results and feed it into the computer for the CEO - he collates all this data the following morning."
Decisions about patient treatment were made by the CEO and medical staff, Mr Webber said.
''The management and the doctors together make decisions very closely - decisions are not deferred."
Although New Zealand had a very high standard of medicine compared with Nepal and Cambodia, he believed the success of the Nepalese hospital demonstrated one way public hospitals could be run more efficiently.
"Our hospitals are overrun by bureaucracy - New Zealand has gone off the rails in terms of bureaucracy," Mr Webber said. "I think a lot less money should be spent on bureaucracy and more put into health delivery."
After the visit, the pair went on to visit the Rose Charities-supported eye clinic in Phnom Penh, Cambodia, which they said had improved vastly from their two previous visits.
During their three visits to the clinic, the pair brought in about $40,000 of surgical and optical equipment donated by New Zealand opticians, including $6000 of equipment from Wanganui optometrist Geoff Duff.
"We've got it now up to the stage where it's probably the best clinic in Cambodia."
-WANGANUI CHRONICLE