JDW National Referral Hospital 2 March, 2010 – With autonomy granted, the Jigme Dorji Wangchuck national referral hospital (JDWNRH) in Thimphu can now take decisions on transfer and management of its budget, without having to get approval from the health ministry.

The prime minister’s and the health minister’s decision for the 38-year old referral hospital, the country’s largest, was endorsed for immediate implementation by the health ministry on February 17.

“It’s to cut the bureaucratic process, such as the medical director having to send papers to the director general,” said the health ministry’s media focal person, Kado Zangpo. “The whole idea is to improve service delivery.”

Health secretary Dasho (Dr) Gado Tshering said the hospital has been given autonomy to take decisions on all its daily administrative and financial matters. “It’s because of the decentralised policy and also to see how well they handle and judiciously manage the budget without the ministry’s supervision,” he said.

Health minister Lyonpo Zanglay Dukpa said that around 55 doctors in 2008 had met the prime minister requesting for the hospital’s autonomy. “The health workers will be part of the committees and the board and, if things are run well, it’s the patients who’ll benefit ultimately,” said the minister.

The overall management of the hospital is handled by the hospital management committee, which has about ten representatives from the diagnostic, clinical and technical staff and chaired by the medical director.

Hospital authorities said that the implementation of autonomy is still being worked out. “Many issues could be decided by the hospital management committee, but we need to work on the rules to see the level of autonomy that’s been given,” said the medical superintendent, Dr Pandup Tshering. “And it’s too early to say if autonomy would translate into better services, because that would depend on the management’s performance.”

Health officials said that the ministry would assist in policy directives and resource mobilisation and intervene only when required or requested by the hospital. “If they feel they need to change the system, to shorten the queue, or transfer staff, then they should do it themselves,” said Dr Gado Tshering. “But the balancing part, such as placement of new doctors, will be done by the ministry.”

By Sonam Pelden