Vacancies for 170 more doctors have been advertised locally and internationally.

This is to ease the doctor shortage in hospitals and health centres.

Permanent Secretary for Health and Medical Services Philip Davies has confirmed it.

Mr Davies also talked about the challenges that Fiji’s healthcare system was facing and the lack of gratitude that hardworking doctors and nurses dealt with almost on a daily basis.

“As far as doctors are concerned, we are currently advertising around 170 positions. In addition to local recruitment, we are also using the internet and social media to bring the opportunities to the notice of doctors internationally.

“The last time I checked, more than 350 people had viewed one of the advertisements that I posted on my own LinkedIn social media site.”

He said interviews for qualified doctors from India might be conducted as early as next month.

“We also expect shortly to be appointing a specialised recruitment agency in India to look for suitably qualified doctors who might be interested in coming to work in Fiji. I expect to be accompanying Hon Minister to conduct face-to-face interviews with the strongest candidates next month.”

Speaking about the barrage of criticisms faced by doctors and nurses on social media, Mr Davies said the good doctors and nurses did daily never get the same attention.

“We also need to remember that, for every complaint or social media post about a bad experience, our dedicated doctors, nurses and other health professionals care for literally thousands of patients every week.

“But people also need to understand that delivering health care is often very complex and things will occasionally not go as well as they should. When that happens, we need to understand why, so we are always improving.”

SUN INTERVIEW: Davies: Fiji’s Health System Good Compared to others in Region

Fiji’s health system is good when compared to other countries in the region, says Health Permanent Secretary Philip Davies.

Prior to joining Fiji, Mr Davies served as the Deputy Director-General at the Queensland Government Department of Health, Professor of Health Systems and Policy at the University Of Queensland School Of Population Health and Deputy Director-General for the New Zealand Ministry of Health.

1. In your view, where does the Fijian healthcare system stand?

Compared to other countries at a similar level of development Fiji’s health system is good. We have an extensive network of hospitals, health centres and nursing stations that cover the entire country. Our doctors and nurses are well-trained and strongly committed to serving patients. And there are few financial barriers for people who need to access care.

We need to recognise that we face some significant challenges. Our remote location means that we sometimes face delays in obtaining supplies of medicines and equipment. The fact that our population is spread across about 100 islands in more than 1.3 million square kilometres of ocean can make communication difficult at times. And, as we saw so dramatically with Tropical Cyclone Winston last year we face the constant threat of natural disasters.

Despite those challenges, we do well against several measures. Our maternal mortality rate, which is a good general indicator of health sector performance, has fallen steadily over the past 30 years and is now one of the lowest in the Pacific. Our childhood immunisation rates are good, which means we offer good protection against some deadly and disabling diseases. And the average life expectancy for Fijians, estimated to be over 70 years, is as good as in the rest of the Pacific.

Given that we spend about five per cent of our GDP on health, compared to Australia and New Zealand which both spend around double that proportion our system represents pretty good value for money.

Of course, we could do more, and do better, if we had more money but that’s always been the case and always will be. There’s no health system in the world that can achieve everything for everyone.

2. His views on criticism on social media.

I have only been closely involved with Fiji’s health system for about seven months and I have noticed the amount of attention it seems to attract on social media. Obviously, I can’t know for sure whether people are more or less satisfied than they used to be with the system. It may just be that the growth of social media means that people’s opinions and experiences are now shared more quickly and more widely.

We also need to recognise that people can sometimes use social media to spread misinformation – maybe deliberately or maybe just because they didn’t fully understand the reasons for something happening. There has recently been a lot of talk about ‘fake news’ spreading via social media. I suspect there may be occasions when some of the claims that are made online about our health system might not be 100 per cent genuine.

Having worked in several health systems across the world I do know that none is immune from criticism. People have very high expectations of their health system, and that is entirely correct. After all, they pay for it through their taxes.

But people also need to understand that delivering health care is often very complex and things will occasionally not go as well as they should. When that happens, we need to understand why, so we are always improving.

It is widely accepted that errors in health care are usually caused by failures of systems and processes, not failures on the part of individuals. If we always try to blame someone then there is a risk that errors will be hidden or covered-up and can all too easily be repeated. So, criticism can be very helpful if it tells us where we need to do better – and, again, there is no health system in the world that is perfect in delivering every service for every patient every day.

We also need to remember that, for every complaint or social media post about a bad experience, our dedicated doctors, nurses and other health professionals care for literally thousands of patients every week. Most of those patients have a good experience, but those stories never get shared on social media or, if they do, they seldom generate much comment and almost never get picked up by the newspapers.

There was an incident earlier this year when two Australian holidaymakers made some very negative comments on Facebook about their experience at Sigatoka Hospital. It was very interesting, and very encouraging, to see that most of the comments people posted in reply expressed support for the hospital and its staff. I’m sure that positive feedback was very well received by the team in Sigatoka.

Negative reports on social media can also be very frustrating for our doctors and nurses if they misrepresent what actually occurred, or don’t tell the full story behind an incident. Our health professionals are bound by a strict code of professional ethics that means they cannot share confidential patient information. That is obviously very important but it also means they cannot respond in those cases where not all the relevant facts of a case are presented – and I can assure you that is not unusual.

3. Understanding the Fijian healthcare system.

There are several important things that should be emphasised.

First, hospitals are only a small part of any health system. It has been argued that the biggest contributors to better health over the last century have been immunisation and measures to improve water and sanitation. We also know that services delivered outside the hospital setting, so-called primary and community care, are much more cost-effective at keeping people well and out of hospital.

Second, people should be aware that hospitals are sometimes not the healthiest places to be. The World Health Organisation has estimated that, for every 100 patients who are admitted to hospital in a developing country, there will be ten who acquire an infection during their stay. And even in the developed world that figure is seven per 100 patients. Obviously, we do all we can to prevent such things happening, but it’s another good reason to try to treat as many people as possible before they need to be admitted to hospital.

Third, there’s a saying that ‘there’s not a pill for every ill’. Overuse, or inappropriate use, of antibiotics can result in the emergence of ‘superbugs’ for which we have no cure. That is a real and growing threat to health. Britain’s Chief Medical Officer has said that ‘antimicrobial resistance poses a catastrophic threat’ and could lead to thousands of deaths. It’s vitally important that people recognise that antibiotics may not always be required and, if they are prescribed, they must complete the full course of treatment even if they feel better.

4. Fijian nurses sought after by Australian and New Zealand hospitals.

There are a lot of nurses from Fiji and other Pacific countries working in Australia and New Zealand. They often seem to be greatly loved and respected by their colleagues and patients alike. That is clearly an indication of how well-trained they are as well as a reflection of Pacific people’s caring nature.

It is obviously a loss to Fiji when one of our nurses chooses to work overseas but we also need to recognise that there are also positive aspects. Nurses often come back home after a spell working overseas and, when they do, they bring new experiences and insights which they can share with their local counterparts. Many also send money back to their families at home, which is obviously good for our local economy.

5. What is the biggest challenge our healthcare system faces?

Like any health system, we face the challenge of meeting public expectations. Demand for health care is constantly growing but the health budget will always be a fixed amount. That is the case in every country around the world, and a challenge we share with other health systems.

As people age they tend to need more health care. Technological developments mean we can diagnose and treat conditions that used to be incurable. We also face the growing burden of non-communicable diseases, which are often caused by unhealthy lifestyles, and which can require costly treatment over lengthy periods of time.

Balancing growing public expectations with finite health budgets is undoubtedly the biggest challenge that we, and most other health systems, currently face.

6. Investment in public health.

About two-thirds of funding for health in Fiji comes from government, with the rest being made up of funding from development partners and patients themselves.

As far as government funding is concerned, the amounts allocated to health obviously reflect the overall state of the nation’s economy and the relative priorities that the government attaches to the various demands on the national budget. Those are decisions for government. Our job, as public servants, is to advise on options for spending and to ensure that the money we are allocated is put to the best possible use in meeting government’s objectives.

7. Expatriate doctors.

Fiji already has many expatriate doctors and they make a valuable contribution to our health system. We are always willing to consider employing doctors from overseas, provided they have appropriate qualifications and experience.

8. Hiring more.

The Government is currently funding a significant increase in our nursing workforce. Numbers of nurses have grown steadily over the past few years and with almost 300 more new nurses are about to start work over the next few weeks.

As far as doctors are concerned, we are currently advertising around 170 positions. In addition to local recruitment we are also using the internet and social media to bring the opportunities to the notice of doctors internationally. The last time I checked, more than 350 people had viewed one of the advertisements that I posted on my own LinkedIn social media site.

We also expect shortly to be appointing a specialised recruitment agency in India to look for suitably qualified doctors who might be interested in coming to work in Fiji. I expect to be accompanying Hon Minister to conduct face-to-face interviews with the strongest candidates next month.

9. Is the locum arrangement working?

The locum arrangement, which enables doctors from outside the ministry to provide additional support to our staff at peak times, has allowed us to respond more flexibly to patterns of patients’ demands. It is currently limited in scope and will only ever play a relatively small part in the system as a whole, but it is a good example of the ministry being open to new ideas and partnering with the private sector to improve services.

Edited by Ranoba Baoa

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