Reprinted from Nation Newspaper July 26th, 2020

As executive chairman of the Queen Elizabeth Hospital (QEH), Juliette Bynoe-Sutherland is on a mission.

Her appointment to the position in December last year when she was still serving as chairman but was also named administrator of the island’s primary health care facility raised eyebrows.

Mindful of the fact that the action did not sit well with some Barbadians, Bynoe-Sutherland told the Sunday Sun: “I knew my appointment was going to be controversial because a lot of people don’t know my background and only associate me through my husband,” but she insisted she took the job confident that she had the required skills.

In addition, she viewed it as an opportunity “to serve my country” and to give back after benefiting from a National Development Scholarship which enabled her to study health planning, policy and finance at the London School of Hygiene. She also holds degrees in history and political science and law and practised as an attorney for about five or six years.

On the question of how the sitting chairman of the board of an institution could also be executive chairman, Bynoe-Sutherland offered this perspective: “At the level of the board, you are just scratching the surface in terms of your understanding and appreciating what the issues are. As executive chair you are able to not just understand the issues and make policy, you are able to shape implementation, make sure it is going in the right direction and it really removes the layers of bureaucracy.”

Her confidence in her ability to perform as she indicated was also bolstered by her previous experience working at Montefiore Medical Centre in the Bronx, New York.

Reform

Eight months into the QEH job, she is already implementing a programme of reform. She said candidly: “The challenge of the hospital is the size and scale; that it is the largest employer and has one of the largest budgets of any state-owned enterprise. And yet with the number of people and the resources, it still requires more resources and more efficient use of what we have. We have to get it right.

“In order to do this job well, you also have to confront power structures that have existed for a long time; a culture which has not emphasised accountability and you are having to confront the fact that many staff are working without the required resources to do the job . . . .

What I have had to do is invest a whole lot of time on building staff morale, on providing people with the resources and the tools they need to do the work that they do, in making people feeling valued and appreciated.”

Positive response

She reports a positive response from staff, some of whom are taking advantage of the open-door policy she has instituted which sees the hours between 8:30 a.m. and noon every Thursday being reserved as “office hours”, giving staff ready access to her office to discuss matters of concern.

She is also encouraging input from QEH “key experts” and other staff with a wealth of long-held worthwhile ideas for initiatives that have gone “unimplemented”.

“I have said, ‘Let us stop talking about things and actually implement them’. I have said to the team, ‘We have to get beyond discussions and we have to come prepared to implement. People are paying a health levy, people are paying a tremendous amount of money to support the hospital and what people are expecting of us is a return on that investment in the institution, so bring forward your ideas’.”

Some of those ideas have already been acted upon with the implementation of projects throughout the hospital that benefit both patients and staff.

For example, in the downstairs hub of the hospital, away from the eyes of the public, biomedical engineers are now working in an extended and refurbished department that has been made more conducive to doing their job. Similarly, mechanical repairs are being done in an area currently undergoing refurbishment, which the workmen attest is a welcome transformation from what existed before. Bynoe-Sutherland argues such improvements being made at this level are critical to staff morale and performance.

“When you are asking people to work in that kind of environment, staff morale can be very low,” she observed, while pointing out her intent is to make life better for staff.

$30 million injection

Prime Minister Mia Amor Mottley recently announced a $30 million injection of capital into the hospital and while Sutherland said that money is “replacing things that have come to the end of life for several years” in a hospital that has been under severe strain, she also said she continuously looked for the means to make much needed improvements in other areas.

Within her scope is a technologically driven hospital with integrated systems.

“I always see technology as a tool and an instrument and you have to make sure the underlying systems and policies are in place with which you can use technology to do things more effectively. You cannot introduce technology into an area that is dysfunctional and then expect the outcome is going to be great.”

Against this background, she disclosed: “The next horizon for me in terms of the journey of the hospital is focusing on better use of technology to deliver care.” Human resource development is also in her plans.

Bynoe-Sutherland also insists her management style with regard to making decisions on projects to be done at the hospital favours tendering. “The Achilles heel of state-owned enterprises is usually in the area of tenders and people tweaking and getting into all kinds of activities.

“What I have said is we are tendering everything . . . . We want to give out tenders and earmark a proportion of the tenders to people with disabilities, young entrepreneurs and women, because the only way to make economic empowerment meaningful is to create opportunities where people know and understand.”

“It is an ethos that says for those of us to whom much is given, much is expected and what is expected of me is fairness and I have gotten the opportunity to make an impact.”

Married to Dwight Sutherland, the former Minister of Small Business, Entrepreneurship and Commerce, who was shifted to the Ministry of Youth Affairs, Sports and Community Empowerment in last week’s Cabinet reshuffle, Bynoe-Sutherland said she had “to think carefully about committing to the hospital, as the mother of a 12-year-old, juggling the responsibilities of wife and mother.”

Bynoe-Sutherland said the Christian that she is and “a person who believes in big ideas and big causes”, she took a leap of faith and accepted the hospital assignment.

“I want to leave this world better than when I found it. I think I am someone who cares. The responsibilities as executive chairman of the QEH may occupy her “heart and soul” during the waking hours, but Bynoe-Sutherland confesses when she puts her head down at night, “what bothers me most is man’s inhumanity to man, deliberate dishonesty and people who are deliberately cruel.”