Administrators at the Kingston Public Hospital (KPH) have had to resort to using police officers to escort some patients home because of the refusal of
relatives to take them back into the households after they have been discharged.
This is one of the strategies the hospital has had to adopt as the struggle to free up bed space occupied by healthy patients continues to affect its ability to meet the growing demand for inpatient services.
Despite the best efforts of the staff of the KPH, several family members only return after the abandoned patients have died with insurance claims for the doctors to sign.
"Sometimes what you find is that the patient has a home, but the relatives either don't want anything to do with the patient or the place is rented out. So a lot of time, we come upon that," said Joan Walker-Nicholson, director of nursing services at the KPH.
"We had a case where the dad was here and the daughter had the house up for sale," noted Dorcas Evans, the hospital's medical social worker.
Despite placing several of these abandoned patients over the years in infirmaries and homes run by charities, the hospital now has 35 patients who have been discharged, but are yet to be released into the care of a relative.
One of these patients has been living at the hospital for five years while most of the others have been there for more than a year.
"The hospital policy dictates that on discharge, relatives must come, or a family member or a neighbour. Someone must come for the patient, so they are discharged into the custody of someone," explained Dr Natalie Whylie, senior medical officer at KPH,
Data shows that 27 of the 35 abandoned patients at KPH are men, with the youngest being 28 years old. The majority are senior citizens.
"They are social cases and the hospital is charged with the responsibility of not just administering nursing and medical care, but also addressing their social needs as well," said Whylie.
"If you were to have them all in one area, you would have a ward. So you can see now how that translates into issues of overcrowding," added Whylie, as she explained that a hospital ward is generally made up of 32 patients.
The inability to place these patients with their families has placed a strain on the staff at the hospital, which is Jamaica's largest trauma centre. It also places pressure on the Government's coffers as billions of dollars is spent to care for these patients.
"It is costing the hospital. I know it is significant because there is a lot that goes into the stay of a patient here at the KPH, and in the public hospitals for that matter," said the hospital's new chief executive officer, Errol Greene.
"We still have to provide the nursing care. We still have to provide the oversight by the doctor. We still have to provide the diet," said Greene, as he noted that sometimes the hospital has to provide clothes for the abandoned patients.
"I am making an appeal for those who can provide an extra pair of pajamas, because the men seem to be most in need of this," he said.
The administrators said some of the abandoned patients were dropped off at the hospital's emergency area by relatives who did not leave their correct names or addresses because they did not wish to be contacted.
"They come and they leave them and they go," said Walker-Nicholson.
"The irony of it is that when the person dies, you are surprised to know that the relatives turn up with insurance things for the doctor to fill out, and at that stage we don't facilitate," said the patient affairs director, Angela Fearon.
She pointed out that the hospital often stands the cost associated with the burial of these patients.
Last year, Health Minister Dr Christopher Tufton told The Sunday Gleaner that non-governmental organisations, especially those that contribute to the health sector, would be asked to play a major role in assisting the Government to transition hundreds of healthy individuals abandoned by relatives in local hospitals.
According to Tufton, charitable organisations, such as Food For The Poor, with a proven track record of building houses, would be part of a new programme to construct halfway houses to assist individuals who occupy spaces needed by the critically ill.
"I am taking advice and consulting on the issue of these individuals healthy enough to go home, who remain in the institutions and keep others, for days in some instances, without bed space for admittance," Tufton said then.
"It's a huge problem, and it has been a long-time problem. The challenge we face is that in a number of cases, the individuals have nowhere to go. In several cases, family members have just abandoned them, leaving them destitute," added Tufton.
At that time, 785 of the 4,800 bed spaces across all hospitals were being held by individuals who the ministry said are fit enough to be discharged.