Six months ago, Oshen Group SA took over the management of King Faisal Hospital with a promise to improve and turn around the facility to international standards. Some people say the turnaround has been rather slow. The hospital’s CEO Dr Joaquin Bielsa held an exclusive interview with The New Times’ Collins Mwai, during which he answered some of the questions surrounding the takeover.

Excerpts below:

It’s about 6 months since you took over the management of King Faisal Hospital. There were high expectations by the public during the handover. Can you say you have lived to these expectations?In this first year of our takeover, we encountered some major challenges including having to consolidate the hospital’s operations. The experience of having a public hospital run by private management is quite new to Rwanda.I understand the concept and I am trying to make it understood. I want to thank the hospital staff and the board for being accommodative to the changes we are bringing.

This is a referral hospital serving the entire country. The numbers in this first months are excellent, an increase in patients and service delivery.We have also done well in terms of financial numbers as well as in special services such as cardiology and neuro-surgery where we have had more patients considered to previous years.We may have some problems but not new ones and we are doing well in terms of services offered. We can assure you that in coming years with the planned investments, equipment and upgrades, this facility will be able to serve people beyond Rwanda.

According to your agreement with the government, you are set to invest about $23M over the next five years, when does this begin and in what areas will the money be spent in?In this first year following the agreement between the government and Oshen Group, we did due diligence to review the entire hospital. We looked at the financial numbers and infrastructure. I have been here for about four months and I think by now we understand problems.The main problem area is the infrastructure including the electricity, IT systems and technical aspects. At the moment, we have five lifts but three are out of order.

We need to start in this area which is one of the critical areas in this hospital.We are working to review all the maintenance aspects. In my last meeting with Rwanda Development Board and one of the main insurance firms in the country, it came out strongly that we need a new IT system in this hospital.For example, under the system, the in-patient system is not connected to pharmacy, outpatient, laboratory etc. By the end of the year, we need to have corrected that.We need new equipment for this hospital. All doctors tell me that if the electricity is not reliable, we have problems working. We are going to start as soon as possible.I want to change the emergency area, theatre as well as install a new ICU.

At the moment, most areas are not in the appropriate locations. For example, we want to ensure that on the ground floor, we have an emergency wing (currently in the basement), ICU and theatre. The most critical areas of the hospital should be placed next to one another.

Currently, you have someone coming into the emergency which is in the basement and then being transferred to the theatre which is on the first floor.The physiotherapy is on the first floor making it hard for people on wheel chairs to access. I want to have a dedicated block for inpatients.We are also going to build a new block for outpatients so that the main block can remain for in patients.Currently, we have 20 consultation rooms for which we need to double to 40 to be able to handle patients better. Administration will also have their own block.I understand everyone in Rwanda would like to see the results by tomorrow. I apologize for the delays but a lot is being done.It is said that as part of the restructuring, dozens of hospital staff were laid off which some people say led to a slump in services provided…After the agreement with government, we made a study and report about the staffing needs of the hospital in accordance with international standards.We brought in experts to conduct the study and had it reviewed.

I am a doctor, I understand the trade, I would like to have my patients accessing the best services.

The hospital has about 165 beds, at the moment, the patients are about 100. Previously I understand that there were very many staff especially nurses but they were not busy as there were few beds occupied.

The study helped us rationalise and reduce the staff. The report had called for more reduction but we only reduced by only half of what the report and study had recommended.

I personally do not like to fire anybody. The dismissal was done as per the Rwandan laws and everyone affected was paid accordingly in about a week.The optimization is necessary to have the staff that we need and according to the international standards. If we need more staff given the number of patients coming in, we will hire more.After the laying off of some employees, we built a new management structure of the hospital we expect this to improve the quality of our services.In this hospital we had only 20 full time doctors, in the recent months, we have hired three new doctors, these doctors are foreigners and are bringing in expertise and training for the local doctors. We want to hire more local doctors too.In the coming days, nine of the local doctors will undertake international training programmes to further boost their capacities in their respective areas of practice.

As much as you have previously insisted that you are not profit driven at the moment, this is still a business. What are your revenue projections for the first year?In the first years, we are not treating it as a business, not from the government’s viewpoint and not from the management. We want to create an ideal facility before we can start seeking our return on the money invested.This is a long-term project and we do not want money to be a priority.As a company, at the moment, we rarely talk about profits, at the moment, we want to have a great hospital.Your contract with the government is also based on continuous assessment; do you think they are content with the state of affairs?The agreement identifies the improvements that we need to make such as new specialties and more doctors. It is an indicator that the new management has some work cut out.We have an interim committee to help lead the process.

The agreement has been leading every action that we take.

One of the major challenges of the local health sector is complicated cases such as non-communicable diseases where patients have to travel abroad to seek care which is very expensive. Any plans to address this as you expand?This is a point that the government wants addressed as soon as possible. I am aware that at the moment, when people seek treatment for certain diseases they have to go to India or other countries for specialized care.We are keen to address this. For example, in the new theatre that we plan to install, we will have machines that can enable us provide specialized care.In a few years, we are targeting to have changed this and also become the hub for people across the East African region seeking medical treatment.Health insurance is one of opportunities that have not been tapped into.

This was a problem in Spain about 10 years ago, how to solve this is that when hospital make offers, all the private insurances align themselves to be able to take care of that.As long as you have the best service, private insurance companies make packages. As soon as we have the latest equipment and specialists, private insurers will have packages for that.That is why we want to make sure that rooms will have not more than one or two beds. We will no longer have wards that accommodate eight patients as is the case now.Won’t this make the services more expensive?It will not make it more expensive. We will make sure that that even people with public insurance can access services.

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