Rt. Rev. Bishop Pradeep Samantroy 19th September, 2014
St Stephen’s Hospital
Sub: Issues that need urgent attention to prevent the collapse of St Stephen’s Hospital
Several of us believe that the moving out of Rt Rev Sunil Kumar Singh and your being given this responsibility as Chairman of St Stephen’s Hospital is of the Lord. We prayerfully look forward to your involvement in correcting the critical issues at St Stephen’s Hospital that have resulted in the severe down-slide and damage to the Christian testimony of this hundred year old hospital in the Capital, and the very real danger of a collapse. Sadly we have seen the mess in Wadia Hospital, Pune, the Jalna Mission Hospital being sold to the Sahyadri group, the hiving off the Clara Swain Hospital in Bareilly, and the deterioration of the Mathura Methodist Hospital. Staff at St Stephen’s are already speaking of their hospital also going that way.
By way of introduction, I am a healthcare IT professional based in Delhi and have been associated with Christian Healthcare in India over the past twenty five years. Having closely interacted with and having personally known former directors of CMC Vellore, Dr LBM Joseph and Dr Benjamin Pulimood, of CMC Ludhiana, Dr Nambodripad, Dr Eggleston and Dr A V Choudhrie, besides Dr Lucy Oommen, Dr J Jacob and Dr Mathew Varghese of St Stephen’s Hospital and several others, I have a fairly sound understanding of the realities and have a deep concern for the way the hospital is being mismanaged and systematically destroyed.
There are a number of matters of concern that may justify inquiring into in more detail. People in key responsible positions have, for reasons best known to themselves, been accepting superficial rationalizations and have been keeping quiet. There are a number of areas that can reveal massive mismanagement. Here are a few issues that you may like to initially consider inquiring into:
The biggest danger that St Stephen’s Hospital is presently facing is the precarious financial condition that could force the Hospital to close down. So the first question that needs an honest answer is the reason for the hospital running at a loss and the extent of that loss?
A major drain on the finances of the Hospital is the Gurgaon facility. What was the budget for the construction of the Gurgaon facility and what has been the final expenditure? Why can it not be called a hospital? Are there GDA regulations preventing this? Are there basic blunders in the choice of location and mismanagement in the construction, the cost of which as I understood went up from about five crores to about eighteen crores. If so how did this happen and who was responsible?
The present average daily expenses and income of the Gurgaon facility will be revealing. Also, what are the accumulated losses to date, in addition to the expenses for land and construction?
What is the profitability of each of the Surgical departments, which should be the main income sources of any hospital?
High expenses in construction activity and repeated rework of the Operation Theater complex in the new block of the main hospital has not only resulted in wasteful expenditure, but the hospital having to do with a limited number of operating rooms resulting in loss of revenue. How long have the theaters in the new block been closed for and how many times have the air conditioning system being redone and at what cost?
How much money has been spent on getting NABL accreditation in terms of staff and related expenses to date? How long has the hospital been working on achieving accreditation? What is the status as of today and when would the hospital get accreditation? Who are the key persons responsible for this situation?
There are the hidden expenses that are not accurately reflected in the accounts of the hospital. The hospital follows a cash basis accounting method as against the accrual basis. Therefore accrued expenses will not be reflected. While this is acceptable for statutory accounting, it is grossly misleading as far as managing the hospital finances is concerned.
Therefore a question on the total current dues to suppliers for each of the key departments such as Radiology, Lab, Surgical supplies and Pharmacy will give an idea of these hidden costs. It is likely to be very high, possibly over ten crores, and will more accurately reveal the gloomy prospects of the hospital.
Why have committed Christian staff left the hospital including such big earners like Dr Sushila Kutty, HOD OB Gynae. She did not get an extension after her retirement date, but older doctors who earn considerably less have been given extensions. Doctors who have been forced to leave, include eminent Christian doctors like Dr Monica Thomas a DM in Neurology from AIIMS and Dr Jamila Koshy from AFMC, Pune and post graduate in Psychiatry.
Staff of the Nursing School have been demoralized for various reasons and not the least of them being out of turn promotions. As a result, some of the senior tutors have left the hospital, and consequently there has been an unprecedented fail rate in the first year and significant deterioration in the performance of the students.
How much has been spent on paying the inquiry officer appointed by the director to inquire into the case of one of the most accomplished doctors in the Hospital, Dr Jacob Puliyel, for the trivial issue of wearing a black band in protest against the removal of a committed Hindu doctor? Is this an effort to demoralize this Christian doctor and in line with the removal of other eminent Christian doctors who had the courage to speak up in the interest of the Hospital? Christian Doctors are difficult to get, and demoralizing them is certainly a sure way to self-destruct!
Have the department heads, including key departments like nursing, given freedom to select competent persons or are they forced to select persons who use influence under personal direction from the director? High staff expenses resulting from over-staffing departments that are loss making and recruiting staff based on criteria that are far from objective is very damaging. Further, department-wise profitability figures will reveal the extent and the areas where losses are excessive.
What is the occupancy of the hospital, especially that of the general wards over the past five years? Why has the concessions to the poor been systematically reduced? Why has the Psychiatry department that caters to the poor and neglected been closed down when other departments like surgery which should make money also run losses because of mismanagement? How does this reflect the Christian mandate and priorities in terms of serving the poor?
A Questionable Leadership
Political maneuvering for position is one of the most insidious methods used to subvert truth, justice and effectiveness. Has the previous Bishop been blackmailed to support improper changes to the constitution of the Hospital to favor the present director? Changing the retiring date from 60 years to 65 years, that was needed for the director to continue in a second term, the removal of key clauses in the by-laws, such as the removal of the stricture not to delegate the power of the board to buy and sell property on behalf of the society, preventing the staff of the Hospital from being members of the Society, besides other changes in the constitution done during the tenure of the present director are extremely disconcerting.
I have closely known the three previous directors of the hospital, Dr Lucy Oommen, Dr J Jacob and Dr Mathew Varghese. They have been role models to the staff and provided a servant leadership in the footsteps of the Lord Jesus. Compared to the modest and austere lifestyles they have followed, the lavish and ostentatious lifestyle coupled with the authoritarian, vindictive and manipulative management style of the present incumbent is disturbing. The question arises as to whether the losses of the hospital have some relation to this change of lifestyle of the director since he took over the leadership. An objective inquiry will most likely reveal some of the answers to such changes and effects of such leadership.
The problem with actively mis-managing witnessing Christian institutions is that the biggest losers turn out to be the ones who appears to be winning, as also those who, by their silence, are a party to the evil. It destroys them in multiple spheres including all moral dimensions.
Answers to some of the questions above can be a beginning for course correction, before it is too late. I am convinced that the members of the present board have been keeping strangely quiet and not responsible enough. Besides, persons expressing concern and asking questions have been removed or sidelined from the board. “If anyone, then, knows the good they ought to do and doesn’t do it, it is sin for them.”
I do hope that Your Grace will consider it appropriate to critically evaluate the situation at St Stephen’s. An inquiry into the issues stated above can be competently conducted by the Society Treasurer. Your personally speaking with the suppressed voices including those from existing staff as well as dismissed Christian doctors, will give you a clear idea of the facts. And it will prevent the truth from being continued to be brushed under the carpet. I do hope and pray that the Lord will give you the discernment and the courage to do what now needs to be done.
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