1. UHWI BIENNIUM BUDGET 2013-2014 / 2014-2015 Dr. Trevor McCartney Deputy Dean F.M.S. – UWI-Mona Medical Chief of Staff - UHWI Acting C.E.O. – UHWI Acting C.E.O. – UHWI Presentation to the UWI Technical Advisory Committee February 15, 2013 St. Vincent and the Grenadines

2. The University Hospital of the West Indies envisions itself as a dynamic, environmentally safe, adequately equipped organization with trained and highly motivated staff dedicated to promoting teaching, research and the delivery of the highest quality health care to meet the needs of the region.

3.  From its inauguration, the function of the hospital was identified as being a center of excellence as a teaching hospital for research and for secondary and tertiary level medical care which is not available elsewhere in Jamaica and neighboring Caribbean territories.  These Budget Estimates for 2013 – 2015 were prepared with this in mind and the acknowledgement of the challenging economic and financial circumstances of the Government of Jamaica and other contributing Territories.  Expenditures will be controlled by the implementation and use of new technology including reengineering of existing operations.

4.  The need to continue the rehabilitation of the sixty-four year old physical plant and the need to replace obsolete equipment.  The increased demand on services.  The past fiscal year has seen the hospital experiencing a significant financial burden due to a number of factors: 1.The need to increase Security through the introduction of technology and an increase of the security staff.

5. 2.Increase in the cost of supplies due to the continued devaluation of the Jamaican dollar, particularly the Medical & Pharmaceutical supplies which are mostly imported. 3.The need for emergency funding not supported by the budget to provide repairs and maintenance of outdated equipment.

6. Actual 2010 Actual 2011 Actual 2012 Projections 2013 10% Percentage Change 2011 v 2012 Total number of patients seen in A&E46,19547,54849,47054,4174.0% No. of patients seen in the Outpatient Department 90,09291,99096,497106,1474.9% Number of Surgical Procedures: Main Operating Theatre 3,7133,7323,3613,697-9.9% Minor Operating Theatre3,1202,9353,4714,16518.2% Number of Deliveries2,3161,9792,0782,2864.6% Mortality Rates5% - Number of patients in Tony Thwaites Wing 1,7501,5711,9732,17025.6% Number of admissions to hospital17,60416,77616,44518,090-1.9% Number of X-rays done: Inpatients13,64512,71513,74615,1208.1% Outpatients10,97911,71114,10915,52020.5% Casualty18,03618,41317,93819,732-2.6% Bed Capacity582 -

7.  The renovation of 18 wards.

8.  Replacement of unserviceable equipments, including:  Operating tables  Ultra sound machines  Ventilators  Anaesthetic machines  Stretchers  Beds

9.  The purchase of three (15 seater) buses, one of which is dedicated to Community Services in the Psychiatry Department.

10.  The completion of Phase I and Phase II of the triage area in A&E

11.  The signing of four major service contracts namely, the Security, Portering/Janitorial, Laundry and Ground Maintenance Contract.  The completion of the backlog of the Audited Financial Statement. The Audit is now current.

12.  Establishment of a private Obstetrics Unit. This will be done in phases, the first of which will see the introduction of a private antenatal and postnatal ward.  The expansion of the Physiotherapy Department  Refurbishing Nuclear Medicine with the assistance of IAEA and the Government of Jamaica.  Construction of a Paediatric Dialysis Unit (NGO/UHWI)

13.  The phased replacement of two boilers.  Upgrade of the morgue.  The purchase of Computer Software Equipment to improve the efficiency of the hospital’s operations, which include the integration of Clinical areas.

14.  A New (5) Room Operating Theatre suite with equipment  The commencement of this project will see the phased construction of a five (5) room major operating suite which is scheduled to be completed by 2015.

15. CAPITAL EXPENDITURE ESTIMATES 2013/20142014/20152015/2016 ($M) PRIORITY PROJECTS 1. Upgrading and refurbishing Physiotherapy Dept.98.000 - - 2. Refurbishing Nuclear Medicine25.000 - - 3. Construction of a Paediatric Dialysis Unit (NGO/UHWI)15.000 - - 4. Boilers19.000 5. Upgrading of Morgue3.000141.250 - 6.Motor Vehicle31.50920.000- 7. New (5) Room Operating Theatre with Equipment292.600 8. Computer Software/Equipment372.083 9. Upgrade Chemotherapy Unit65.000 - - 10. Construction of a Adolescent Psychiatric Unit40.00075.000 11.Plant & Machinery4.8675.3545.889 12.Office Equipment/Furniture & Fittings3.0926.0005.788 TOTAL PRIORITY PROJECTS969.151924.354708.427

17. ACTUAL APPROVED BUDGET BIENNIAL ESTIMATES BUDGET LINES2011/2012 2012/20132013/2014 % Increase/ (Decrease) 2014/2015 % Increase/ (Decrease ) EXPENDITURE STAFF COST 4,416.943 4,331.263 4,389.495 5,052.44715.1 5,172.6492.4 OPERATING COST 1,879.010 1,739.797 1,410.505 2,743.17494.5 3,017.491 2.5 CAPITAL EXPENDITURE 77.363 - -969.1510.0 1,651.69070.4 TOTAL EXPENDITURE 6,373.316 6,071.060 5,800.0008,764.77251.1 9,841.82912.3

18. ACTUAL APPROVED BUDGET BIENNIAL ESTIMATES BUDGET LINES2011/2012 2012/20132013/2014 % Increase/ (Decrease) 2014/2015 % Increase/ (Decrease ) REPAIRS & MAINTENANCE 218.835 200.000 162.146 240.71948.5 264.79010.0 MEDICAL & PHARMACEUTICAL SUPPLIES 789.439 634.517 514.422 868.38368.8 955.22110.0 SERVICE CONTRACTS 356.902 400.000 324.292 656.283102.4 721.91110.0 UTILITIES 412.823 400.000 324.292 635.67796.0 699.24510.0 OFFICE EXPENSES 9.820 5.280 4.281 10.802152.3 11.88210.0 OPERATING EXPENSES 91.191 100.000 81.072 331.310308.7 364.44110.0 TOTAL OPERATING COST 1,879.010 1,739.797 1,410.505 2,743.174108.7 3,017.4912.5

20. ACTUAL APPROVED BUDGET BIENNIAL ESTIMATES BUDGET LINES2011/2012 2012/20132013/2014 % Increase/ (Decrease) 2014/2015 % Increase/ (Decrease) SUPPORTED BY: MINISTRY OF HEALTH CONTRIBUTION 3,927.726 3,584.321 3,400.0005,144.04551.3 5,835.64413.4 MINISTRY OF EDUCATION CONTRIBUTION 1,134.300 1,212.344 1,150.0001,739.89851.3 1,973.82113.4 CONTRIBUTING GOVERNMENTS 256.933 474.395 450.000680.82951.3 772.36513.4 5,318.959 5,271.060 5,000.0007,564.77251.3 8,581.82913.4 INCOME 1,054.357 800.000 1,200.00050.0 1,260.0005.0 6,373.316 6,071.060 5,800.0008,764.77251.1 9,841.82912.3

21. Ministry of Health = $5,144 Billion Ministry of Education = $1,740 Billion Contributing Governments = $681 Million

22.  The UHWI budgetary request to be consider for the period 2013/2014 is JA$8,764.772B. Supported by: Ministry of Health (JA) 5,144.045 Ministry of Education (JA) 1,739.898 Contributing Governments 680.829 Total Government Contributions7,564.772 Patient Fees 1,200.000 Total Budget 8,764.772

23.  The estimates of Expenditure were thoroughly considered and are based on the realities of the global economic climate and status of the Caricom States.  Budget geared towards maintenance of accreditation by C.A.A.M-HP and the continued high standard of health care expected from a University Hospital.