Venue : Function Room 3, North Tower Hospital.
Time : 18:00 h to 19:55 h
Date : 28 April, 1997

Present:
Datuk Dr. Loh Thiam Ghee, Chairman of Medical Advisory Board
Dr. Fong Chee Kin, Chairman of OT Sub-Committee
Dr. Dalina
Dr. Robert Liew
Dr. Ngun Kok Wah
Datuk Dr. Radhakrishnan
Dr. Bachan Singh
Dr. Tan Poh Hua
Dr. Anne Wong

Absent:
Dr. Charlie Chan
Dr. Mary Samuel

Tha main thrust of the letter from Dr. Radhakrishnan was that due to the many changes in the policies for the allocation of lists to the anaesthetists since he joined the medical centre, he had lost out repeatedly.

He also disagreed with the current system whereby all new lists would be automatically allocated to the anaesthetist who had not filled his quota with no option for the other anaesthetists to change their lists if so desired.

It was agreed that the points raised by him were not without merit and that a change to the system for allocation of new lists was in order. In order to reduce any misunderstandings, specific guidelines would be laid down.

Dr. Fong C. K. informed us that while Mr. Stuart Pack had said that new lists should be given to the anaesthetist who had not reached his quota of sessions, this should be looked on as a recommendation that he should be given lists when available to reach his quota as soon as possible with no restrictions on the specific list which should be given.

Dr. Loh T. G. stressed that there should be some mechanism whereby the hospital gave due recognition to those who had joined the hospital earlier and this could be achieved by allowing the more senior anaesthetists first preference when new lists were available.

He firmly believed that all lists which were currently held should remain untouchable and could only be changed if mutually agreed to.

After some discussion, the following guidelines were agreed upon:-

1. In order to be fair, the optimum number of sessions for each anaesthetist would be set at 10 sessions per week. This would allow great flexibility in rostering especially when anyone went on leave.
2. Each new anaesthetist should be given additional lists as soon as possible to allow him to achieve his optimum quota of lists (currently agreed upon at 10 per week). Once achieved, his quota should never drop below this level. It is incumbent upon the administrators of the medical centre that
1. No further new anaesthetists be invited to join the centre until all the current anaesthetists have achieved their optimum quota, and
2. New anaesthetists are forewarned of the probable work load to expect either when they are interviewed or at the time they are invited to join the centre. In general, all new anaesthetists should have a minimum of 5 sessions and these 5 sessions must be newly created ones.
3. Whenever a new list is created, the list will be offered to the anaesthetists starting from the most senior member and then in order of seniority (based on their duration of service with the centre as active consultants) down to the most junior member. A new list must be a newly created list. Not one that has been changed from an old list. For example, when an open list is changed to a named list such a list will remain with the original anaesthetist.
4. If any anaesthetist decides to take up the list he must ensure that any necessary changes to the roster be mutually agreeable to all anaesthetists and surgeons concerned.
5. He must also ensure that the quota or ratio of types of lists (Emergency/Open/ Day Care/Named lists) be equitable to all the anaesthetists.
6. If he has already achieved the optimum quota of lists, he must relinquish one of his lists to the anaesthetist or anaesthetists who have not met with their optimum quota, again with the proviso that clause 4 and 5 be complied with.
7. Should no anaesthetist take up the list, then it automatically goes to the anaesthetist who has not met his optimum quota of lists.
8. Under normal circumstances, only when all anaesthetists have attained their optimum quota of lists, should any anaesthetist be allowed to have more than the optimum number. However, should circumstances dictate, perhaps because of the impossibility of arranging the roster appropriately, or if the anaesthetist with less than the optimum quota should voluntarily decide not to take up the list, then such discrepancies will be acceptable. As always clause 4 and 5 should be complied with.

Dr. Anne Wong voiced her concern with the involvement of the nursing department in the drawing up of the anaesthetic roster and also in the allocation of new lists. Dr. Fong C. K. fully agreed that the nursing department should not involve itself with the above so long as the anaesthetic service is provided. Should there be problems with anaesthetic coverage, Miss Irene Quah or her deputy should highlight this to the anaesthetist arranging the roster and only if the matter remains unsolved, should it be brought to the attention of the chairman of the OT Subcommittee.

Furthermore, all communications and requests, from the administration or OT Subcommittee, should be done in writing to avoid any misunderstanding or miscommunication.

Regarding the opening of new lists, Dr. Anne Wong stressed that it should only be done when there were sufficient staff, both quantitatively and qualitatively, to ensure the provision of good and safe medical care to the patients.

Dr. Ngun K. W. brought up the matter of the occasional occurrences of when more than one anaesthetist were to go on leave at the same time. It was agreed by all that more flexibility be practised to accommodate all leave requests especially during long holiday periods, as often, many anaesthetists, surgeons and nurses would like to take leave during these periods and it would make sense to consolidate the lists if necessary and if possible. These are generally quiet periods at the hospital and it would be a good idea for more staff to take their leave then, rather than to take their leave during a busier period.

The meeting was closed by Dr. Fong C. K. at about 19:55 h.