The issue of bed shortages at the National Referral Hospital (NRH) is not new, what is new is the speed in which images get uploaded on social media.

Recent images of patients lying on the floor, and some being treated while lying on the floor, caused an uproar on social media. Indeed, the images are confronting and something needs to be done.

What is the cause? Experts in the subject say there are two key considerations – intrinsic and extrinsic causes.

Intrinsic causes include staffing shortages, poor discharge policies and lax admission protocols, which includes bed designations.

Extrinsic causes are often regarded as acts of God – say a sudden influx of patients caused by a viral outbreak or a pandemic.

Seems clear that to manage this crisis a proper understanding of the cause or causes needs to be identified, and with it an output-based plan of action.

The Ministry of Health (MOH) has responded with the establishment of a Bed and Patient Taskforce Committee (BPTC). Their job is to manage bed and patient flow within the hospital to ensure minimal waiting time from initial examination at the Emergency Department (ED), to admittance to the wards and discharge.

The MOH has also strengthened the customer/patient care service, and additional staff, both nursing and non - skilled staff, will help coordinate patient and non - patient movements at the ED.

So, from the MOH’s perspective it appears that the cause is intrinsic - better management of patients from the time they are admitted to the time they get discharged is the solution.

While this is good, an assessment should also be made when extrinsic factors are at play. If there is an outbreak can the NRH cope?

Perhaps we should plan and prepare based on a scenario where there is an outbreak – that way during ‘normal times’ there will always be enough beds for the sick.

But we can also play our part. The MOH is encouraging those patients with routine illnesses which do not require hospitalization, to visit their nearest clinics, the ED is for serious cases only.

So, with some forward planning and cooperation from the public we could all manage this crisis. Fact remains we are one of very few countries in the world where health care is free – so there will be resource constraints even in the best of times.