Letter to the Editor: Guam Memorial Hospital needs structural reform

Guam Memorial Hospital

By Sen. Therese Terlaje

I write to the people of Guam in an earnest appeal to urge your senators to place Bill 13-38, an act relative to establishing a public-private partnership for Guam’s public hospital, onto the September session agenda for discussion and reconsideration by the body.

After the bill failed to pass in third reading by just one vote during the May session, the public call for a change in the GMH management structure has grown stronger, backed by healthcare experts, longtime public servants, both the

governor and lt. governor, the private sector, hospital consultants, Dr. Eusebio, the current chief medical officer of GMH, Dr. Mike

Cruz, adjutant general and former GMH medical director, as well as current and former GMH nurses and other personnel.

They all recognize the urgent need for a management shift that can be achieved through the resources, networks, and expertise of a public-private partnership.

The fact remains that even without Bill 13-38, the governor and GMH management themselves, off and on pursue their own versions of partial privatization of particular services or assets of GMH but do it without stakeholder input, without transparency, without assurances of accountability or improvement and without embracing the management shift recommended by

previous task forces that can be held accountable and that will better guarantee the results we expect from our taxpayer investment.

Similarly, GMH is also currently in the process of hiring yet another CEO without any publicly vetted parameters to guarantee improvement or success and without any change in the management system that would bring additional

 resources or expertise. 

We no longer have the luxury of giving the benefit of the doubt that the current management structure will bring improvement, despite good intentions.

The current structure does not shield patient care from political interference.

Pursuing a massive change such as privatizing part or the whole operations of our only public hospital cannot and should not be done unilaterally and behind closed doors, but instead should be transparent and include public input.

The point of Bill 13-38 is to get the experts together, the people who have devoted their careers and lives to healthcare, along with agency leadership and other expert stakeholders, who can put their brains together to create a 

framework that a partnership should follow, and that the legislature will 

commit to finance to ensure the hospital’s success in patient care, and an accountable management free from political changes

In every budget process in the nine years I have been a senator, it has been a fight to increase GMH appropriations above the governor’s request and appropriations committee allocations. Often, as was the case this year, the legislature has had to pass supplemental bills for additional funds to GMH, citing dire emergency conditions. Yet we have also seen appropriations to GMH refused, not implemented, not spent, and in the case of ARP, taken back by the governor.

Despite our differing opinions and perspectives, we should all agree that GMH needs help beyond funding. 

While an additional $40 million subsidy will provide  the immediate cash

infusion necessary to maintain services at GMH for one fiscal year, it does nothing to solve the underlying issues that keep us from moving forward and that threaten to impede the medical care and financial viability of our new hospital as well.

It’s like mopping up water, without fixing the broken pipe. And with the limited resources the government has, we can’t afford band-aid solutions that cost more in the long run.

After years witnessing the hard work, dedication and good intentions of those

at GMH, I firmly believe a private-partnership for overall management will help solve systemic and long-term challenges.

However, before Guam’s public hospital is privatized in whole or in part, it is incumbent upon us as the legislature, the lawmaking branch of the government,

to make policy that would ensure that the PPP framework is created by the experts and goes through a transparent, fair and competitive process with built-in accountability mechanisms so that our island and our taxpayers receive the best value. 

Let us do this together today in bipartisan cooperation by placing 

Bill 13-38 on the agenda without delay.

Sen. Therese Terlaje is a member of the 38th Guam Legislature.