Health Matters Gibraltar Health Authority Annual Report 2005 Health Matters Gibraltar Health Authority Annual Report 2005 Credits Contents PUBLIC HEALTH SECTION Public Health in 2003 8 Dr. Vijay Kumar, Director of Public Health (lead) Vital Statistics 8 Miss M. Sene, Cancer Registry officer Immunisations 8 Mr. J. Easter, Health Promotion Officer Life expectancy and mortality 9 Health Promotion 10 Infectious Diseases 12 What is Bioterrorism? 14 HEALTH CARE SECTION Response to Bioterrorism 14 Dr. David McCutcheon, Chief Executive (lead) SARS 15 Dr. P. J. Nerney, Primary Care Co-ordinator Dr. S. Higgs, Consultant paediatrician Health Care in 2003 16 Mr. M. Haroon, Consultant ophthalmologist Gibraltar Healthcare Development Programme 16 Mrs. C. Vinent, Senior Physiotherapist Obstetrics and Gynaecology 16 Mr. A. Wink, Senior Occupational therapist General Medicine and Specialties 17 Ms. M. McLeod, Senior Dietitian Paediatrics 17 Mr. A. Montero, Laboratory Manager Anaesthesia and Intensive Care 18 The late Dr. Andrew Correa - Obituary 18 Mrs. C. Macias, Sponsored Patients Officer Laboratory services 19 Mrs. G. Phillips, Head Pharmacist Speech assessment and therapy 19 Mr. E. Lima, Director of Finance and Information Technology Operating Theatre 20 Mrs. E. Cervan, Medical Records Manager The New Hospital 20 Eye Care 21 ENT Services 21 Information Technology 21 PRODUCTION Palliative Care 22 Mr. S. Perera (graphic design & photography) Clinical Psychology 22 Mr. S. Escudero (photography) Mental Welfare Services 22 Miss M. Sene (administration and proof reading) Physiotherapy 23 Occupational Therapy 23 Nutrition and Dietetics 23 Public Health 2004 Minister’s Foreword The Hon. Ernest Britto, Minister for Health Vital Statistics The period covered by this report Population According to the Government Statistical culminated with the most exciting and Office, the final results of the national significant improvement to our Health Census 2001 published this year showed the resident population of Gibraltar to be 27,495, Services in many decades when we representing a growth of 3% from the previous inaugurated our new St. Bernard’s census in 1991. These finally published figures differ only very marginally from the Hospital at Europort. provisional figures originally published and therefore the analysis presented in the public This came as a result of many months of meticulous planning and hard work by GHA Staff throughout the preparations for the main move on 12th health report for the year 2002 remains February 2005. Some departments started to move into the new building during late 2004. largely valid. The opening of our new St. Bernard’s Hospital required a capital investment in excess of £55,000,000, including some £20,000,000 of new equipment. The success story of the New Hospital is there for all to see and from the very first day it started to attract favourable comments, not only from patients and their families, but also from visiting health professionals who compare it favourably with private hospitals of the highest standards in their own countries. Births Gibraltar is indebted to all those who in any way either directly or indirectly helped GHA in the successful migration of all its patients in St Bernard’s The number of babies born in Gibraltar rose dramatically in 2004 to Hospital from its old location in the upper town to its new environment in the Europort area. 421, when compared to the relatively constant numbers in previous years (around 360). Of these, 223 were females and 198 were males. The migration went quite smoothly and all patients and essential equipment were moved within a 5 hour period. Without doubt, this would not have been The proportion of these births attributable to the resident population possible except for the understanding and co-operation of those who suffered the inconvenience of drastically reduced parking in the vicinity of both was 91.2%, that of the Forces population accounting for the rest. hospitals as well as on the routes between them. Also noteworthy was the co-operation of the general public in avoiding the use of their vehicles during the Deaths migration period. This eased the circulation of traffic and made it so much easier for the vehicles carrying patients to move between the two hospitals. The birth rate in the resident population rose sharply this year to 14.0% reversing the downward trend in local birth rates since 1992. During 2004, 111 females and 110 males died, giving a total of 221 deaths in the All members of the GHA Staff co-operated magnificently by their full attendance, the long hours worked and by carrying out the transfer so efficiently and The birth rate in the Forces population is estimated to be 23.0, also resident population, a crude death rate of 8.0, again roughly similar to previous effectively. Last but not least, Gibraltar’s gratitude goes to the patients and their families for their forebearance and patience during the move and in the a significant rise. years. A further fifteen deaths of non-residents were also registered in Gibraltar. subsequent period of adjustment after arrival at the new hospital. Their co-operation was fantastic and they helped to make the job of all those persons involved with the move very much easier. The number of births to teenage mothers remained constant this There were no stillbirths or early childhood deaths this year. year at 23, but this year for the first time, a birth occurred in a mother It would be foolish of me to pretend that as a result of the new hospital everything is now perfect in our Health Service, that there is nothing more to do to Once again, the differences in gender patterns for the age of death were pronounced, as young as 14. There was also one birth to a 15-year-old mother. The continue to improve it, or that regrettable patient incidents and experiences will not occur from time to time. But the same is true of even the best medical but less striking to previous years. This year, the pattern for both men and women overall number of teenage mothers each year has hardly changed in facilities in the world. To ensure that we learn from mistakes so that they do not reoccur, in September 2004 we opened the Health Services to greater showed similar numbers of deaths until the mid 60s, after which the death rate recent years and continues to be a matter for concern. There were no scrutiny. Not only is the GHA’s own internal complaints procedure more open, timely and transparent, but it now includes an external examination by an for men rises sharply to peak at around 80, falling gradually thereafter, while for teenage pregnancies this year in the Forces population. Independent Panel from outside the GHA with very great powers of investigation. women, the peak occurs a few years later, in the mid 80s. Only 13 men reached the At the other extreme, there was a significant rise in births to 90s, the oldest dying at 96. In contrast 26 women reached 90, three women reached Of course, the opening of the new St. Bernard’s Hospital has not just been the inauguration of a new building, impressive as it is. The wards are divided mothers aged 40 years or older – this year there were 16 births a 100 and one woman survived to 104. into spacious and comfortable rooms with one, two, three or four beds in each and most rooms have their own bathroom. A total of 212 beds are available, (3.8%) in this age group as against 5 (1.5%) in 2003 and 8 (2.2%) about 40 more than in the old hospital, and each bed is being provided with its own television and radio facility. There are three Operating Theatres, as Heart Disease - this year with 49 deaths (22%) - used to be the most common in 2002. The age of the oldest mother was 51, while the oldest opposed to only one in the old hospital, as well as day-surgery facilities. There is a modern and enlarged Accident & Emergency Department, a dignified cause of death but this year has yielded its supremacy to Cancer, with 50 deaths mother in 2003 was 43. and spacious Mortuary, an Endoscopy Suite and a Staff and Visitors Canteen. But as I said, the new building is not the whole story. More Consultants will (23%). This phenomenon is not unexpected, as people are living healthier lives soon be recruited and new medical services, never provided before in Gibraltar, will soon be available here. The forthcoming arrival of a new Consultant through to older ages when cancer is more common. However, the actual numbers General Surgeon will help with the launch of the new concept of day surgery, as well as with the introduction of new techniques such as ‘keyhole surgery’. Life expectancy of deaths from both heart disease and cancer were the lowest this year for the last Improvements will also be carried out in the coming months to our system of patients health records, to our procurement methods and to our IT and seven years. Gibraltar enjoys a good Life expectancy in keeping with the Communications systems. The types of cancer causing deaths have changed this year. Prostate cancer was standards for western societies and the actuarial tables from the Continuing to look through to the future, we will be seeking to carry out further improvement to systems and practices at the Primary Care Centre responsible for the most deaths, followed by cancer of the pancreas. Although Census 2001 show that a baby born in 2001 could expect to live up in order to provide a more patient friendly service. We are also in the initial stages of preparation to carry out a review and modernisation of mental lung cancer was the cause of only three deaths this year, it still kills young – it was to 78.5 years (if male) or 83.3 years (if female).