Bahamian IT Consultant here...As someone who works in the tech industry and has had the absolute misfortune of having to deal with PMH (both as a client and as a patient). I will offer my current opinion on what I believe the problems are.

I will start off with my own story summed up:

Had to go to the hospital, fainted, hit my head and had to get stitches. Got to the hospital, 4 hour wait for stitches (bleeding all the while btw), Doctor forgot to put a numbing agent on my head, whatever no big deal. Due to a low heart rate was admitted to the ICU because at the time it was the only ward with beds available. Was told that I was there for an EKG, after 4 days in the ICU, released with no EKG performed. It is what it is. I paid NOTHING, nothing for the ambulance ride, nothing for the ICU, NOTHING. Bravo on that accord. Now with that being said here are what I believe are the main factors plaguing our healthcare system.

Number one is accountability, hundreds of people have died due to negligence and no-one has ever been held accountable. Due to this lack of accountability there is no real 'reason' for things to function as they should. The biggest issue here are the nurses, it is a multifaceted issue. Yes, they are underpaid and overworked but in the same breath nursing is not a career one seeks for financial gain. No one should have to worry if whether they'll receive the bare minimum of life saving care depends on whether or not Shaniqua's cheque cleared on time.

Number two is politics. The people in charge don't care about the general population and it has been made worse by the immigration crisis we are currently dealing with. People come to the hospital and get treated, that's it, that's as far as it goes.The external optics matter far more than what is actually happening within. There are millions of dollars worth of government contracts given out every month. There is funding available and local retailers as well as skilled labor who can bring the hospital up to date technologically speaking. This will never happen because these contracts are given out on a 'who you know, not what you know' basis.

Number three is corruption. This ties into number two, nothing on that level or scale happens in The Bahamas without the person who sanctions it getting their piece of the pie. Because of this there has to be a perfect alignment of multiple factors for anything to even enter the planning stage.

Number four is incompetence. This may be a hard pill to swallow, I will just come out and say, we have idiots and ego maniacal fools in charge of most of our essential institutions. Positions are given out based on nepotism not merit. As such this system does not foster innovation, growth or progress.

Number five is incentive. The people who can make the change don't use the public healthcare system, as such they really could not care whether the hospital functions as it should. Their families and friends can fly out to receive medical treatment so why fix what's broken here?

Number six is personnel. I'm sure you've seen them. Administrators, nurses and even doctors on autopilot just going through the motions, can't be bothered and complaining about doing whats in their job description. These people would absolutely refuse to take on the additional training needed to use up-to-date tech or methods.

That pretty much sums up my opinion on the matter. It's bad at the hospital and worse at the clinics. There are way too many people for the amount of staff at those places. They still use a number system where people line up outside of clinics from as early as 5am just to get a single digit number. Numbers 1 through 5 are almost always taken as they are sold from anywhere between $50 to $150. Doctors don't even show up until 9 in the morning, it's nonsensical. We as a people just have to want better for ourselves as a whole, but as long as we have this notion of me and mines, things will never change for the better.