First World standards not welcome in TT

THE EDITOR: As you know, a neurosurgeon originating from Florida has been suspended from practising at the San Fernando General Hospital, for speaking up on what amounts to prima facie negligent medical care. I happen to know the name of the doctor which has been circulated in other media.

I do not intend to itemise each issue as much of this was reliably covered in mainstream media. It comes down to this: Is the doctor lying or is he telling the truth?

All the doctor did was share his experience of Third World medical care compared to First World care, to the world, on Facebook. I read what he said and have a copy of the post which was removed. He made no mention at all of any individual patient nor was any patient made identifiable. Yet we are told he is being investigated for a possible “breach of patient confidentiality.”

The way the authorities will deal with this is along the following lines. In local talk it works like this: “You come from Florida wey t’ings very different in a First World country. You eh know how it is dong here nuh, in a small island wid limited resources like we own. You doh understaaan!”

Local culture doesn’t appreciate the basics of medical negligence – a very basic five-stage legal test, which doesn’t allow for “standard cultural practice” as a defence.

The matter is now likely to become yet another political football. Everything that the highly skilled doctor has said will be given a different spin – to make it appear that he “didn’t understand.”

How can I be so sure? Well, I used to work in TT at the Port-of-Spain General Hospital as a doctor 30 years ago. I saw very similar deficiencies in care that the Florida doctor observed and reported.

Perhaps unlike the Florida doctor I understood the TT culture and mindset better. So I knew that opening my mouth to official channels would get me sacked. So I did it differently. I found a reputable reporter and leaked it all.

What happened next was that the then minister of health (a medical doctor) shut down the reported facts – for which I had hard evidence. Even subsequent to the media leak, if I had handed the evidence to the minister, I would have been sacked for some spurious reason.

Ever since those days, doctors in TT have been regularly muzzled, as can be seen from various media reports over the years.

I’ve been following regularly what is happening in health services in TT. Although I am over 5,000 miles away I hear true stories from real people on what public sector health services are like at point of delivery. Some structures and technology may have changed, but mindsets and practice haven’t changed that much. Third World it has remained.

I’ll deviate slightly – but you will see why – to say that TT’s Canadian police commissioner Dwayne Gibbs and deputy commissioner Jack Ewatski resigned on August 7, 2012, under organised and lawful institutional pressures which forced them not to do a First World job.

The institutions found a way to “investigate,” find “facts” and squeeze them out. It was all official – the findings of competent people. Gibbs and Ewatski were taught a lesson.

I believe somebody would ask me what is the lesson? The lesson is that experienced and highly skilled professionals from First World nations ought not to come to TT and try to deliver First World standards of practice in any public sector sphere. They would be going against the grain.

The specific lesson for highly trained medical practitioners from the First World is: Avoid TT at all costs – it’s not worth the risks. You may be attracted by new challenges but you really cannot make a difference to the systems that surround your work by being open and honest, and putting patients in your care first. Attempting to do the latter means you will get, firstly, into endless red tape, then into hot waters, and have your good names thrown in the mud.

Uninformed other First World doctors remain free to take their chances in TT, where nepotistic lynch mobs flourish.

DR RUSSELL D LUTCHMAN

consultant forensic psychiatrist

Birmingham, UK