THE EDITOR: The present chair of the South West Regional Health Authority (SWRHA) is occupied by the person who wrote the book on “quality” standards mandated by the Ministry of Health. I have always respected this person as a significant contributor to our country’s health system.
Even as I write, I have before me a copy of a comprehensive, well-written and meticulously referenced manual – Infection Prevention and Control Policies and Guidelines for Healthcare Services (2006). The chair of the SWRHA contributed significantly to the content of that manual and indeed has worked tirelessly to entrench and enhance “quality” standards and guidelines within our health services.
There is no gainsaying then that I am baffled as to the SWRHA board’s rationale for deciding to withdraw the hospital privileges of a visiting neurosurgeon who criticised existing systemic deficiencies at the San Fernando General Hospital.
In a recent article (The Lancet: vol 392, Nov 17, 2018), Kruk and others undertook a systematic analysis of amenable deaths in 137 low, middle-income countries (LMICs). “Avertable mortality” is considered to be the sum of preventable deaths, viz, those deaths that can be prevented through population-wide preventive methods, and “amenable deaths” or those deaths that are generally averted by available healthcare provision once any given condition arises in an individual.
The authors explored the extent to which excess mortality in LMICs is attributable to “low-quality” health systems in an era that targets easy accessibility through “universal” health coverage.
As far back as the decade of the 1990s, TT had embarked upon a programme of healthcare reform with its explicit objective being the provision of universal access. One can only surmise that the thrust toward “quality enhancement” was meant to ensure a heightened level of individual health services with the focus of the latter being on hospital care.
As it stands today, the present PNM administration, like administrations overseen by the same party in the past, keeps using jingles, walkabouts and sporadic advertisements in the way of reacting or responding to health crises that rear their heads from time to time.
Hence, when there is a huge dengue epidemic, the minister would spring into action with a sense of urgency and with widespread publicity concerning his efforts at mosquito eradication.
Little concern even today is expressed by the Health Ministry regarding acceptable safety standards for road users and pedestrians alike until some catastrophe occurs and there is an unnecessary loss of life.
This attitude of lethargic reactivity is well exemplified in the recently passed marijuana legislation that is demonstrably pathetic in terms of the lack of clear thinking regarding exposure of unsupervised children (with cannabis use confined only to private homes) and existing workplace norms that conflict with employers’ requirements.
To say that the visiting doctor may have committed a “breach of confidentiality” begs the question: whose confidentiality, the board’s and, by extension, the hospital’s secrets, or that of their patients?
The PNM, when in government, never invites critical appraisal of its performance. Rather than do so in a milieu of mature exchange, it habitually extinguishes the message by calumniating the messenger. This is its unfortunate brand of antiquated politics.
That retrograde habit which is a disservice to the country and its advancement will never go away unless the PNM is done away with as a political force.