Guyana’s entire medical system, government and private has never been made accountable for medical errors or malpractice. Indeed, there are even “practitioners” outside of the formal medical system who unlicensed, yet offer remedies and cure-alls to the general public, often unchecked by those in authority. These unlicensed practitioners offer “bush” (herbal) and other remedies which can probably be categorised as alternative medicines but are dispensed in an uncontrolled and unmonitored fashion with no way of proving doses or determining which specific ailments are ameliorated by these “remedies.”
Still, while the operations of unlicensed practitioners offering medical remedies is a serious one, requiring sensible attention and regulation, it is the formal medical system, particularly the government run hospitals and health centres which require the most urgent attention. Government hospitals and health centres are the most widespread medical operations in the country and treat the vast numbers of patients. The monitors of the medical system are also government agencies for the most part, so it is necessary for them to get their own house in order first, as it will considerably increase their leverage and effectiveness in dealing with private medical institutions and medical practitioners in private practice.
Over the years the Georgetown Public Hospital Corporation (GPHC) and other government hospitals have all had to deal with the appearance of negligence or malpractice in the treatment of patients including pregnant women. Several unnatural deaths have sparked internal inquiries by the hospital administration, however, the general public have not seen the results of these processes manifested in an improvement in the quality of the medical care and accompanying services of the government hospitals and health centres. Neither have there been any signs of culpability being placed at the feet of any medical personnel for harm being caused to persons receiving medical care.
Not that we consider the matter of making a medical practitioner publicly accountable for negligence or malpractice to be a light matter. The issue of determining culpability for a medical error or negligence is itself something for experts in the field to determine and is not easily resolved. Nevertheless, it is a matter concerning the health and well-being of patients and embarking on a path to the full resolution of this issue of medical error or malpractice requires urgent commencement in a structured and open fashion. It is time that this issue which has been kept in the murky hallways of dubious secret consideration be brought into the light of public discussion.
A possible format for this public engagement can be through town hall-type meetings popularized by the US political system. With members of the Medical Council of Guyana fielding questions from stakeholders in the industry and the general public, we can be well on the way to grappling with a problem that has been causing families much grief and possibly negatively impacting the confidence of medical practitioners at all levels. The discussions can also touch on the quality of pre-medical care service such as the accommodations available for patients awaiting medical attention, as well as their accompanying relatives or friends, and the availability of beds and ward accommodation for patients.
Although there have been many such cases over the years, just recently, another family have demanded an investigation into the death of a pregnant 30-year-old mother, who died just days after delivery. Our report noted that, after the infant was transferred to the Neonatal Unit because of difficulty breathing, the mother was required to climb several flights of stairs daily to feed her new born child. According to our report, the mother of two may have died from a heart attack according to a post mortem examination.
Whether or not the hospital is culpable or the medical personnel vicariously culpable is not for us to determine in these pages. However, it seems clear that there are matters requiring attention, such as the need for the mother to climb several flights of stairs to feed her child, or indeed for any reason at all. Logistics about patients’ comfort and their movements are some of the things that the hospital administrators can aggressively investigate and initiate urgent change. The attitude of porters, nurses and doctors and their recognition and acceptance of their responsibility to ensure their patients’ comfort is another matter that should be within the capability of the hospital administrators to address.
However, much of the time there is a disconnect by those in the medical system with the suffering of individual patients in their care. This same disconnect with the suffering of customers is endemic in the customer service environment, but of course with the medical system bad customer service can more easily evolve into a life and death struggle for the patient mainly because of unknown health complications present. What a public discussion between the public and the medical system can achieve is removing the disconnect that exists and putting a human face on the sufferings of patients and their families.
The tragic death of two children after pre-chemotherapy treatment is another distressing example of the need for an open and frank process of reform in the medical system, particularly since the public perception of the country’s government-run health institutions is being continuously degraded. In the process of open reform of the medical system in Guyana, the concerns and challenges of medical practitioners and care givers themselves at all levels should also be ventilated and addressed, as it would be disingenuous to contemplate that problems do not exist in this regard.
It is highly likely that private practitioners and private medical institutions will also simultaneously upgrade their facilities and services even if just to maintain their competitive advantage and this too will redound to the benefit of all Guyanese.