Dead ba­bies re­port: a con­torted es­cape

Jamaica Gleaner - - OPINION & COMMENTARY -

WE SYM­PA­THISE with Marc Ram­say’s anger at the public de­fender’s broad, and con­torted, ex­cul­pa­tion of man­age­ment and staff of the Uni­ver­sity Hospi­tal of the West Indies (UHWI) for the deaths of sev­eral preterm ba­bies dur­ing last year’s erup­tion of the ser­ra­tia and kleb­siella bac­te­ria at the in­sti­tu­tion, not only for her find­ings, but also for the route Ar­lene Har­ri­son-Henry took to­wards her con­clu­sions.

Fur­ther, we ques­tion, in the cir­cum­stances, given that some of the par­ents of the dead ba­bies de­cided to in­de­pen­dently seek, re­dress through the courts, whether Mrs Har­ri­son-Henry should have pro­ceeded with her in­ves­ti­ga­tion and, hav­ing done so, pub­lished her find­ings. For while this news­pa­per does not, at this point, ques­tion Mrs Har­ri­son-Henry’s pow­ers un­der the law to have pro­ceeded in the man­ner she did, we would have pre­ferred if it were the sub­ject of ju­di­cial re­view.

In the event, we un­der­stand the con­cern of Mr Ram­say, who rep­re­sents the moth­ers of three of the dead ba­bies, that Mrs Har­ri­son-Henry’s vin­di­ca­tion of the hospi­tal’s staff of “med­i­cal neg­li­gence” and her con­clu­sion that the char­ac­ter­i­sa­tion of the bac­te­rial in­fec­tions as an “out­break” was “purely a me­dia cre­ation” is prej­u­di­cial to his clients.

At the time of the Oc­to­ber 2015 rev­e­la­tion of the cases at UHWI and the Corn­wall Re­gional Hospi­tal, this news­pa­per ac­knowl­edged that noso­co­mial in­fec­tions were a rel­a­tively com­mon fea­ture of health in­sti­tu­tions and that the very young, the old and those with im­paired im­mune sys­tems, pre­ma­ture ba­bies among them, were most at risk.

How­ever, what Dr Trevor McCart­ney, the highly re­spected physi­cian and then CEO of UHWI, re­ferred to in his ev­i­dence as a “plague” oc­curred in the con­text of on­go­ing de­bate about the re­sources avail­able to, and the man­age­ment of, Ja­maican hos­pi­tals. In­deed, the re­port of one sur­vey, re­leased at the height of the dead ba­bies con­tro­versy, high­lighted the fact that con­tracted clean­ers were not do­ing a good job, in­clud­ing fail­ing to fol­low pro­ce­dures. That, in our view, was a re­flec­tion not only on the com­pe­tence of the in­de­pen­dent con­trac­tor, but also on the in­sti­tu­tions’ man­age­ment.

HOSPI­TAL MAN­AGE­MENT

It may well be true that there was no “out­break” of ser­ra­tia and kleb­siella, as Mrs Har­ri­son-Henry in­sists, in the sense that the num­ber of cases did not reach the thresh­old for the in­fec­tion to be so de­clared. Per­haps, too, that the hospi­tal man­age­ment and staff did an ex­cel­lent job of de­con­tam­i­na­tion when the mat­ter came to light. Maybe they have noth­ing to an­swer to.

But jus­tice, as the public de­fender ap­pre­ci­ates, need not only be done, but should man­i­festly be seen and ap­pear to be done. The con­duct of her probe, on the face of it, was on the ba­sis of ev­i­dence from UHWI gov­er­nors, man­age­ment and staff, whose ac­cep­tance as wit­nesses of truth we have no ques­tion.

But there ought to have been two el­e­ments to this in­ves­ti­ga­tion, one be­ing the sci­en­tific. In that re­spect, we would have liked to have seen in­de­pen­dent ex­perts en­gaged on the man­age­ment of noso­co­mial in­fec­tions in hos­pi­tals and to re­view whether best prac­tices were fol­lowed at UHWI. That didn’t hap­pen.

Sec­ond, while we ac­cept the chal­lenges of lim­ited re­sources and other con­di­tions faced by the staff of Ja­maican hos­pi­tals, there are also ques­tions of whether man­age­ment prac­tices and com­mu­ni­ca­tions sys­tems in the in­sti­tu­tions con­trib­ute to, or ex­ac­er­bate, the dif­fi­cul­ties. Mrs Har­ri­son-Henry didn’t go near these mat­ters.

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