By Kenton X. Chance
Minister of Health Luke Browne, in response to this question, says that his approach in his ministry is patients first.
“If there is in this case — and I do not anticipate that there will be — any negligence that could be validated, then, obviously, somebody has to be held responsible for that. I am saying to you, though, that it is not my view that this will be the case,” Browne said Monday morning.
The minister, speaking on Boom FM, said he will not defend suboptimal service in the nation’s health care system but said persons should not blame Allen’s July 28 death on the postponement, twice before July 14, of an “urgent” surgery.
Allen’s surgery was postponed as two of the three anaesthesiologists at the Milton Cato Memorial Hospital (MCMH) fell ill.
Frustrated by the situation, Allen, 75, wrote on July 14 to the management of the MCMH and copied the letter to Browne, Chief Medical Officer Dr. Simone Keizer-Beache, and Cuthbert Knights, permanent secretary in the Ministry of Health.
He warned that the delay could have “fatal consequences” and said that because of the situation, he better understood “why one on my friends was surprised that I was having surgery done in SVG”.
After receiving no response to or acknowledgment of his letter, Allen attempted to use the media to call attention to the situation.
He submitted the letter to at least one local newspaper, saying in a cover note, “Maybe it needs a public exposure for such matters to be rectified, I therefore ask that the attached letter be printed in your newspaper.”
The letter became public after Allen’s death.
In his radio appearance on Monday, Browne said that on July 14, when the letter was written, he was not in St. Vincent and the Grenadines.
“And I took the opportunity, shortly after that, even though I was in Dominica for the funeral of one of my aunts, to respond to him.
“It was sent by email with a cover email. I said, ‘Brother Oscar, I would ask that this be given urgent attention and action.’
“This is while I was overseas and this is a case where the letter wasn’t sent to me in the first place but I saw it as duty, … as someone who is copied in on the letter, I saw it nonetheless, took the opportunity to respond to it and respond to all persons who were copied in on the letter to say that this matter needs to be given urgent attention and action.”
Browne, who was in Dominica for the funeral of his aunt, said this was done and shortly thereafter — I’m abroad all this time, I am having my own grieving and difficulty — the surgery was performed”
The health minister, however, said that he could not go into the specifics of when the surgery was performed, saying, “There are some matters of patient confidentiality, whether or not the patient is dead.”
Towards the end of the radio programme, Browne said that he had responded to Allen’s letter on July 19 and the surgery was done on July 19. As he mentioned the dates, he told listeners that he had “got the confirmation”.
‘This is not a ministry of cover-up’
The health minister’s statements come amidst focus on the MCMH — the nation’s main healthcare facility — over a number of troubling developments there recently.
In July, prominent lawyer Grant Connell made it public that he had to fly his son to Barbados for medical attention after being told at MCMH that they had no plaster of Paris to attend to a broken hand.
In his radio appearance on Monday, Browne said: “I don’t want anybody to ever come to the conclusion that I see my role as the role of defending or upholding things that are not right and treatment that is suboptimal.
“And if there is negligence or any other form of incompetence in the medical services, or any other aspect to deal with health, I think we should move against that.”
He said that his view that there was no negligence is “based on what I know.
“But there is a process that can be followed in relation to that and based on what I know — and a process that will be followed in relation to any other case – and at the end of the day, if somebody messes up in relation to a patient and negligence is found, then the individual who is responsible for that action will be held responsible.
“This is not a ministry of cover-up. At the end of the day, we want what is best for the patient, we want is best for St. Vincent and the Grenadines and we are seeking to get what is best for the patients.”
Asked if he has called for an investigation into the situation involving Allen, Browne said: “I know some details and we will respond to the family, or any other individuals who might want some further information, but, just believe me that this was not as straightforward as some people are trying to make it out to be.”
Prime Minister Ralph Gonsalves has since said that on June 6, one of the three anaesthesiologists at MCMH fell ill and on June 9, another fell ill.
This left just one anaesthesiologist at the hospital to deal with critical and elective surgeries.
Some persons have blamed the delay of the surgery for Allen’s death but Browne said he does not believe this was the case.
“… I don’t think that that is the right conclusion, based on the facts of the case. I know the facts of the case, I am not at liberty to discuss the facts of the case because of the confidentiality matter,” Browne said.
He said maybe this could be disclosed at a later date, with the permission of Allen’s family.
Browne, who at 32, is the youngest member of the Cabinet, said that he does his “best” as minister of health.
“I do my best all the time and the truth is, you will always have those moments when you question yourself and you’re frustrated that you are not able to do more, but we have the hand that we have and we do the best that we could do with our hand.”
‘not responsible for dabbling in the minutia’
Browne said that the general point that should emerge in relation to Allen’s letter has to do with the delays.
“And to the extent possible, I have asked and there is official correspondence to this effect on the record that all inconvenience and delays be minimised and that we direct a lot of our energy into being able to find whatever, or come up with arrangements that will help us to minimise this inconvenience…”
Browne, however, seems to be attempting to evade responsibility for “bad administration” at the hospital.
“I take responsibility for general direction of the ministry,” Browne said, adding that he knows his functions based on section 60 of the Constitution.
Section 60 of the constitution says: “Where any Minister has been charged with responsibility for any department of government, he shall exercise general direction and control over that department; and subject to such direction and control, every department of government shall be under the supervision of a public officer whose office is referred to in this Constitution as the office of a permanent secretary: Provided that two or more government departments may be placed under the supervision of one permanent secretary.”
Browne further commented: “So let’s not have a loose conversation about it (his responsibilities)”.
He added: “I am not responsible for dabbling in the minutia of administrative arrangements. I’m not responsible for dabbling in the minutia of technical details but I am responsible for the general direction of the ministry. And my general direction and the general direction of the Cabinet is recorded. It is on the record in relation to what we want to do.”
Browne said that this general direction of the Ministry of Health has to do with the ministry’s seeking to minimise “the inconvenience to patients and the delays in relation to those surgeries.”
He said that the ministry is actively doing this and is in conversation with diplomatic allies asking them to see if they can help.
The health minister said that his ministry is also exploring possibilities with the local medical schools and individuals across the region to help strengthen some of the provisions of service.
Browne said that one of the ways in which his ministry is moving to minimise negligence is the publication, soon, of a patient’s charter.
He said the patient’s charter is “going to basically set out that our interest is in the patients first and doing our best by the patients.”
Browne, however, said that having said that, no matter how the nation’s healthcare advances, “being the fact that we are from a small, poor, developing nation in the Caribbean, there will always be the need for us to interface with medical expertise approach”.