By *Guevara Leacock
On A View from the Outside this week, we turn our attention to professionalism, with the view being that professionals should be judged by the quality of their work and judgement under the conditions they face.
At a recent Ministry of Health press conference, the Minister of Health, Daniel Cummings, described the Chief Medical Officer (CMO), Dr. Simone Keizer-Beache, as one of the most distinguished CMOs in the entire Caribbean. He praised her competence, her experience, and a vigour he called unsurpassed. He pointed to her recent work on mental health training for police officers in collaboration with the Caribbean Public Health Agency (CARPHA).
Four and a half years ago, the same Daniel Cummings, then in opposition, sat at a press conference criticising protocols the said CMO had approved for Parliament. Those protocols required Members of Parliament (MPs) who had not disclosed their COVID-19 vaccination status, which in reality meant opposition MPs, to speak from a plexiglass booth at the back of the Parliament chamber, wearing a double mask. Cummings objected to separating people into vaccinated and unvaccinated.
Same woman. Same professional. Same job. Two characterisations. What changed was not Dr. Keizer-Beache. It was the politics around her.
In late 2021, the Unity Labour Party (ULP) government introduced a rule under which public sector workers who refused a COVID-19 vaccine were deemed to have abandoned their jobs. More than 300 people lost their livelihoods, including teachers, nurses, police officers, and workers in modest jobs such as school janitors and Town Board employees. Families lost homes and assets.
The majority of those workers only began returning to their jobs after the change of government in November 2025. The High Court ruled in March 2023 that the vaccine mandate was unlawful and unconstitutional. The Court of Appeal overturned that ruling by a 2:1 majority in February 2025, and the matter is now before the Privy Council for a final determination. Whatever the final answer, the human cost was paid years ago, and it was heavy. Many Vincentians suffered heavily under the law described as draconian.
Dr. Keizer-Beache was the professional face of that policy. The then-prime minister said repeatedly that he was acting on the advice of the CMO. The president of the Public Service Union, Elroy Boucher, called the vaccine mandate the most wicked, most evil piece of legislation ever passed in the Parliament of St. Vincent and the Grenadines and named the CMO as one of its architects. In December 2025, Boucher called on the Public Service Commission to retire her. His union, he said, had no confidence in her.
There were other grievances. In February 2021, it was reported that the CMO granted an exemption from pre-arrival COVID-19 testing to passengers arriving by private jet from a high-risk country. At least two persons from that vessel later tested positive for COVID-19. When asked about it at a press conference, the CMO declined to answer, citing patient confidentiality, which many Vincentians saw as an official hiding behind professional ethics.
In May 2021, the CMO assured the country that there had been no deaths from a COVID vaccine and in a later court affidavit, she acknowledged that a woman who died in January 2022 had suffered progressive weakness, which may have been due to serious adverse effects following COVID-19 vaccination. Critics say the first statement was false. A fairer reading of the situation might be that the death came eight months after the assurance was given. It might also be argued that concerns about the adverse effects of the COVID-19 vaccines were waved away rather than engaged.
There was also the general tone of the period. Vincentians were advised to wear masks, in some cases two. A public health emergency that outlived the pandemic was declared. In fact, a close check might determine that it is still in existence. There was testing requirements for unvaccinated teachers long after travel restrictions had been lifted. For Vincentians who lost their jobs, dignity, savings and houses, what happened looked less like science and more like stubbornness and pure evil.
Between March 2020 and mid-2021, St. Vincent and the Grenadines faced three emergencies at once — a global pandemic, a serious dengue outbreak in the second half of 2020, and the eruption of La Soufriere in April 2021, which forced somewhere between 14,000 and 20,000 people from their homes into 87 shelters.
More developed and wealthier countries would buckle under one of those disasters, much less three. St. Vincent and the Grenadines managed all three simultaneously well, especially the medical aspect of the COVID-19 pandemic, recording roughly 120 COVID-related deaths in a population of about 104,000. The Pan American Health Organization (PAHO) commended the coordinated response of St. Vincent and the Grenadines as a study in resilience, with the CMO named among those praised.
I should also declare an interest. I know Dr. Keizer-Beache to be an excellent physician. She cared for my grandmother in the final years of her life, and her skill, her advice and her bedside manner were everything a family could ask for. She is a Vincentian national scholar and a formidable intellect. I say this openly because you should weigh my warmth when you weigh my judgement.
We, on A View from the Outside, wish to highlight a crucial point at this juncture. Nobody who wanted the CMO sacked ever said she was a bad doctor. The criticism was never about her medical practice. It was about her judgement exercised against the Vincentian population, with the power of the state behind it. That distinction matters, and it points to the real issue.q
The popular story is that the CMO was a zealot who hurt workers. Those who defend her say that she was a professional doing her duty under political pressure. We, on A View from the Outside, suggest that there is a third point of analysis.
Look carefully at how we, on A View from the Outside, say the ULP government used the CMO. Every time the vaccine mandate was challenged, the then-prime minister pointed to the advice of the CMO. When he was asked in October 2022 why unvaccinated teachers still had to test weekly, he answered that this was the CMO’s advice and that when somebody is obliged in law to advise him, he is very careful not to reject their reasonable advice.
On its face, that is deference to expertise. In practice, it made the CMO the lightning rod. The government kept the authority to decide. The CMO absorbed the public cost of the decisions. When Elroy Boucher attacked the architects of the mandate, he was attacking the person the prime minister had pointed to — the CMO.
The worst position a professional can occupy is responsibility without power. A civil servant cannot answer back, cannot campaign and cannot go on the radio to explain the caveats that may have been in the CMO’s written advice. Vincentians never saw that advice. We only ever saw and heard the then-prime minister’s characterisation of it. For all Vincentians know, the CMO may have recommended exactly what was done, or something different. Vincentians have no way to tell, and that opacity served the politicians, not the CMO and not Vincentians.
What has changed under the new NDP government is not, we suspect, that the CMO is suddenly free of micromanagement. There is no evidence that the CMO was micromanaged before. Two other things have changed. First, the task. Mental health reform and CARPHA training are public health in normal times, where competence produces visible wins and nobody loses a job. Any competent and able CMO looks better in calm waters. Second, the political use of the CMO has changed. Cummings’ praise costs him nothing and buys him a great deal. It tells Vincentians and the civil service that the new government’s quarrel was with the old ULP politicians, not with them. Under the ULP, the CMO’s name legitimised policy. Under the NDP, it legitimises the transition. In both cases, the CMO’s reputation has been partly an instrument of somebody else’s politics.
Professionals will sometimes make unpopular decisions under pressure. That is the nature of professional jobs. A CMO who only ever gives comfortable advice is not earning their salary. If we punish every official whose honest advice goes badly, we will end up with officials who give no advice at all, and in a small state like St. Vincent and the Grenadines, that can least afford to lose its scarce expertise, that is a genuine concern.
However, the protection professionals deserve comes with a debt. If Dr. Keizer-Beache is to be shielded from blame for political decisions, Vincentians are entitled to candour about what she actually advised. More than 300 families paid the price of the vaccine mandate. Nearly five years on, no one, politician or professional, has apologised to them. The Privy Council will eventually tell us what the law required. It cannot tell us, though, what decency required. And, on that question, the silence from every quarter is telling.
Dr. Keizer-Beache is an excellent physician and by the account of the professionals closest to her work, a distinguished public health official who helped steer St. Vincent and the Grenadines through three emergencies at once. But she was the face of a policy that did real harm to real people, a policy whose full paper trail we have never seen. The praise now being heaped on her is no more the whole truth than the abuse that came before it. Both were convenient to the politicians doing the talking.
The lesson in all of this is not about the CMO. It is about Vincentians. We should judge our professionals by the quality of their judgement under the conditions they face, insist on seeing where their advice ends and political choice begins, and reserve our loudest anger for the people we elect to govern our country — the politicians. Until we learn to do that, every talented public servant in St. Vincent and the Grenadines will know that their reputation is on loan from whichever government happens to be in office.
*Guevara Leacock is a barrister at law of Lincoln’s Inn in England and an attorney at law in St. Vincent and the Grenadines. He has a keen interest in history and politics and is a social commentator.
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