Sat | Aug 19, 2017

Editorial: Ferguson’s sense of siege

Published:Friday | October 30, 2015 | 10:00 AM

That he is inarticulate and seemingly incompetent are not the worst of Fenton Ferguson's faults. He's not one for transparency. It is perhaps a holdover from his days of involvement in study groups of a kind for which tight-knit structure was the norm - whether their roots were at Wildman Street or Lady Musgrave Road.

That sense of siege with which, decades later, Dr Ferguson has infected the health ministry is preventing serious and mature dialogue on the state of Jamaica's health-care system and what ought to be its priorities in the context of a developing country with serious economic challenges. In the process, Fenton Ferguson has further weakened not only trust in his leadership, but public confidence in the island's hospitals and clinics, evidenced by the debate over the outbreak of the klebsiella and serratia bacteria at the neonatal facilities at two of the island's leading hospitals - the University Hospital of the West Indies and the Cornwall Regional Hospital - resulting in 19 deaths.

Nosocomial infections are not unusual in health-care facilities, environments where bacteria and viruses are plentiful and in which they are likely to become increasingly hardened to antibiotics. In the circumstance, the best antidote to such bugs is prevention by the practice of basic hygiene, which clearly broke down at the University and Cornwall Regional hospitals. That is a management failure for which those in charge of these facilities ought to be held accountable. Indeed, the two top managers at the University Hospital, from the administrative and medical sides, have tendered resignations.

The other management failure, at least at the University Hospital, according to its board, was the tardiness of its top officials to adhere to reporting protocols for informing the health ministry of such bacterial or viral outbreaks. Yet many people remain disbelieving of Dr Ferguson's assertion that he only became aware months after the eruption and the day it became a public issue in the press.

 

culture of secrecy

 

Given the health ministry's culture of secrecy, that is not an unreasonable perception - that people believe that Dr Ferguson, as well as his top technocrats, ought, at least, to have known, but attempted to hide, the problem. They have fodder for this in the minister's handling of the report of an audit of public health-care facilities that he commissioned in May in the face of criticism of his management of the health sector.

That audit was completed by September, but rather than making it public as the basis of a frank policy debate, Dr Ferguson jigged at the periphery, ostensibly to prevent embarrassment to officials and institutions that might have been identified for fault. Reasonable people presumed a thin-skinned attempt to deflect personal blame.

In the event, that report, if properly done, should have signalled the klebsiella and serratia outbreak - or something akin to it. The audit was announced in May, and the first case at the University Hospital was in June when the work should have begun. Moreover, among its findings, grudgingly shared with the public, were of inadequate systems and infrastructure for infection prevention and control, in particular, in the areas of maternity health management, neonatal units, intensive care, operating theatres, and accident and emergency departments.

Dr Ferguson would be expected to be especially attentive to these matters and for his chief medical officer to be exercised at any report of a bacterial outbreak at a neonatal unit.