Tue | Jan 23, 2018

Editorial | Dead babies report: a contorted escape

Published:Tuesday | October 18, 2016 | 12:00 AM

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.