Tuesday 23 October, 2018

SLMDA reacts to OKEU dialysis patient death: We warned govt

SLMDA wishes to extend sincere condolences to the family of the patient of the OKEU Dialysis Unit who recently passed.

This press statement must embrace and be clearly mindful of all the tenets of decorum, sensitivity, respect, dignity and empathy for the grieving family at this difficult time. Let us all keep them in our thoughts and prayers.

However, it would be remiss of SLMDA not to bring to light the danger of administrative actions void of appropriate consideration(s), given our level of ill-preparedness to deal with the ensuing consequences. This recent incident highlights the dangerous notion that healthcare decisions can be directed on the basis of political expediency rather than clinically, evidence-based and rationally driven decision-making. The transitioning to the OKEU is too slow, piecemeal, dysfunctional and appears politically rather than clinically driven.

Certainly, not providing all the support services at OKEU before moving the Dialysis Unit would have made it very difficult to provide the emergency support needed when a patient on dialysis crashes. This is always a real possibility for patients during dialysis. SLMDA did warn the relevant authorities on several occasions of the unintended consequences of such vacuous decision-making without collective professional consultation and adequate risk management considerations and in particular, the specific danger to dialysis patients. The practice of medicine, unlike many other professions, carries a very narrow margin for error, but more especially so in the setting in which we are given to function, with ever increasing demands from the public, but very limited diagnostic and therapeutic options.

The callous attempts at removing the fiberglass roof at the GONS without obtaining prior and necessary approvals from the Occupational Health and Safety Department and the DCA (to protect and safeguard the workers, patients and visiting public) brings to mind another recent case of wanton disregard and disrespect for public safety. Even doctors got ill because of this unparalleled level of reckless and irresponsible behavior; but more pressing is the unhygienic, inhospitable and inhumane ambiance in which we the doctors and healthcare workers are being asked to deliver healthcare services to the public, which stands in sharp contra-distinction to any moral and ethical considerations.

We have pleaded repeatedly with the authorities to remove the workers and patients from the GONS, but no one appears to be listening. SLMDA had no choice but to lodge a complaint to the Health and Safety authorities to investigate these matters, which has resulted in a temporary halt to the roof demolition. SLMDA awaits a full report from the Occupational Health and Safety Department outlining the issues, giving clear guidelines to ensure the health and safety of all workers and the visiting public and the enforcement of the law where relevant authorities exhibit recklessness in making decisions against the public interest. At the heart of our responsibility and duty is an unwavering commitment to safeguard the public health interest.

We continue to warn the authorities of the dangers of continuing operations at the GONS and wish to highlight once more that every attempt ought to be made urgently to complete the East Wing at the SJHRS rather than the time-consuming and cost prohibitive option of building a new facility.

It is time to urgently rethink and reset the priorities in good conscience and in the public interest as the clock continues to tick. The Hewanorra International Airport, the presence of hotels in the south and the public all remain areas of exposure and increased vulnerability of immeasurable consequences if we do not act now to urgently close these gaps. Risk-management considerations are not being taken seriously and that is good reason for concern.

Healthcare services must always remain available to and efficiently operated in the greater interest of the public good. This is a national imperative and not a partisan issue. No citizen should have to ask themselves, how do I access healthcare for my family? Why should the decision to live or die be pegged to whether or not the citizens have the means to access private vs public health facilities? This is most unconscionable and it is the Government’s responsibility (any government) to provide such public access facilities for its citizens. The notion that National Health Insurance can operate properly outside the framework of a carefully customized Universal Healthcare plan is an oxymoron conceptually and operationally, the former being one of several possible funding mechanisms for the latter.

There should never be disproportionate promotion of private sector growth at the expense of the public and the public purse without equitable and reciprocal returns on investment. The St. Lucian public must continue to speak out for what is right, for what is in its best interest collectively, and must of necessity take up its rightful place in shaping its destiny.

SLMDA once more is calling on the Government to accelerate the efficient and cost-effective transitioning to the OKEU, to fast-track the commencement of works on the East Wing at the SJHRS, to evacuate everyone from the GONS soonest and to continue the broad consultations on healthcare with stakeholders including the Executive of the SLMDA.