Who Should Take Responsibility for Cornwall Regional Hospital?

In Lloyd B. Smith’s column titled “To Resign or not Resign” was published in the Jamaica Observer of Friday, 13 May 2018. Though I agree with the principle of a leader taking responsibility for his actions, I believe calls for the health minister, Dr. Christopher Tufton, to resign “in the wake of the Cornwall Regional Hospital debacle” are unfounded.

For instance, calls by the opposition’s spokesman on health, Dr. Dayton Campbell, focus solely on Dr. Tufton’s decision not to close Cornwall Regional Hospital (CRH). But, has he or any other asked how CRH – one of the most modern of public health facilities in the island – come to be in a state that would require it to be closed?

Clearly maintenance, or rather the lack thereof, is at fault. But, it may also be argued that the lack of user fees has contributed to the ineffective maintenance of this building. This would again cast blame squarely at Dr. Tufton, if it could be proved that this did not exist before. I contend that Dr. Tufton’s predecessors are equally to blame.

In the late 1980’s – approximately 30 years ago – I was part of a team involving the Ministry of Construction (Works) and Pan-American Health Organization (PAHO) which inspected hospitals islandwide, including CRH, to evaluate the state of the nation’s primary healthcare facilities. The finding was that poor maintenance was the main problem.

This finding was presented to the Ministry of Health at the time, which was prior to their commencement of the Hospital Restoration Programme (HRP). The study singled out poorly trained maintenance personnel and inadequate resources being allocated to maintenance. The records should indicate what was done with this information.

The present circumstance would seem to indicate that whatever may have been done was still inadequate. So rather than a “Culture of Ethics” being a problem, what needs to be addressed is a culture of poor maintenance. The older hospitals were designed to be naturally ventilated, not CRH. So, maintenance of this facility is more critical.

A number of floors were renovated at CRH under the HRP. Of all Dr. Tufton’s predecessors at time, who can wash their hands of any responsibility regarding maintenance of this facility, and maintenance of the island’s healthcare facilities in general? The opportunity now exists for Dr. Tufton to make sure this situation is not repeated at any other facility.

Roadworks and the Disabled

In Brian Bonith’s article “Barbican Blues” published in the Jamaica Observer on 1 June 2018, it was reported that the Executive Director of the Jamaica Council for Persons with Disabilities – Dr. Christine Hendericks – had written to the National Works Agency (NWA) on the previous month “ to express her organization’s concern that “the needs of people with disabilities were not taken into consideration” with regard to the Barbican Road Improvement Project.

In response, NWA’s Communication and Customer Services Manager - Steven Shaw – had refuted their concerns stating that “the disabled community’s concerns were taken into consideration before construction” and invited the Jamaica Council for Persons with Disabilities to meet with them on the matter. I have been unable to find any reports whether such a meeting took place and, if it did, whether a resolution was reached.

Nevertheless, these concerns remain relevant as roadworks, such as Constant Springs Road, seem to replicate the same design. Dr. Hendericks was specifically concerned that (i) the median was a challenge to the visually-impaired, and (ii) lips of the sidewalks were too high. Constant Springs roadworks have not progressed to construction of the latter yet, but her observation regarding the medians is still relevant.

Mr. Shaw had responded that crossing Barbican Road would be facilitated at signalized points. However, such points are few on Constant Springs compared to Barbican Road, not to mention the greater number of schools, apartment blocks, public and retail establishments that are located along Constant Springs Road. So, it would seem the matter is even more critical there.

It was Dr. Hendericks’ expressed desire that corrective measures be taken rather than have offending works continue “and then have to knock it down”. It would also be expected that NWA would see this as an opportunity to implement the 2014 Disabilities Act and display the government’s willingness and readiness to be compliant and, in so doing, provide the infrastructure needed for buildings along the roadway to become compliant.