Needed – a regime of care consistent with the value we place on lives

A powerful letter penned with skill, patriotism, and a profound love of humanity by Oscar Allen, who died at the Milton Cato Memorial Hospital (MCMH) on July 28, has provoked an ongoing debate about the regime of care offered at that institution. 

With the exception of pregnant women who go to the hospital to bring life into this world, everyone else goes to the hospital seeking therapeutic relief from injury or illness; and although the vast majority leave having obtained relief, some will surely die.

In a time of such great loss, no family member should be expected to rationalize the circumstances leading to the deaths of their loved ones. In their grief, they require the comfort of their communities, not the calculus of clinicians, health care experts and politicians. But it is also undeniably true that to relieve future suffering and prolong future lives, we need to identify the causes of morbidity and mortality both within and beyond the MCMH and implement a regime of care consistent with the value and dignity we place on our lives.

Nothing better illustrates the value we place on our lives than the budgetary choices we make. Our hospital is perennially short of money to meet recurrent expenses – medications, supplies – and of course to attract critical specialist personnel. And whereas it is undeniably true that the hospital has never been more strongly resourced (including 211 beds, 89 doctors across 20 specialities, and 202 nurses) it is also true that government spending across our entire health care sector comprises only 10.5 pe rcent of the national budget. 

The MCMH is in fact the crown jewel in our constellation of publicly funded health facilities. None of the 39 health clinics, one polyclinic, or the five district hospitals can offer the range of care available at the MCMH.  Hence, if a lack of resources results in clinical deficiencies or failures at the MCMH, it undercuts the vitality of the entire pyramid of health facilities which we have constructed. 

The Government must therefore increase health care funding at the MCMH, consistent with the expectations of the Vincentian population. That might very well mean giving reduced funding to other areas of governance. It might mean more strictly enforcing collection of the modest fees charged to its patients, many of whom are fee-exempt. And it should certainly mean that wastage and pilferage be reduced to as low a level as possible and that doctors who use the MCMH’s facilities for their private clients pay reasonable fees to the institution. If the MCMH is the cornerstone of our health system, the funding directed to the hospital must reflect that value.

We rely, of course, on our medical experts to exercise their best medical judgment in the treatment of the multiple pathologies that come before them. But we do need to bring attention to the centrality of cohesion in the delivery of care to our patients. If a doctor makes a mistake, a patient may die. If a nurse makes a mistake, a patient may die. If a lab or x-ray technician refuses to honour his/her call within the appropriate time, a patient may die. Just one error by one person and the entire fabric of care disintegrates and patients suffer.

It is, therefore, absolutely crucial that the hospital constructs and maintains administrative protocols and supervision that can quickly respond to systemic challenges. The MCMH is an asset of the greatest national import. It is our responsibility to protect it, for our very lives depend on it.