EULALEE THOMPSON
NOBODY IN Jamaica bothers to collect data on medical errors or adverse medical events. At least, not the Ministry of Health nor the Medical Council. So there is no way to measure the nature and scale of bad outcomes of care.
The Health Ministry said "no such data is stored". Then, this is the Medical Council's take on the matter:
"We act based on complaints. In all circumstances we approach the doctors concerned ... We don't have any formal thing. We operate based on the people who complain. We write to the doctors, decide whether the doctor is at fault (or if there is) mismanagement. We can rule against the doctor and in which case, it's up to the victim to take it further," said Dr. John McHardy, registrar, Medical Council.
Not entirely surprising, the Medical Council has admitted in the press that 50 per cent of the doctors on its register are not licensed to practise, in other words have not paid their yearly fees in order to lawfully practise, as required under the Medical (Amendment) Act, 2004. However, these doctors continue to practise and see patients undisturbed. Even more, the Council doesn't see it fit to publish the names of licensed practitioners in a place where the man-in-the-street can make informed health care choices.
The main issue is really about patient safety and the proper functioning of systems created to protect the public's interest.
The Pan American Health Organisation (PAHO) states that there is an enormous worldwide human toll as a result of failures in patient safety. About 10 per cent of patients in industrialised countries suffer because of preventable events. Medical errors in the U.S. cause more deaths each year than breast cancer, car accidents or AIDS, according to a 1999 study by the Institute of Medicine; in the United Kingdom one in 10 patients suffers an adverse event while hospitalised; in Australia, New Zealand and Canada, the rate is about 16.6 per cent. Even with inadequate data collection in developing regions, the World Health Organisation (WHO) estimates that the risk of health care-associated infection is two to 20 times higher in developing than in developed countries.
To promote patient safety, there should be clear policies and procedures for addressing medical errors such as this very transparent policy issued by the (U.S.) Harvard Hospital and available on their website:
"Medical care must be patient-centred. In the aftermath of an incident, the primary objective must be to support the patient and maintain the healing relationship. Patients and families are entitled to know the details of incidents and their implications. Communication should be open, timely, and sustained. We must eliminate the adversarial relationship that a secretive, liability-focused approach to patient communication fosters. The caregiver's role is to provide comfort and support and to consider the full breadth of patients' needs".
Then there are clear guidelines to follow in cases of medical errors:
" A serious incident should trigger a cascade of responses. The first concern should be to minimise further harm to the patient and relieve suffering. Next, to protect evidence, institutions should immediately secure implicated drugs, equipment, and records. Members of the health care team and appropriate administrative and clinical leadership need to learn of the event promptly.
" As soon as possible, the patient and family should learn of the event and the facts as initially known. They will likely need emotional and psychological support, and this should arrive seamlessly. Finally, the medical record should document clearly all these actions. Caregivers may also require support, depending on the type of event."
Please send your feedback to eulalee.thompson@gleanerjm.com.
