Are the government and opposition satisfied with the quality of medical care offered in Guyana?

Dear Editor,

Further to former President Jagdeo’s very correct suggestion made at Babu John that there should be a discussion of substantive issues facing the nation which need to be addressed by the main protagonists in the upcoming elections, I hope that you will afford space in your column for this modest contribution, which I believe raises an important issue in respect of which a response would be welcome from the powers that be and the powers that want to be.

One service which has received much public attention over the past few years in Guyana is medical care. We have seen new hospitals built and old hospitals refurbished at great cost to taxpayers. Specialty facilities have appeared, most prominent being the ostentatiously named Caribbean Heart Institute, which has received praise for high standards and efficient delivery of service. A great deal of expensive cutting edge medical equipment has been sourced and purchased by the government, permitting dialysis treatment for failing kidneys and precision surgery for failing eyes.

On the other hand, there also appears to be among some doctors, nurses and hospital administrators a callous disregard for the lives and comfort of patients. It seems that not a week goes by when the newspapers are not reporting on the unnecessary and untimely death of an otherwise healthy woman giving birth, or the death of a child as a result of misdiagnosis or improper administration of treatment. The perception is that medical doctors who should qualify only as general practitioners undertake responsibility for procedures beyond the reach of their qualifications and experience, and deaths are reported after procedures which should be run of the mill. When there is a tragedy, a wall of silence goes up in the medical profession. Only a doctor is qualified to assess the medical treatment which has been given and to pronounce on the quality of that treatment and the competence of the doctor administering it. But in Guyana’s small medical community one doctor will not speak out against another. Bereaved family members complain futilely to the media, the hospital, the medical council, the government, and eventually desist.

In some of the private institutions, profit appears to be more important than good medical advice and care. It is whispered in respect of one such institution that the doctors actually receive a commission for patients who consult them and are admitted by them into the hospital. This of course would if true be a highly unethical conflict of interest. Complaints have been made in respect of one hospital that patients receive prescriptions after consulting and paying a doctor, then are told that the prescription will be given to them only at the hospital’s internal pharmacy, and must be filled and the drugs paid for at that pharmacy.

Perhaps the cryptic description of the medical service industry in Guyana provided by the United States Consular advice to citizens states the position best: “Medical care is available for minor medical conditions. Emergency care and hospitalization for major medical illnesses or surgery is limited, because of a lack of appropriately trained specialists, below standard in-hospital care, and poor sanitation.” The result is an overall distrust of medical services offered in Guyana. Those who have no choice endure; those who can afford it, whether with their own money or with taxpayers’, seek treatment abroad.

My questions then to both contestants are:

(1) Are you satisfied with the quality of medical care offered in Guyana and the quality and efficiency of the hospital/clinic administration within which that care is offered?

(2) Are you satisfied with the system of accrediting medical personnel and monitoring continuing education of medical personnel?

(3) Are you satisfied that there is an adequate system of oversight and standardization of private institutions and private medical practitioners?

(4)Are you satisfied that there is an adequate system of inquiry and accountability in the event of medical mishaps?

(5) If you are not satisfied, what shortcomings have you identified and what causes have you deduced led to those shortcomings?

(6) (To the incumbents) What measures have you implemented to ensure the quality of delivery of medical treatment in Guyana both in public and private institutions in terms of items (1) to (4) above?

(7) Have those measures been successful so that the quality of medical care in Guyana is now satisfactory? If not, why have the measures been inadequate?

(8) (To the opposition) What new ideas do you bring to the table to improve shortcomings which you discern exist in the medical field in Guyana? If you perceive that there have been failures, what changes do you propose to alleviate those failures?

Yours faithfully,

Timothy M Jonas