Saturday, February 24, 2018

Gambling on care better than St Ann's


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Health Minister Fuad Khan will likely never feel his hands more full than at the present. Among the challenges of his troubled portfolio loom those entailed in putting into credible operation the new Scarborough Hospital, for which the sod had been turned in 2003.

After more than a decade of planning, hoping and waiting, expectations rise to the extent of seeing in the Scarborough Hospital the bringing of Tobago health care more or less on par with that of Trinidad.

As Dr Khan makes the rounds of his ministry, however, the most immediately pressing concern will be to find out what went wrong with the Cheryl Miller case. The handling of this case went sensationally far beyond medical competence. Sitting on Good Friday, High Court Justice Vashist Kokaram ordered Ms Miller's temporary discharge from the St Ann's Hospital.

"What is the harm in her conditional release," Justice Kokaram asked almost rhetorically. He then ruled on the assumption that the tender loving care of family members could suffice for the patient until her examination by an independent psychiatrist and a further court hearing on Friday.

The judge thereby asserted the rule of law to override the medical assessments of the St Ann's Hospital specialists, who did not even deem Ms Miller fit to attend court on Good Friday.

In this, the court could be regarded as playing to the gallery of a public opinion roused to heights of outrage over the manner by which Ms Miller had been taken from her office and put in hospital. That process by which she was admitted to the psychiatric hospital is indeed impossible to justify in any society with a decent respect for human rights and freedoms.

Once at the hospital, however, doctors deemed her needful of timely specialist care that was presumably not elsewhere available. It is on this factor that Health Minister Dr Khan remains apparently focussed, having noted that "there is much more to the story".

The St Ann's Hospital has been judicially obliged to wash its hands, and yield a patient at least temporarily to the uncertainties of family care. For now, such a ruling implies a second-guessing of the professional judgment exercised by presumably qualified St Ann's specialists.

With the patient placed beyond their reach, where now does ultimate responsibility for the well-being of Ms Miller lie? The Health Minister, a physician and a politician, must be doubly exercised by the outcome headlined as "home free" for someone assessed as needing institutional care.

Matters are now complicated with the entry of politicians such as Fitzgerald Hinds, who has compared media interest in the case to that of "vultures". This is remarkable coming from the notoriously ill-spoken PNM Senator, who has himself made a career of feeding politically on the carcasses of issues both old and dead.