Ending the medical clique

PURELY in the public interest, it is essential that the medical profession in Trinidad and Tobago be strictly and continually scrutinised. This function now seems more vital than ever in light of the serious controversies which have erupted concerning doctors who are accused of practising in specialties for which they are not properly qualified. A few weeks ago, in fact, we published excerpts from a letter written by Prof Courtenay Bartholomew to various medical authorities pointing out the malpractice of a private doctor who treated a female patient for HIV/AIDS when the woman did not, in fact, have the virus. This, in our view, was a scandalous case of exploitation of a patient who was not adequately tested and who suffered great personal anguish and major marital problems when her husband became aware of her treatment for the dreaded disease.

The amazing aspect of this episode, however, is the fact that Prof Bartholomew’s letter was written to the Council of the Medical Board of Trinidad and Tobago, among other institutions, six years ago but nothing, absolutely nothing, was ever done about it. This, in our view, amounts to a shocking delinquency on the part of the Council which by law is invested with the responsibility for maintaining the standards of the profession. In light of this case and other serious controversies in which the profession is embroiled, it seems to us that the time has come for the Government to look critically at the membership of the Council and how it is elected with a view to making changes that would modernise the Council, enabling it to better serve both the profession as a whole and the interests of the public.

In this respect, Health Minister Rahael may find it useful and enlightening to examine the changes made to the kindred council in Barbados and current legislation to reform the Jamaica Council where the membership is being widened to include lay persons and representatives of the respective health ministries and the University of the West Indies. In the case of Jamaica, lay members will come from the field of law and accounting together with a consumer rights advocate. By comparison, the Council of the Medical Board of Trinidad and Tobago comprises strictly of doctors appointed by a small proportion of the profession. There are no representatives of the Ministry or the University and no lay persons on it. In our view, this limitation to private doctors on the Council cannot be regarded as a healthy one as it makes for the pursuit of narrow self-interest, nor does it ensure that the public interest is adequately served.

The Medical Council of Jamaica, long seen by critics as a clique that protects its own, has welcomed the proposed legislative changes which have also received bipartisan support in the country’s parliament. According to the Bill to Amend the Medical Act in Jamaica, the Council as it now stands does not adequately serve the general public. “Comprised predominantly of medical practitioners, the interest and concerns of members of the public are not being sufficiently articulated on the Council,” the Bill explains. “It is considered desirable that there be more non-medical persons on the Council who would speak for the public, thereby enabling the Council to be a forum for discussion and debate between doctors and patients.” In light of Prof Bartholomew’s charges and the way it is composed, a similar criticism can be levelled at the Medical Council in TT, that it functions as a self-protecting clique. In the public’s interest, Minister Rahael should see the need for similar changes.