A bureaucracy in disarray?

First Published: 2005-12-24

Dear Sir,

I empathize with the remarks of Trade and Industry Minister Leslie Miller in Parliament recently regarding the murder of his young son in 2002.

It appears that over three years later, the Attorney General's Office has made no progress with the investigation into this murder. Indeed it is rumoured that the files have disappeared, and the authorities seem to have no response.

Mr. Miller is not the only person subjected to the AG's apparent inefficiency. The Minister of Health is also waiting on the Attorney General's Office. Dr. Marcus Bethel has been served with an appeal from a decision of the Hospital and Health Care Facilities Board (the Board), and waits for advice from the AG's office to respond.

The Board licenses private hospitals and medical clinics (health care facilities). A Complaint was submitted to that Board concerning the death of Christopher Esfakis on April 22, 2002 in a local hospital. The Complaint (brought under the Hospital and Health Care Facilities Act) alleges deficiencies in the "management, diagnosis or treatment" of Mr. Esfakis allegedly causing his death. The Board has recently determined that it has no responsibility for "case management issues" although the Hospital and Health Care Facilities Act gives it that function.

It appears that the Board (the majority of whom are doctors) exercised its judgement without regard to the hospital records, the autopsy, or its statutory duty. By what criteria then, did the Board, exercise its discretion?

If it is not the duty of the Board to investigate a complaint relating to the "management, diagnosis or treatment of a patient" then what purpose does it serve? If the Board abdicates its duty to investigate a Complaint, of what use are the standards required by regulation? The Board renders itself useless when it refuses to determine whether hospital treatment meets the standard for "appropriate care" and its regulations thereby meaningless.

And hospital fatalities appear not to be reported to the Chief Medical Officer. Although this is a criminal offence, the Attorney General's Office takes no action. As long as a health care facility is safe from the lame arm of law, its patients remain at risk.

In the interim, the Board receives fees from the facilities it licenses. But it appears that there has never been an accounting to Parliament of the fees collected.

The British require accountability from their health care professionals. London lawyers advising on this matter ask why there has been no inquest. The question is partly answered by the predicament of the recently appointed coroner, who still has a substantial calendar of criminal cases to complete.

This is a serious administrative failure, in a country that reports unnatural deaths on a weekly basis. The backlog of cases will only accumulate.

Is Leslie Miller justifiably outraged? If so, he is not alone. The mail boat collision victims, jet ski and motorboat victims, road victims, and hospital casualties, must empathize with Mr. Miller's outrage. We pay dearly for Parliament to pass laws for our protection. We pay for the Attorney General's Office, the Police Force, the Justice system, the Port Authority and the Hospital Board to enforce the law. Are we getting what we pay for?

In some cases, it appears not. The silence of the relevant authorities in the face of these casualties looks like indifference, or worse, complicity in the casualties themselves. These casualties reflect that we have become a reckless nation. The ineffectiveness of the authorities show that we are becoming a lawless nation.

The first and most basic function of Government is to uphold the laws aimed at protecting citizens and residents from physical harm: whether by assault, murder, dangerous driving, unsafe operation of marine craft, or the failure of a hospital to deliver appropriate care. A government that fails to carry out this basic function, forfeits its right to govern.

We have been independent for 32 years. But do we have sufficient self- respect to uphold our national institutions? Do our authorities have the wisdom and the will to govern by principle and not politics?

We are quick to blame God for tragic losses. But if we are slow to even investigate those actually implicated in those casualties, we can count on more.

What best distinguishes progressive nations from third world nations is accountability. We are only credible as a nation if our democratic institutions function as intended: to make our inhabitants, politicians, CEOs, and even professionals, accountable according to the law.

It will be truly better in the Bahamas, if only we follow through: if our authorities find the courage to do what duty requires and integrity demands: to carry out their functions without fear or favour.


Leandra Esfakis

November 28, 2005

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