Dr Lloyd Goldson ought to be commended for exposing the dangers that some pregnant women and their unborn children faced at the Victoria Jubilee Hospital in Kingston while the institution did not have the right tools to sterilise equipment used in some high risk-deliveries.

Claude Robinson

Instead of praise, he has been hauled over the coals by bureaucrats in health administration although permanent secretary in the Ministry of Health Dr Grace Allen Young insists he has "not been disciplined".

Speaking on Beyond the Headlines (RJR FM-94) Wednesday, the top official in the health ministry said Dr Goldson, consultant obstetrician and gynaecologist, had just been "reminded of the communications policy" that determines who can be "official spokespersons". and he was not one of them.
Dr Allen Young's protestations, notwithstanding the 'reminder' of the protocols governing un-free speech, sound very much like a reprimand to me.

Given the intense media scrutiny of the failures at VJH and the death of one infant at the hospital, I would be very surprised to hear of further disciplinary actions against Dr Goldson, but the incident raised several fundamental questions that should not disappear as just another 'nine-day wonder'.

These questions include the factors behind the death of one infant; the capacity of the facility to deliver the standard of care that health professionals have been accustomed to giving and which patients have come to expect; and the role of 'whistle-blowers' in good governance.

On the first matter, Dr Goldson took the unusual step to turn to the media last weekend to highlight a problem which he said was putting patients at risk.

DR GRACE ALLEN YOUNG... insists that Dr Goldson has not been disciplined

A device called an autoclave, used to sterilise equipment needed to perform critical procedures such as Caesarean sections, had not been working for weeks, thus forcing the daily cancellation of several operations thereby increasing the risks to patients.

The Sunday Observer reported: "In the last six weeks we have cancelled about 60 cases," said Dr Goldson. "On average we do about five of these cases per day. A 41-year-old woman was cancelled on four occasions, it was her first pregnancy and the baby died. It just does not get much worse than that."

At this time, we do not know the cause of death of the baby and the contributing factors. What we know from an official ministry statement is that "doctors pulled a live baby from Carolyn Edwards Brown during a C-Section operation at the VJH on September 11" and the baby "died sometime later".

In a statement Wednesday the ministry said, "Further investigation is therefore being undertaken to determine whether the child died of natural or clinical causes". Noted attorney Ethlyn Norton Coke has been named to head the investigation. No doubt, she will do a thorough, fair job and let the chips fall where they may.

Without prejudice to the investigation, I believe that the inability to have a properly functioning autoclave may very well be a reflection of the stress and strain under which the country's social services and infrastructure have to bear in a very tight budget.

After paying salaries of health workers, teachers, police officers and civil servants, many agencies and departments have very little money left to buy basic materials, to fix and replace worn-out equipment.

The malfunctioning autoclave may just be a symptom of the 'autoclaps' ahead when the just-concluded and forthcoming public sector wage increases take effect.

WHISTLE-BLOWERS AND ACCOUNTABILITY

Dr Goldson's decision to go public is part of what is emerging in some parts of the world as whistle-blowing in which persons, acting in good faith and in the public interest, go against the grain and bring matters to light that their colleagues and employers in governments and corporations would prefer to have hidden from public view.

Whistle-blowing is a very controversial idea, generating strong feelings on both sides of the issue. Some see whistle-blowers as selfless individuals driven only to protect the public interest and ensure that organisations, both government and corporate, are held accountable. Others see them as 'snitches' or as we say in Jamaica 'informers' motivated only by personal notoriety and fame.

One of the celebrated whistle-blowers, of the modern era was Daniel Ellsberg - a former State Department analyst who leaked the Pentagon Papers in 1971, a secret account of the Vietnam War and its pretexts to The New York Times. The papers revealed endemic practices of deception about the justification for the war and contributed to the erosion of public support for the war.

More recently, we have seen where managers of corporations have blown the whistle on former colleagues who had strayed from the rails of public probity. That list includes Cynthia Cooper of Worldcom and Sherron Watkins on Enron, who exposed corporate financial scandals at those entities, leading to convictions of some of the firm's principals.

Governments and corporations generally do not like whistle-blowers but under pressure from advocates for good governance a growing number of countries are adopting legislation to protect whistle-blowers, who acted in the public interest, from retaliation and retribution.

Those who study these matters say the laws contribute to good governance, but at the same time, they say corporations or government agencies accused of misconduct still retain the age- old "shoot the messenger" mentality.
There have also been many cases where whistle-blowers have been subjected to criminal prosecution in reprisal for reporting wrongdoing.

Should we have a whistle-blower protection law in Jamaica? The issue is important in a country like ours that goes against two ingrained traditions, namely the Official Secrets Act, which is sworn to keep government activities hidden from the people, and the culture of 'informer fi dead'.
Carolyn Gomes of Jamaicans for Justice and Wayne Jones of the Civil Service Association (speaking on Beyond the Headlines Wednesday) favour such a law, but believe it's not likely to happen soon.

I believe too it is something we should strive for as we continue to strengthen the democracy we have been developing in the last 50 years or so, despite all the difficulties.

Some people will be tempted to use a whistle-blower protection act as an opportunity for grandstanding, but they would be quickly exposed by a vigilant media and discerning public. In any event, their potential for harm would be outweighed by the good that would accrue from those who genuinely seek to protect the public interest.

We have a vigorous and vibrant Press. We continue to move towards a culture of openness with the Access to Information Act which allowed the media to get information on issues ranging from the prime minister's travel expenses and attendance of ministers at Cabinet meetings to various decisions of public bodies.

For the period January 2004 to March 2006, a total of 1,014 applications for information were submitted to government departments. Of these 478 (47%) were granted while only a miniscule 18 cases (2%) were denied, the Gleaner reported Thursday, a day celebrated globally as access to information day.
According to the ATI Advisory Stakeholders Committee, Jamaica's performance with the ATI "has been similar to, and in some instances better than, the performance of other countries" in the first two years.

These are important steps towards more open and accountable governance. The next steps should be to reduce the exemptions to the ATI; the repeal of the Official Secrets Act; and introduction of a 'whistle-blower's act' that would protect individuals who reveal information in the public interest even if these persons break the rules in doing so.

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