Dear Editor,

I wish to publicly commend Dr. Aggrey Irons on his insightful, precise analysis of some problems in Jamaica’s health services. The points on which he elaborates unequivocally demonstrate the penetrating precision of his psychiatric background. Having worked at the Kingston Public Hospital for many years where my team and I in a 60-bed unit (30 males, 30 females) saw some 15,000 per year at our outpatient clinics and over 700 new admissions per year, I understand fully his references to sub-standard conditions, inadequate remuneration, and working beyond the call of duty to ensure quality medical care. It was all about the unstated cause of national development.

Reflections on my stay at KPH recorded in my book Clinical Embrace – A Mid Century Journey to KPH speaks to many of these points. Aggrey’s reference to racist attitudes, not always daintily disguised, is relevant. The issue of new layers of bureaucracy is also timely. We taxpayers need to be concerned about the cost of these entities, their overall contribution to patient safety – the bottom line – and their impact on efficiency of the process. The public will recall with disquiet the occasion not so long ago when we had no bags in which to store blood for blood transfusion, and bags had to be borrowed from Trinidad.

There was an omission in Aggrey’s analysis – probably due to his innate modesty – namely that our infant mortality rate has been significantly reduced, by all standards in the Anglophone Caribbean, and the life span in Jamaica at over 75 years is better than the USA’s with all their resources. These facts are essentially due to the commitment, dedication and hard work of our doctors, nurses and allied professions.

John AS Hall

Medical Council of Jamaica

2 – 4 King Street

Kingston