There is a species of unfairness that is part of the culture of public discourse in Jamaica, and it manifests itself in how those who question the Government of the day are treated. When one party is in power, those who ask questions are labelled as hacks and ‘bad-minded’, but when similar questions are asked by others when the other party is in power, they are described as being objective and patriotic.

This particular tendency dates back decades. I recall one journalist asking the late Wilmot “Motty” Perkins who — in addition to Perkins — qualifies as a serious journalist. He named Dionne Jackson-Miller. Described as a terrier, no government minister could expect to face Jackson-Miller or Motty and have an easy ride. Things have changed, but not for the better.

It is in this context that the public discourse on Cornwal Regional Hospital (CRH) must be viewed.

The days of Ferguson

During the unforgettable dead babies’ saga of 2015 — which the media labelled a scandal — then Minister of Health Fenton Ferguson was put to the sword. Even after he was removed as minister of health those who wanted his head were not satisfied. The then prime minister was accused of being complicit in what was being characterised by many in the media as a sordid affair. To complicate matters, Ferguson misspoke by saying that preterm babies “were not babies in a real sense”. The then Opposition had their man, and the media happily played along.

Preterm babes are those born after less than 37 weeks of gestation. These babies account for about 28 per cent (almost three in 10) of all early neonatal deaths, according to the World Bank. In essence, deaths of preterm babies are not unusual, and the rate of 28 per cent excludes those born with congenital malformations or birth defects, such as organs not being fully developed.

The World Health Organization estimates that in developing countries, such as Jamaica, preterm births are in excess of seven per cent of live births. A 2015 publication of World Prematurity Day indicates that Jamaica’s preterm birth rate was 10.2 per cent. The annual average number of births over the previous 10 years was about 40,000. This means that there would have been about 4,000 preterm births each year. Neonatal deaths in Jamaica were reported at 522 in 2016, according to a World Bank report. The current rate is 10.9 per 1,000 — down from the high 27 per cent in 1967 and average of 14 per cent in the 1990s.

A Gleaner news report of November 20, 2016 showed that between January and September 2016 there were 112 neonatal deaths at the Victoria Jubilee Hospital, but only four were as a result of infections. There was some dispute, however, as to whether the figure of 112 was correct — some sources insisted there were more than 112 deaths.

At the height of the Ferguson ‘lynching’, an October 2015 story in The Guardian newspaper begun as follows: “Jamaican authorities are struggling to cope with a hospital infection which has killed 18 babies in three months…” This was in relation to the University Hospital of the West Indies.

Using the 28 per cent, which the World Bank says is the percentage of neonatal deaths accounted for by preterm births, there would be an average of 140 preterm deaths per year in the last few years. The larger point being made is that death of preterm babies and other neonates is a part of the reality of health care, but happily there have been reductions in the mortality rate. While efforts at prevention must continue, deaths will occur, and while some deaths are preventable, and some are due to unclean surroundings, even in clean surroundings deaths will occur. But few considered these facts in 2015 when Ferguson was being put to the sword.

The days of Tufton

Today we have a hospital facility which the technocrats said poses a serious health risk to staff and patients such that they recommended evacuation. Add to that the decision of the minister to reject the advice of his senior technical people. Add further the fact that the minister then received a report from another set of experts stating unequivocally that the building had cancer-causing agents. The minister sat on that report for a year. Throw in the minister’s attempt to belittle — as “playing politics” — the efforts by his opposing number to expose the facts. Top off all of that with the fact that over 100 nurses, doctors and other employees have reported serious illnesses. Where are the voices of consternation and condemnation?

The same media practitioners who took Ferguson to the gallows are largely still in place. The only real change is that the parties have changed seats in Gordon House, but few are calling for truth-telling, factual analysis, and accountability. Death of preterm babies is a global phenomenon, but a death-causing hospital building is not.

I listened an interview between Jackson-Miller and Opposition spokesman on health Dr Dayton Campbell a few weeks ago and I concluded that she holds the view that Tufton had good reason for not evacuating the hospital in February 2017. Her reasoning was that, although the technocrats had made the recommendation, since the Pan American Health Organization (PAHO) report did not recommend closure the minister was understandably in a place of uncertainty. But the flaw in that argument — as Campbell was at pains to point out — was that Tufton received the PAHO report in April 2017, some eight weeks after the ministry’s technocrats had made their recommendation. Thus, Tufton acted on his own counter advice for several weeks.

But it becomes more mind-boggling. The minister not only sought the advice of the attorney general — in a matter in which such involvement was completely irrelevant — and then got bad advice, the minister stated that PAHO gave him verbal advice that he needed not close the facility. When PAHO finally gave their written report in April 2017 they predicated their advice on the predetermination that the facility cannot be closed. So we have to ask, what kind of health expert, or health organisation, would be aware of the reported agents present in the hospital and not recommend its closure?

In the end an evacuation — that was deemed unworkable in 2017 — was effected a year later after hundreds of people would have been exposed to the agents.

Rather than getting a hard-hitting public interview of the minister, the largely biased media have not only been treating the minister with kid gloves, some have gone to bat for him and are treating with subtle disdain those who are seeking to hold him accountable. These are the same practitioners who poured scorn and ridicule on Ferguson. This kind of double standard is not only painfully unreasonable, it is bad for the country.

Independent commission needed

I am not of the view that this bungling is to be laid at the feet of Tufton only. I refuse to believe that the Cabinet, and more specifically the prime minister, was unaware of what was happening. If the prime minister did not take an interest in the matter in 2016 to 2017 he would have been derelict in his responsibilities to babies and adults, healthy and sick, at the CRH. If the prime minister had been duly briefed on the matter from back in 2016 into early 2017, and specifically of the recommendations of the ministry’s technocrats, and later of the PAHO report, and did not instruct the minister of health to move to address the matter, he, too, would be even more derelict in his duties to protect the people of this country.

So, unlike many others, I am not calling for Tufton to resign, I am urging the Private Sector Organisation of Jamaica, Medical Association of Jamaica, Nurses’ Association of Jamaica, Jamaica Medical Doctors’ Association, the trade unions, the Church, the universities, and all concerned citizens to call for the establishment of an independent commission of inquiry to look into what went down at CRH. Among the terms of reference of this commission should be: To inquire into when Cabinet was made aware of full circumstances at the hospital and what actions it took or ordered to be taken at the time it became aware.

Perhaps, unsurprisingly, Minister Tufton will be of the view that the call for a commission is political. He may propose, instead, a qualitative study spanning decades to inquire into what factors led to the breakdown in the maintenance of the hospital. Conveniently, this study would cross several political administrations. But we do not need such a study, as we know that the reason for this is that the health system was underfunded due in part to the reckless notion of free health care. What is most needed at this point is to establish what actions were taken by the Government at the critical point at which, for the first time, the building was found to have agents that could result in cancer, or more so deaths.

Dr Canute Thompson is head of the Caribbean Centre for Educational Planning, lecturer in the School of Education, and co-founder and chief consultant for the Caribbean Leadership Re-Imagination Initiative, at The University of the West Indies, Mona. He is also author of three books and several articles on leadership. Send comments to the Observer or canutethompson1@gmail.com.