Medpoint Clinic: Was technical advice disregarded?

By TP Saran

In the continuing saga of the Medpoint clinic, the Leader of the Opposition has commented in a press conference that the advice of medical consultants was not taken into consideration, reason enough for him that the incumbent Minister of Health should resign, or at least step down until the ICAC enquiry is on.

Clearly in this case, nothing has been produced officially so far to prove indubitably to the public that the decision to buy the clinic for the purpose of setting up a National Geriatric Hospital was based on a solid rationale, and the prime person who must bear the responsibility is the head of the ministry, namely the Minister of Health.

As lay citizens we are not in the secret of the gods, but we are sufficiently informed, given the various portals available nowadays, that we can raise some pertinent issues with the help of the information at our disposal and a bit of common sense. In a recent matter that was publicly aired in the UK recently, the question was asked whether ‘ideology should drive policy?’ The conclusion reached was ‘No’. Policy should be based on sound evidence.

Our view is that government, which is basically the emanation of a political process, is perfectly entitled to conceive of a project for ideological reasons. Thus, if such was the case as regards a National Geriatric Hospital, it is acceptable. However, one does not need to be a genius to appreciate that a hospital is a highly complex organisation, of a highly specific technical nature. And the narrower the focus – geriatrics, in this instance – the more complex the technicalities and the more specific the requirements. Which means that, even if the government has announced such a project in its programme, the logical thing is for the Minister of Health to have it considered by the appropriate technical entity in that ministry, and appraise the Cabinet of the recommendations of that committee. And we presume that that is what both the Prime Minister and the Cabinet would expect to be done.

That is what ministers are for: not only to merely execute, but to advise on the feasibility of projects within their field. The starting point would have been a needs analysis, for which methodologies exist. Alternatively, technicians with experience are there to look into the subject and, given their grounding in the local context, it goes without saying that careful attention must be given to what they have to say. And the medical consultants did have very cogent arguments that were not in favour of a centralized hospital for the geriatric population.

Without waiting to be served on a platter, the Minister concerned should have requested for all the information available in the ministry on this dossier, held further discussions as needed and in particular listen to the experts, and then report formally to the Cabinet. It is difficult to imagine that a Cabinet in which sits several doctors and which is headed by a doctor would have failed to take on board the views of the experts concerned provided these views were brought before the Cabinet in the first place!

It does not seem that this was done.

What is interesting is that there seems to be a convergence of opinion on the part of the public and medical practitioners who are not in the Public Service to the effect that a centralized geriatric facility will not best serve the needs of this segment of the population, thus supporting the position of the medical consultants who obviously reached their conclusions and made their recommendations on professional and scientific grounds.

Is the Medpoint clinic a case of opportunities missed? Can it still be salvaged, as something other, perhaps more appropriate than a geriatric hospital? We do not think it is too late to get an enlightened and forward-looking technical input in this regard, so that best use will be made of taxpayers’ money, without going into unsustainable further expenses.

In summary: let evidence, and not ideology, drive policy.

* Published in print edition on 18 February 2011