Letters & Opinion

St. Jude and the Art of the Con — Part 8: Under the Microscope or the Proctoscope?

Image of St. Jude Hospital.
Image of David Prescod
By David Prescod

“IT’S the responsibility of the media to examine the President with a microscope, but they go too far when they use a proctoscope.” – President Richard Nixon. (A proctoscope is an instrument for examining the human rectum, that last portion of the intestine ending at the anus.)

This seems to be the fate of St. Jude. Seventeen months after this government terminated the consultant and suspended the hospital’s reconstruction, there is still no formal accusation of fraud in the reconstruction process, while the original issue of the consultants being responsible for the delay in completion of construction has long since been replaced by suggestions of poor design of the facility.

To bolster those newly-found reasons for condemning the hospital, we have witnessed a steady parade of people who have publicly voiced fault with the construction. None of them have, however, indicated how those faults would affect the provision of medical services. These criticisms, though, have only brought into sharp focus the high level of involvement of the board, management and staff of the hospital in the reconstruction process.

The former Chairman of the St. Jude Hospital Board, Percival Mc Donald, has confirmed that a Technical Committee met regularly, and that the choice of reconstruction of the hospital in its original location was arrived at by consensus.

Mc Donald has also confirmed that the plans for the hospital were modified following regular consultation with the staff of St. Jude, and that one such requested revision was for the inclusion of private rooms within a ward area.

Confirmation of staff involvement is also provided by Dr.ChierryPoyotte, then CEO of St. Jude, who, during a visit to the hospital at the stadium site on January 21, 2014, advised that “we have spent a lot of time and effort in terms of reconfiguring the new hospital.” youtube.com/watch?v=rSzFWc-mxmU (1:46 mins).

Confirmation of this is also provided in an interview with the Consultant and the Project Manager hosted by the then SLP government’s press secretary on June 8, 2015, one year before this current crisis was initiated by this UWP government, youtube.com/watch?v=iAdbJk1gsZY: request for private wards by staff, (22:24 mins); staff consultation (36:02 mins.).

Yet, Minister Guy Joseph, referring to his site visit to St. Jude Hospital the previous week when he was accompanied by medical personnel, had this to say during his press conference of April 12, 2017: “I was quite impressed with the input made by the doctors and I couldn’t understand why these people were not engaged from the beginning”, youtube.com/watch?v=mM_nNp4y-Vc (2:59 mins).

So that while much has been made of the demolition and re-erection of partitions in the dialysis building, the cost of doing so for all partitions of a building providing 12 treatment rooms and a common public area would be approximately EC$50,000. This cost is insignificant on a contract for this and other works said to be worth EC$12,000,000, where the allowance for contingencies is likely to be in excess of EC$1,000,000. But much has been made of it.

What the reconstruction process has also brought to the forefront was the necessity for compromise in the design effort. While we hear, then, that rooms and corridors are too small, corridors define room sizes, so that widening of a central corridor also means a narrowing of the rooms on either side of it unless the building footprint is expanded.

The same is to be said for ceilings that are now claimed to be too low, as installing pipework under an existing floor will necessarily lower the ceiling height. The only issues here are: can this lowered height be tolerated? If not, is a ceiling necessary? And if the ceiling is necessary but the lowered height cannot be tolerated, can the pipes be re-routed? Compromise is required.

Yet, according to Minister Joseph at his pre-Cabinet press briefing of September 25, 2017, “the recommendations are, to get St. Jude’s functional, you have to condemn the whole of the bottom floor”, (stlucianewsonline, September 25, 2017). No reasons for this are given by the Minister, neither is this recommendation to be found in the Technical Audit.

With respect to room sizes, guidelines published by the American Institute of Architects Academy of Architecture for Health, together with the Facilities Guidelines Institute, fgiguidelines.org/wp-content/uploads/2015/08/2001guidelines.pdf, allow a minimum clear floor area equivalent to 10’x10’ for private rooms, and 9’x9’ per bed in a ward (Section 7.2.A2). For many people, a 10’x10’ bedroom would be considered a “small room”.

And while much has been made of the issue of accreditation, accreditation of a hospital is mainly concerned with the medical practices and procedures adopted by that facility, not with its room sizes, accreditation.ca/intl-en/accreditation/.

Yet, we continue to see the cultivation of a negative public attitude towards this reconstructed hospital, and in the process the denigration of the service that many people of impeccable integrity have provided to the Project Steering Committee for this hospital.

We wait with great anticipation to see who is going to volunteer for this now inevitable proctological examination when the next crisis hits us.

Next week, we join the search for fraud.

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