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Balancing the scale
THE public outrage over the death of baby Luke is understandable. The instinctive reaction is to blame someone. And, ultimately, someone must accept blame.
When I dubbed this a case of institutional murder, however, I had in mind the fact that the issue was larger than the negligence or incompetence of one individual. It was a continuous, systematic and procedural failure that could be caused only by poor management and policies.
I received an e-mail this week that sought to give a balanced view from the other side:
“Dear sir, I am writing with regards to my own opinion about this tragic issue.
I am a medical doctor (a children’s one at that, too.) I have worked at the Eric Williams Medical Sciences Complex (EWMSC) in the past as an employee in the paediatric A&E department, and since then been to the UK and now (I have) returned to try and play my own part in building our nation and improving the lot of our people.
So that there must be no misunderstanding of the intention of my message, let it be stated categorically that:
This is a very unfortunate and tragic event. My condolences go to the family. I would appreciate if you let them know that persons (including a doctor) have expressed this via this medium.
There is no doubting this fact, and there must be no attempt to trivialise or cover it up at all.
That a wrong diagnosis resulted in the end point of the death of this child must not be denied.
That the right diagnosis at the time of the Monday night visit would have made a difference in the outcome—we can ask that question forever and never answer it with certainty.
Still, this cannot reduce the dreadful impact of this event on the family involved. The hope that goes with ‘what if’ can never materialise.
During my time in the A&E in EWMSC Paediatric Department, we were exceedingly short-staffed.
We worked eight persons per day—three from 8 am to 4 pm, three from 4 pm to midnight and two from midnight to 8 am—eight-hour shifts, and frequently through our lunch time (I recall holding a sandwich with my left hand and sitting to write a patient’s notes with my right).
Those days we attended to about 200 before midnight and about ten-12 overnight (six persons multiplied by eight hours multiplied by two day-time shifts per day equals 96 person hours). Ninety-six person hours to attend to about 200 patients—a patient in 30 minutes, assuming each patient had only to be attended to once and not reviewed!
The A&E in EWMSC is now (slightly) better-staffed, but the fact remains that the staff there work under very trying circumstances.
(Compared to the UK, the word ‘under-resourced’ is a bad joke), patients walking past the door and staring in, persons knocking on the door and interrupting a consultation asking, ‘I here for — number of hours! All yuh know when I am going to be seen?’
The sound of a patient cussing and threatening to beat somebody up if they are not attended to “now” is all too common.
The picture I am hoping to paint is that this is a stressful area of work, but we all have, within our chosen field of work, stresses to overcome!
It can be very busy, especially Monday 8 am to midnight (add 50 patients to the figure above).
My point: I do not know the young doctor involved. I now, like half of Trinidad, know only her name. She has been subject to stress and threats to her life and well-being.
The girl has reportedly shed more buckets of tears than ought to be due to someone. I feel the last statement is meant to underline my feeling that this individual recognises that an error in judgment has had dire consequences, but she is a human being.
She is subject to errors in her judgment. She is a junior doctor working in a stressful environment. She did not go out to work with an intention to slaughter, before shift’s end, some innocent child.
I respect your efforts at seeking redress/justice on behalf of this family. I hope I am not being seen here as trying to interfere with that process.
I would recognise that whatever form of justice that is extracted or dispensed is not going to reverse this tragedy. It shall unfortunately not bring this baby back to his family.
Address the shortcomings of the system as you have pointed out.”
By Anand Ramlogan 2008-03-23
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The doctor who wrote these comments should be severely disciplined or sacked! Sure enough, I'll be Mr Unpopular in T&T from today onwards.
The Ministry of Health and Mt. Hope hospital will do well to hunt down at least two doctors who feel they are at liberty to breach patient and employer confidentiality. If there was never discipline in the medical profession in T&T now is the time to crack the whip! Oh now dey want tuh know how to find the doctor. I'll give it to you plonkers out there, who should be doing this.
Here it is:
But on Monkey Island dey go claim dey eh have dee resources, time, money, legal process etc etc etc etc. Basically dey blasted lazy no ass! Allyuh lucky I wasn' runnin' dat country because all de blasted corruption allyuh like woulda been flushed out a'ready!
I am disappointed that Anand Ramlogan has opted to use this doctor's apparent breach of medical ethics and code of conduct to gain some kind of attention to this matter. But I expect popular opinion in T&T to prevail and differ to mine. I have good reason to think that the breaches I alluded to above were unauthorised, and possibly illegal.
Now that the doctor's comments are in the public domain I need to take issue with their substance and form.
"There is no doubting this fact, and there must be no attempt to trivialise or cover it up at all." Fair comment because it applies to all such situations.
"That a wrong diagnosis resulted in the end point of the death of this child must not be denied." - This points to a lack of medical training and awareness of legal consequences. Why? Firstly, from a legal standpoint the opinion has the quality of defining 'legal causation'. Was this doctor privy to all known facts and was so authorised to make such an opinion? I have very reasonable doubts from the overall wording of the email that s/he did not have such information and authority. Medically, the doctor asserts that 'wrong diagnosis' was the 'thing' leading to death. This is a reckless statement in the context of the email or parts of it that are quoted. It might be a statement that the public will like but it is not for that doctor to make such an assertion. Reckless because it demonstrates no consideration of the several other factors that need to be excluded in finding 'causation' in a case like that.
And just for clarity, the supposed doctor was not cautious or skilled enough to make a different kind of statement i.e. 'If it was found from a thorough investigation that wrongful diagnosis was causally linked to the child's death, that fact should not be withheld or covered up.' Will monkeys afflcted with Monkey Island attitudes spot the difference? I don't expect so.
"That the right diagnosis at the time of the Monday night visit would have made a difference in the outcome—we can ask that question forever and never answer it with certainty." This is more high-calibre garbage! Why? Because having made a very conclusive statement on 'wrong diagnosis' resulting in death - s/he then jumps on the fence to assert lack of certainty. But even jumping on the fence is a stupid act, demonstrating lack of medical expertise and training. The question of inaccurate diagnosis is a matter for the investigating authorities to focus on or for an invited expert to comment on. And it is for them to determine whether and to what degree inaccurate diagnosis contributed to the child's death - not for one individual doctor sharing an email with Anand Ramlogan to decide upon.
The picture I am hoping to paint is that this is a stressful area of work, but we all have, within our chosen field of work, stresses to overcome! So what? If stress isn't a factor or one to be dealt with why mention it.
It can be very busy, especially Monday 8 am to midnight (add 50 patients to the figure above). This is the same story the world over.
My point: I do not know the young doctor involved. I now, like half of Trinidad, know only her name. She has been subject to stress and threats to her life and well-being. And? Like what pray tell, is the relevance of this ? It is what happens in a banana republic.
"The girl has reportedly shed more buckets of tears than ought to be due to someone. I feel the last statement is meant to underline my feeling that this individual recognises that an error in judgment has had dire consequences, but she is a human being." The "girl". Oh puhleese. Now she's a 'girl'. Like should we be referring to young male doctors like "dee boy". She is a big blasted woman - a doctor - for Christ's sake! Yes I feel sorry for her predicament, but such terminology like 'girl' - look, just give me a break. This kind of wording is to introduce her perhaps young(er) feminine role and to display some sympathy with that. Utterly irrelevant. All doctors (male, female or other) in the same situation will have recognised their lack of judgement or error - when somebody 'dead'. 'Human being'? So what? As far as I know all doctors are human beings. So what's the relevance of that? The wording is to introduce inappropriately some degree of sympathy and excuse-making for this doctor. Again the doctor who is making these statements about another doctor demonstrates little appreciation for the special medical and legal duties doctors have to patients. I have no doubt that other doctors in their large numbers in T&T will find sympathy with the captioned views. Their sympathy is born of a lack of appreciation of the issues relevant to the tort of negligence.
"She is subject to errors in her judgment. She is a junior doctor working in a stressful environment. She did not go out to work with an intention to slaughter, before shift’s end, some innocent child." - This is such an inept statement it is shocking. Errors of judgement in medical and legal terms is not the core issue. All doctors, pilots, lawyers, teachers etc make errors of judgement. So what? Why is this proferred at all? In the context of the whole sentence it is meant to excuse the doctor in question. Intention to slaughter? What utter drivel? Totally irrelevant. The poor chap or chappess blunders onto the mens rea for murder. Bull in a China shop comes to mind - or just plain bull! Is it his/her business to make such a confident statement about another's intentions or lack of it? No! But this is the Trini mentality - 'I go say w'at ah want!'
But note also that the statement about 'lack of intention' etc is made in the context of the preceding comments about poor resources, overwork and stress etc. This is really to create an impression of pardonable mistake - which it isn't for the commenting doctor to do. None of his/her business - whatsoever to comment upon - especially to Anand Ramlogan. But on Monkey Island there is such a culturally acceptable blur of all boundaries that you get a sense that you could say what you want whey you want - "..man is a free country..who dee hell is you tuh tell we w'at to do and w'at tuh say!" - eh?
"I would recognise that whatever form of justice that is extracted or dispensed is not going to reverse this tragedy. It shall unfortunately not bring this baby back to his family." Stating the obvious - but more important is 'why?' - in the context of the whole email. In reality the commenting doctor is of the 'There but for the grace of God go I' - so 'I should not be too harsh, because the way the system is, I could be there too in few weeks or months' - kind of attitude.
"..Address the shortcomings of the system as you have pointed out." And this last statement really cuts to the doctor's apparent lack of understanding of the whole fiasco and the role of lawyers in this. Oooh...so let's see Anand Ramlogan is meant to address the short-comings of the system whilst his clients have been served a 'very dirty unpalatable dish'. Well, I sincerely hope that is not the main role of lawyers in T&T in cases like these. I would have imagined the role would be more client orientated i.e. suing the health authority dry! Large organisations that run health services don't seem to feel anything other than pain resulting from unexpected big financial beatings. Whilst money never brings back lives - the matter of compensation is of the utmost importance! Any beneficial secondary effects for health systems from such legal sting is a bonus. If dey have 400M to throw around on private jet dey could throw a few million to compensate the Marshalls - and to improve the blasted health services in T&T.
Balanced view from the other side? Look nah Anand, it appears that when an unskilled, misguided and possibly illegal viewpoint is proffered it may not be recognised as such. I'm now deeply worried that if such piss poor medical viewpoints are floating around T&T, the Marshall's are in danger of not receiving the full justice they deserve.
Declaration: I have not implied that Anand Ramlogan gave support to the doctor's opinions. I acknowledge that he reported on a doctor's opinion that "sought to give a balanced view". I took issue primarily with the doctor's opinion, whilst disagreeing with Anand on a single point that the opinion, whatever it's quality and motives, should not have been distributed to the public.
As you know Captain, the UK has a 'whistleblowers' act whereby employees can comment about employers or employment practices under certain circumstances. Employers even tell their employees about this act.
Perhaps, giving that this doctor worked in the UK, he thinks that he is allowed such a freedom in Trinidad. Especially since he might have had expectations that Anand would keep his emails and correspondence private.
Are we seeing Anand as a Monkey Island lawyer who might bend if not break rules to suit his purposes?
The 'certain circumstances' are rather restrictive as regards the so-called 'whistleblowers act' which is correctly, The Public Disclosure Act 1998. This a most misunderstood piece of law in the UK - it isn't permission to blow the whistle. Rather it makes potential whilstleblowers jump through several narrow hoops i.e. no carte blanche. I have personal experience of studying the legislation in question with a view to using it.
It provides certain protections against dismissal etc. However, most would-be whislteblowers are worn out by jumping through hoops - so in the end only the most determined and the most serious cases reach the 'public'. Employers are obliged to inform employees in the UK about their rights under the Act and refer to the Act in employment contracts.
I thought I should explain that in very brief summary so there is no apparent confusion about what this doctor did i.e. whether the doctor thought he had such freedoms in T&T.
Assuming for the moment the doctor believed he had UK rights in T&T - he would have demonstrated what a fool he truly is. UK law and rights are not applicable in T&T - fullstop. T&T is a separate sovereign Nation.
What the doctor did is more likely to be an act of bungling stupidity.
Interesting that you speculated that he might have had expectations that Anand would keep his confidence. One could imagine that the doctor was a close associate or friend of Anand. Would an average doctor in T&T, who is not on close confiding terms with Anand take such a chance? I don't think so.
Two possibilities arise even if remote:
The latter seems more probable to me. I think you could figure it out, that if the doctor had made such a disclosure to me - his ass would have been finely chopped grass. I wasn't going to stand for that shit.
The question you ask, could well be taken as a rhetorical one by a proportion of people - in the context of the whole matter. I make no such assumption.
Anand may gain popular support among those who are oblivious to the seriousness of the disclosure. However, I don't think Anand did himself any favours among a crowd that knows the intricacies of these matters. Anand's commentary of this week did not appear well thought out - and reminds me of the commentary of 25th March 2007 'Plotting for Panday' where he put Panday on high pedestal almost reaching the heavens i.e. "..virtually incorruptible. His personality and traits have no leaning towards materialism and ostentation, and his primary concern and love is politics."
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Balancing the scale has been long overdue and well past due.!
...In saying so, I must commend Anand for his past successes in standing up for the poor and down-trodden in this very wealthy nation of ours, but devoid of "human compassion" and so lacking in real leadership, from the very highest office in the land and trickles right down to the Prime Minister and his Cabinet and Ministers, to heavily influence his Administration completely, with no exceptions.
...The real problem I have with this issue is what tools are there available to the public to "balance the scales" while holding someone, be they Government Ministers or CEO's or Administrators of their respective Ministries or Crown Corporations and Institutions, personally responsible and accountable when horrible and preventable situations like these occur...!
...without getting into the details of the case, as I am not priviledged to "all the facts" except for what was reported in the media, I am sure with time, the full story will infold and reveal itself, especially if it goes on to trial in a court of law....!
...I feel certain that the majority of our people feel that an injustice was perpetrated on the child and the parents, and would have no problems in seeing some kind of "monetary awards" given to them in an attempt to compensate them for this tragedy...
...but this is where the "problem" lie. It is the "taxpayers" who are forking out their monies to compensate for those who should be held personally responsible and should in some way be made to pay any amounts directly from their own pockets, when it is proven that there was either "personal negligence or that of the institutional negligence as a whole", including the Minister of Health and/or The Administrators of the Health Care facility...
...After all, the taxpayers paid their monies in taxes, and the Ministers accepted their postings and their salaries and perks taking an oath to carry out their responsibilities with due care and diligence on behalf of the taxpayers...thats not an unreasonable expectation at all...the taxpayers should therefore expect nothing less...!
...so not being familiar with "constitutional law", the question is, how do we as a people go about balancing the scale, when the "Government simply cuts out a cheque" in the event of a court award against them, and forgets the people thereafter...! No skin off their nose, its not their money to begin with, so they don't care...! How do we go about holding them both responsible and accountable for these tragedies?...
...just as a sidenote, recently it was reported in the Canadian News Media, that the Canadian Medical Practitioners had "agreed in principle" to "apologise or to say sorry" to the family and relatives, when medical procedures or treatment end with negative results. In addition, they have also agreed to sit down with the family members or relatives and tell them "the whole truth" of what occurred when things go wrong...!
...they are currently working out the exact wordings to be said, so as not to "admit to or accept blame, but to simply tell the truth...as a consequence of "pending lawsuits and insurance liabilities"...!
...public polls supported this, as they recognized "errors and oversights" will occur nevertheless, but they will be more sympathetic towards the individuals as well as the institutions, if they were not given the run around but told straight out the truth, as they know it will surface in the course of investigations anyway, so why lie or do the popular thing in "monkey island", everyone doing the "spin doctoring thing", everyone and his uncle...!
...this way too, "settlement resolutions" seldom reaches the courts, most of them being mediated and settled through the lawyers,(most with non-disclosure clauses) as the courts take a very dim view of "spin doctoring" and putting the public, (read taxpayers) through the "proverbial hoops"...!
...furthermore, if it were to in fact reach to trial and gross negligence was established, juries have the tendencies to impose hefty sanctions to all and sundry, along with "corrective measures to be implemented in the court order within specified time frames" and as such governments or institutions and individuals alike must within the specified time period show proof of the implementation of these corrective measures...!
... otherwise failure to do so, they will be held in contempt of such an order as handed down by the courts...hence the reluctance to go to court and the willingness to resolve the issues via mediation ourt of court...!
...in addition, this also has severe "political backlash" for governments too, something they are not inclined to look forward to, including their Ministers, who will certainly lose their seats come next election, if this proves to be an embarrassment for Government of the day...! So this serves as an incentive to avoid these unpleasant situations at all cost...! In short, to be responsible and accountable for their actions and their respective Ministries...etc...!
...such being the case, the public may only be advised through the media that an agreement has been reached between the lawyers and the Government or Institution as the case may be and everything has been put to rest to the satisfaction of all parties involved...!
...this way the public feels re-assured that the system worked, justice was served and that the grieved parties had not only heard the truth, which most often is what they want to hear, of what went wrong?... and that they have been adequately compensated with the help of their lawyers for these unfortunate incidents, and were not subjected to further stress and inconvenience and hardships by either the Medical Practitioners, the Government Institutions or the Courts...!
... I know that this is 2020 vision thinking for us in "Monkey Island" and too far to grasp for the "delusional and lame brained" Prime Minister or his cronies to even consider, as they are first and foremost "taboo" to the truth..! He along with his Ministers have been getting away with "blue murder" for far too long, and the "pendulum" has swung too far to the left to find a way to recalibrate the scale...!
...It has been allowed through utter neglect, incompetence or both, to decay and crumble into disrepair and lack of hope and frustration for the people, as the Prime Minister proudly walks around hiding behind his "shades" not only because he feels his future so bright but also that he can't face his own people "eye to eye". A classic case of "avoidance of the "truth", it shows in the eyes...!
(In North America, Patrick Manning will never be able to face the people, the press or have any public interaction wearing shades, as this is considered as an insult to the people as a whole if you cannot make "eye contact".! When last have you seen President Bush of USA, Prime Minister Harper of Canada, Former Prime Minister Tony Blair of U.K or any other renowned world leader facing the public wearing shades? Never!)
...And I am talking about Leaders of First World and Developed Countries...not Monkey Island...!
...So this may be all well and good for him, but what about our people? He does not care, and he shows it openly, so why expect the unexpected from him...he's not affected, he goes off to Cuba for his heart check ups and medical treatment...! His Ministers goes off to Canada, U.S.A or England or elsewhere, they don't care!...!
...so for him and his cronies, you'll get just about all the "spin doctoring" you can get, including the "leg break", the "off break" mixed with a few "googlies thrown in for good measure" to confuse the public, but never a "straight ball", never the truth...! And thats where our problem lie...!
...so now the $64 Million dollar question is, balancing the scale is long overdue and good for our people, but with what and by whom??? How do we go about getting the scale really and truly balanced back again???
....all the best and hope you succeed in this undertaking for the sake of Luke and his family and for all our people...! The time has come...!
...goodluck Anand, your work is cut out for you...!
...best wishes...Trini.t.o.o
Your questions and observations are spot on as usual. I sincerely hope it brings vision to the blind in T&T. All I can do is hope beyond hope.
There are a few things I wanted to comment on and clarify if possible.
This business of apology and owning up to when things go wrong medically, has been long visted in the UK. In reality what it does is make a mockery of the word 'sorry'. When a doctor chops out the wrong leg, takes out the wrong eye, reclessly ends life for lack of good medical practice - 'sorry' is a slap in the face. This business about saying sorry in the UK was really an attempt to limit cost i.e. cost and time spent surrounding litigation. Yes in some cases it is appropriate - I cannot deny that. However, overall, the strategy serves the health authorities in England more than the people. Why? Because individual the health authorities get away legally and there is no public or legal precedent set in 'stone' (i.e. law). So when it is all covered up by an individual legal agreement it leaves it open for other health authorities to make similar mistakes. Oh yes, in the UK they will tell you about how "We share information on litigation with other authorities" - to which I would say, in their terminology "Codswallop!". And the object of all this higher level apologising and settling out of court is really about protecting Ministers asses (arses if you're British). So - basically it is politics again! Again! So 'blue murder' stands to be legally covered up by out of court settlements. Yes - it may serve the needs of individuals but I have serious doubts that that serves the health interests of the public.
Boy, you doh know (in a manner of speaking - I make a presumption) how blasted corrupt health services are! I know because I've seen it 'wid meh own two eye' for 22 years. Ah know dem inside out! Ah know all dey tricks! Ah does spot dem from 10 miles off. Doh leh meh start tuh tell yuh about how rape at St. Ann's was covered up (yeah on Banana Island 'self). Dat go take meh another two days and another 20,000 words.
On the matter of negligence, there are two main types for the courts - 1) Tort (civil) and 2) Criminal. As far as I know most civil cases of negligence are not tried by juries in the UK. I don't know about T&T or Canada. Criminal negligence cases in the UK usually arise when gross negligence cases move up a notch to 'manslaughter by gross negligence'. But with new law in the UK, the offence of 'manslaughter by gross negligence' is abolished in its application to corporations, under S20 of the Corporate Manslaughter and Corporate Homicide Act 2007. Do juries decide upon (civil) negligence cases in Canada and T&T?
I agree that the pendulum has swung far too much to one side. Manning et all know that very well - and that is why they 'fraid to go into a local public service hospital in T&T. You think Men-in-Black in Private Jet go take dey chances in a killing field - the likes of Mt Hope? Look nah man! When yuh have yuh private jet you go to Cuba - eh? Dat way yuh doh get wax orf by yuh own killing field!
The heavy hand of justice must assist in re-balancing the situation. So now that the pendulum has swung so far to one side, it needs drastic forces to re-balance it. Anand and others should rise to this opportunity. Look, to make it graphic - pressha dey stones until dey bawl like 1000 Tarzans! Dat my friend, is dee kinda pain dat corrupt regimes need in order to get dey act together. We're dealing with an insensitive regime, openly displaying callous disregard for the need of it's citizens. No mercy! The lyrics of AC-DC 'Inject the venom' rings in my ears:
Thanks Captain for the pointer or two on the clarification, much appreciated...!!!
...I was so focused on the grieved family actually getting at the "truth for a change", that I overlooked completely the questions and issues you raised, all very valid ones at that, and thanks for shining the light on them...!
...when the negative results ends in "loss of life" under questionable circumstances, there will normally follow a "coroner's inquest" which operates very much like a court, and has all the powers of a court to subpoena witnesses as well, to get at the truth, and to also determine at the same time whether the death was as a result of "criminal negligence" and who are the party or parties who should be held responsible for the tragedy...!
...if "criminal negligence" is established at the end of the inquest, then the party or parties held responsible may wind up being formally charged with criminal offences relating to the death by the Crown Prosecutor of the Province or State. This trial will be heard in the Provincial Superior Court of Law before a Judge and Jury...!
...if "criminal negligence" is not found or cannot be established, and it is ruled to be "accidental", a mishap or otherwise, then of the grieved party is free to pursue civil litigation on their own to seek redress for their loss, pain and suffering etc...arising from the accident or mishap....!
...so as you asked, I hope this helps to clear up my "faux pas" a bit, as much of the civil litigation winds up in some kind of mediated settlement...as much of the facts-(the truth) have already been established at the "coroner's inquest " and it makes little sense to contest it further at long drawn out trials which will not only be very costly, it will further "irritate" the judges who can be very punitive on people or institutions who are trying to "hide the truth or do a cover-up (the spin-doctoring) when all the facts are so evident and already on the table...!
...the only exceptions here will be how good a defence can be established and advanced in support of the responsible parties, i.e (it was not all their fault entirely) or the "injured party may have been partially responsible for what happened so as to "mitigate" any damages, as this is not something considered by the "inquest" as they are only interested in fact finding...!
...in the case of "criminal negligence resulting in death", this is where the "jury" takes up there responsibilities very seriously, and apart from determining "guilt or innocence" from the evidence presented (the facts), they also provide recommendations to be followed so as to prevent such incidents from happening in the future...!
...this now becomes part of the judgement rendered and handed down by the courts in addition to the "sentence" imposed by the Judge towards the "guilty party or parties" which have included in the past to my knowledge, Governments, Crown Agencies and Instutions as well as to include individuals themselves...!
...Captain, I read and heard you message loud and clear, along with on whats happening with respect to the "sorry or apology" etc on your side of the pond, and I understand fully what you are saying, because I believe them to be true and as they happen nearly every day within the medical system.
...I also know from my own personal experiences that there is a lot of "Politics" involved along with "Political Influences" that comes from very high offices, to cover up, sweep under the rug, and sometimes to deny, deny, deny at all cost in too many of these types of unfortunate situations...!
...however, the process finding the "truth via an inquest" is both transparent, vigorous and thorough, as the hearing is open to the public, and the "truth will eventually come to the surface" through the process...!
...so I was really caught up with the "truth" being told to the family and relatives up front, as they have realised that it being the "truth" will be brought out nevertheless, which will attract the wrath of Judge, or Judge and Jury as the case may be, which ever one applies, and in the end, the sanctions will be much "harsher on them at that stage" for trying to fool the system and to make a joke of the courts and the system as a whole, not forgetting the "victims" themselves who are now given the opportunity to provide "victim impact statements" prior to sentencing when parties are found "guilty as charged."...!
...so just for the sake of knowing the truth of what happened, that in my mind is a good starting point for families and relatives, just to know what the heck happened here...truthfully...at least they know that much, cause in most cases the situation cannot be reversed...!
...then they can decide whatever their next course of action might be based on the "facts" or the truth, but that is their option to do what they feel are within their rights, rather than having to be given a whole set of "nancy stories" by the Spin Doctors and then have to pursue getting at the truth through the courts - through a painful and frustrating experience, not forgetting the financial burdern and stress imposed upon them by this process especially when they run on and on for years...as in on our "Monkey Island"...you looking at five years and more before it even reaches a "trial hearing date"...!
...I hope I have been able to shed back some light on your questions...at least I tried to...!
...I also hope that justice will come much sooner, as there has been too much agony and pain inflicted by an "uncaring government" already on our unfortunate people, especially the poorer ones who can least afford this type of aggravation...just think about it, inflicted upon them by their own stupid government's inadequate and underfunded health system, an inept Government that they elected not too long ago and who has now betrayed them again, and again, over and over and again and again...oblivious to their everyday needs...how sad...!
...When will it end??? well now is the time, and as you so quite rightly put it, no mercy asked and none shall be granted...! No Mercy at all!!! Ever...!!
goodluck......Trini.t.o.o
I'm delighted to read what happens on your side of the pond.
Over here in the UK there are also to kinds of court approaches 1) Inquisitorial 2) Adversarial. Coroner's Courts over here are inquisitorial, so they aim to find fact and the jury is assisted to give a number of verdicts. None of those verdicts are about 'criminal verdicts' so to speak. Recently, a Coroner delivered an unlawful death verdict to a man who had been aquitted of murder in Greece. But 'unlawful death' carries no criminal penalty. The role of the Coroner in the UK is quite different to the Coroner in the USA and Canada I imagine. I suspect the Coroner in T&T may be rather similar in functions to that the UK.
However, there is an interesting new narrative verdict of 'neglect' in the UK which came about in 2005 after the landmark case of Middleton. This of course was a real help to relatives who wanted to sue on grounds of negligence. But the verdict of neglect in itself was not a finding of 'negligence' - English law may seem strange. An average person - not legally minded - might think "Whuh is dee difference between 'neglect' and 'negligence'?"
From my personal experience of Coroner's inquests they do not dig very deeply. Yes there will have been high profile inquests like for Princess Diana where they would spare no detail. The Coroner in the UK, like any other court depends on the total honesty of the information given. I've seen the Coroner receive half truths. At one Coroner's inquest the health authority put me in the hot seat on the grounds that the doctor who was in charge had left employment - which was a load of utter nonsense. The Coroner quietly accepted that. In reality the health authority did not want the doctor in the Coroner's court because he was mentally disordered (with dementia) and had been given the nudge - and that could have become obvious and material in the investigation, if he had made an appearance. Well, I'm quoting only one such incident - but there were other incidents where the Coroner accepts what he's told - simply because he has no reason to suspect anything. You can't know what you don't know the context of.
The processes for finding the truth appear more transparent on your side, mindful of the power of the Coroner's powers you describe. I'm betting though, that on Monkey Island nothing near what you describe will be in operation.
The Luke Marshall case stands to be come tomorrow's 'toilet paper' - not as long as I arong ('around' if your'e an American accented quasi-Trinbagonian).
...your points are well taken and noted, and yes there are minor differences throughout most developed countries, the principles are basically the same but the application differs, but only marginally...!
...most democracies throughout the first world nations are not in themselves perfect, they all have their own flaws and weaknesses..the difference though is that there are potent forces at work constantly to keep the politicians and the government of the day on their 'P's" and "Q's" all the time, so they may get away with some things for a while but not all the time...they will eventually have to be held accountable for their actions...!
...some of the most potent forces that keep them on the "straight and narrows" are the "opposition party members" in parliament, the news media, radio television and the press, special interest lobby groups, and lastly but most importantly, the people themselves who have the greatest say and powers...!
...so when something happens of public interest, the lobbying, the new-smedia and the people themselves will force the politicians and by extension the government to "listen" and to make the changes that are required, including "firing ministers" who are not carrying out their responsibilities as they are supposed to, or those who are caught "napping" in their duties and functions, or not truly representing the "public's best interest" in some of their activities and decisions they are making...!
...so whether it is health care or policing or security or education or government services, the Minister responsible will be held "accountable" or else the Prime Minister or Premier as the case may be will not be able to have Parliament functioning, unless a decision is made to remove the "infected" politician forthwith...! the people will insist without letting up until their demands are met...the newsmedia will also hound them to death and so will the special interest lobby groups...so these activities make it work for the people by the people...!
...unfortunately, TnT has a long way to go, and the Pastor keep selling this "elusive 2020 vision" all the while the people can't even see today let alone that far into the future...they are too busy looking for food and shelter and security which the Pastor is intentionally keeping them in that frenzy and state of mind, that they can't see his scheme and plan...after all he living high off the hog while he have them scrunting for a living...daily...!
...Manning is about 63 years old, what does he care of what's going to be around in 20 years from now? what does he care? for all he knows, he already has a "defective ticker" and may not be around for too long...so he is living it up now at the people's expense and he simply does not care...not one iota...the man is heartless...!
...but then the problem with we Trinis, is that we are our own worst enemies, just give us a chance, and we willl flog ourselves to death. We talk all kind of nonsense all the time, but we do nothing about it, we're all talk, just blowhards...!
...Well, the Pastor Manning caught on to our game, and he playing us like a "fiddle" except we don't know the song...he alone knows it. Truth is, he is a real "snake oil salesman", and he selling us a bill of goods, and we either don't know it or we don't want to know it...
...I am talking about his 2020 Vision, which only he alone can see, nobody else. We can't even afford to buy "glasses" so how we going to see this 2020 vision he keep talking about, and distracting us from the real problems we facing daily, while he keeps on hiding and giggling at us from his "mansion", what a bunch of fools he has made us into, and we don't even know it ourselves...!
...so yes for little Luke Marshall, we have to keep the fire going, the pot boiling and the pressure constantly fixed on the government to hold them accountable and answerable for their actions or inactions...if some good is going to come out of all these unfortunate tragedies, which are now becoming daily events and so easily accepted by the people as the "new norm"...!
...not a peep from the "snake oil salesman", but all they talking about is half billion dollar jet plane, billion dollar stadium, 45 million dollar repairs to Hilton Hotel - billion dollars water taxis, billion dollar blimps "eye in the sky", just to name a few, and all the while the people starving, can't buy food, people getting killed every day, no security, no roads, no education or schools, no police stations, no health care or hospitals, but then what the heck, who needs all that stuff, not the Pastor, he just got his $148 million mansion and now wanted his own $500 million jet plane and he's happy like pig in mud, while the people suffering daily...what a preacher, what a pastor, we just can't figure what book he's reading from, thats why I think he is nothing more than a snake oil salesman...nothing else..."a sneaky snake oil salesman"...selling our people an empty dream to cling on to while he robs them blind...and all the while they are all talk but no action...and he knows it all too well...!
...so like Anand said in his opening remark, the seven day wonder will dissappear from the radar to go on to the next killing or robbery...kidnapping or hijacking ...
...but poor Luke should not be forgotten in all this...! never...so yes I too repeat your words Captain, No Mercy!...none whatsoever! we shall keep the fires going and the pot boiling all the time...just to keep the heat on them, no rest for the weary, the preacher, the pastor, the devil himself or the sneaky snake oil salesman...!!
..goodluck..Trini.t.o.o
...Democratic Governments in most of the developed countries of the world are not exactly perfect, but there is a never ending process of trying to make it better as time marches onwards...their peoples insist on it from their elected government Ministers...including their Prime Minister or President or Premier...whoever is the "leader"...!
...but not so in good ole Trinidad & Tobago, we keep on going backwards forever and a day, and the people are so set in "complacency" and "acceptance", that there is no real need to motivate the leaders to implement changes...!
...the reason I say this is that, in looking at some of the same processes here and on your side of the pond, along with what's currently taking place in TnT, the people are not mobilizing and using their "real power" in any meaningful way, they are just laying back and taking it as it comes...be it crime, poor roads, water, electricity, lack of proper hospitals, health and medical care, policing and security, spiralling food prices and shortages...the list goes on and on and on...!
...for democracies to work well as they should, they must also have "potent" balancing forces at work as well, and these come in the shape and form of good responsible "opposition members" in parliament, not people there just for namesake and a job for themselves, vibrant and active special interest lobby groups,(environment, poverty, health care, crime.. etc) a "free press" whether television, newspapers, radio etc..., (to keep it in their face everyday, all day, shame them to no end till they resign or do the right thing) and lastly and most importantly, the people themselves, who holds the "most power" to kick ass their elected representatives and demand they do the bidding of the electorates, rather than that of themselves, their leader or their party's interest first...!
...hence I said no democracy is really "perfect", but in developed world class countries, they work extremely well, as the "people" will see to it that those elected officials not resposive to their electorates will "never be re-elected" in their respective riding again...not even under a different party name as sometime happens here...!
...many a Minister has been forced to resign due to public pressure exerted by the people, the press and by the opposition demands, that makes it impossible for "government and parliament" to function unless the errant Minister(s) were removed from their respective Ministries for their inefficiencies...!
...Presidents and Prime Ministers as well as Premiers have been forced to remove Ministers time and time again for lack of performance, and these have been all brought about by public pressure and a "hungry press" for blood, be it the television in ther face daily, or the print media and radio giving them a dialy dose of "un-popularity for their misdeeds". ..but not in good ole Trinidad and Tobago, they just sit back relax and take it on the chin, day after day after day...just read the horror stories about getting a simple passport, birth certificate, or anything for that matter from government services...! yet it continues unabated...! we like it so..!
...so back to Luke Marshall, yes, the "Pastor Manning", the "preacher", the "bus driver", and for me "the snake oil salesman" walks around oblivious to the needs of the people, while he enjoys the fruit of their labour, lives in his $148 million mansion, trying to slide in on a $500 million jet plane for him and Hazel, talks a lot about billion dollar this and billion dollar that, whether its blimps, stadiums, water taxis, tsunami shelters, etc.. etc..none of which will really come of use to the people, while they die in the hospitals for lack of care and medicine, no beds, no roads, no food, and the rest of the people are just paralyzed and can't re-act anymore, he has them that way, the "snake oil salesman, selling them a "pipe dream about some elusive 2020 vision" that only he alone can see...no one else...even if they try to stay alive for that long...! The Madman is taking us "backwards" every step of the way, just take a good hard look, keep your eyes wide open, and you'll see it...!
...but what does Megalomaniac Manning care about, he is about 63 years old now, has a "bad ticker" and knows he will not be around by that time, (so he won't have to pay the piper?) so to heck with them, he's having his day now, and let those fend for themselves who remain and are there by 2020, of whats left of his "trail of destruction", that will be his legacy...he simply does not care...does he not show it?...you bet...!
...they said he has a bad heart, I wonder if he really has a heart at all...Lucifer in disguise maybe???
...so good luck to the good fight for Luke Marshall and all the other "Lukes" out there and their families, we won't forget or let you be forgotten, that you have been duped and deceived by the ones you trusted most, your Prime Minister and his government to provide you the protection you were so rightly entitled to and deserved, and they failed you miserably...they need to pay for it...in spades...the whole useless lot of them...from the very top down...! No mercy must be shown to them, none at all...!
keep it up and good luck..! Trini.t.o.o
Very stimulating indeed Trini.t.o.o. Having read your most wonderful perspectives on all this, I came away thinking that the Nation is paying with its blood and its people. Whilst I have little sympathy for the 'people' as a whole, I do feel very saddened that innocent children and mothers in childbirth should die in the way they have.
I'm hoping beyond hope that this wakes up the grass roots in T&T to their folly at the last election - and that they develop a memory for what their mistakes were.
Essentially the message must be - let's ensure the basics are in place. And to spell that out:
I'm sure we can add to the above list. But really has any government in T&T delivered well on the above 7 things? I don't think so. And I hope Mr Grass Roots doesn't think so either.
So Mr Grass Roots look at those 7 things above and arks yuhself have I been 'lucky' with the kinds of government I've been experiencing in the last 20 years. If you cannot answer for yourself, then take my answer - NO!!!
Especially on Health, Mr Grass Roots, you know you eh gettin' it good. Come nah man - you cyah tell me San Fernando General is your dream of a proper Hospital. How about ketch ass to get a prescription? But watch it Mr Grass Roots them fellas at the top dam good at selling you a promise, to make you hold strain just a little longer. Man, you have been waiting for 40 years for the basics to be delivered - you think you goin' tuh get it by the nex' elecshan - you really t'ink so boy? Nah boy, doh make fun wid a serious matter.
I'll leave it there for now. But I do want to ask Mr Grass Roots to start meeting with his MP at least once a month. Start piling on the presssha! Demand what is righfully yours before dey spend it on some chupidness like anodda blimp or a private jet!!
Rated *****Five Star***** by Site Admin - 2008-03-30 20:48 GMT.
Captain, I could not help noticing your mention of the San Fernando General Hospital, a place no one really wants to be, not even for a visit...short or long...!
...but it is definitely an "experience" I can tell you, for I happened to spend the most of January '08 in and out of that hospital...what a "horrifying experience" something we see so often from the "backwoods" in some African States/countries...something out of the real world...something time has moved forward and forgot behind...a sad reminder of government's neglect for the well being of the people of our once lovely nation...so wealthy, but so little to show for it..."healthcare" that is...!
...as with yourself, we try our best to keep separate our professional life from our personal dealings, but this one took the cake, my visit to the hospital after some forty years...it was so say the least, very frightening...scary stuff...something you want to forget very quickly, but you can't...it won't let you...to see such primitiveness in medical care still exist and is foisted on our people daily...what a collosal shame...!
...I could not lay blame to the staff, they were trying to do their best under the most adverse conditions, but "shortages" were the norm of the day...bring your own bedsheets, pillow cases, medicines (prescribed drugs?) - could not get the CT Scan report because they were "out of paper" to print out the report (for a week???)...
...the neurosurgeon could not operate on the patient because "there were only three ICU beds available" and these served the entire southern half of the country??? including the "private nursing homes" where we had moved our patient on the advice of the neurosurgeon, so that he could get quicker access...!
...my visit to the "senior management" at the hospital was also a "horrifying experience", and against my family's wishes for fear of "retaliation against them and the patient"...as well as my visit to the Minister of Health, Jerry Narace's office...but still to no avail, ( he was not available) its a system and people completely dysfunctional and removed from the real world of medicine of today...no equipment or supplies, no medicine in a hospital?..staff shortages, ...no beds or ICU units...what is a hospital???
...in fact, the hardworking nurses were glad when we (my family and I) cleaned up, washed and fed the patient as they were so short staffed...just plain tired...they were happy to get some assistance...for a change...!
...I am glad the outcome was more positive than I first expected, but that only came about with a lot of help from some very "helpful people", but it truly scare me to think of what some people have to go through on a daily basis, especially those who are limited in resources (people or money)...!
...so yes, it was a travel back in time for me, an experience I won't likely forget, as I sat on a bench in the waiting area of the lobby, looking at the "wall plaque" commorating the opening of the hospital by Princess Magaret dated February 1955, such a beautiful gesture to the people of our country, and now so sadly neglected, it remained the same but for the neglect, not even a "new coat of paint", with mildewed walls and a "Ward One" for mental patients, looked like something coming straight from a "horror movie", something no one should be subjected to in a civilised society, even the zoos in some countries I know have better accomodations for their animals...let alone for humans, and unwell people at that??? I could go on and on this way, but its a very depressing subject matter so I'll leave it alone...but its a shameful way for any Government to treat its people, especially when it continuously boasts of all this "so called wealth" they talk about...
...most civilised countries consider the "true wealth" to be their citizens, but not in good ole TnT, ...!
...for me it will always remind me of, and remain a "monument and legacy" of an uncaring government and Prime Minister, who has single handedly destroyed a beautiful people and a country - and have stood in the way of progress and prevented them from truly becoming and enjoying a first world nation, as they so richly deserve after all their personal struggles and perseverance...but he just won't let them go that way, its not in his plans...its for him and him alone... !
...so yes, its a place to stay away from, the hospitals I mean... my country and people I can't leave or forget, but ...I don't have or pretend to know all the answers...except the people are paying for this in "blood" as you say, and they are the ones who have to come to grips and hold the bull by the horns...!
...sometime they say its better to die with dignity than to live in disgrace...sad to say, but the truth really hurts sometimes, how long can they the people avoid the truth...they are marching as a country and a people "backwards in time" and they have to recognize it and do something about it, anything...nothing is not a viable or real option...if it not perhaps a bit too late in the day...!
...sad to say, but we going backwards like hell...if not in hell itself already...hope not!
..goodluck Trini.t.o.o