Medical practitioners culpable in maternal death cases to be censured – Health officials

Jan 04, 2017 News

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-Disciplinary Committee established to make process more efficient

During the course of the past year the Ministry of Public Health recorded a dozen maternal deaths. While some of these deaths were reportedly unavoidable there are reports that others could have been prevented.

Some medical officials have been implicated and their action and/or inaction have gained the attention of the Guyana Medical Council.
According to Minister within the Ministry of Public Health, Dr. Karen Cummings, while there are currently two individuals being investigated by the Medical Council, at least one other was reprimanded last year in relation to a termination of pregnancy.
This course of action, Minister Cummings said, does not characterise a new development, since according to her, there were four medical personnel who were also disciplined in 2015 after they were found to be culpable in cases of maternal mortality.
These disclosures were forthcoming at the Ministry’s end of year press conference last Friday.
Elaborating on the disciplinary process, Chief Medical Officer, Dr. Shamdeo Persaud, disclosed that when matters gain the attention of the Medical Council there are three disciplinary measures that can be instituted.
These measures, he said, essentially allow for medical practitioners to be censured. Being censured could translate to supervision, suspension from the medical practitioners’ register or being stricken off altogether.
Dr. Persaud is a de facto member of the Council because of his CMO portfolio. He disclosed that of the four individuals who were censured in 2015, two were suspended for a period of time. He, however, did not opt to share information on the period of suspension.
When pressed about the status of the four doctors in question, Dr. Persaud revealed that at least one was a senior doctor and the three others were at the residency level within the public health sector.
Without speaking of their respective positions, Dr. Persaud said that among those who gained the attention of the Medical Council in 2016, there was the doctor who was reprimanded for the termination of pregnancy. The doctor, according to Dr. Persaud, was required to undergo supervised re-training for the termination of pregnancy.
Of the two who are currently before the Council one is from the public sector and the other is from the private sector. “These investigations are with the Medical Council for final decision and disciplinary action,” Dr. Persaud divulged.
But according to Dr. Persaud, the majority of maternal death cases seen by the Council are likely to always be from the public sector since the public sector is tasked with catering to most deliveries.
He, however, noted that “the maternal death rate in the private sector sometimes equals or surpasses that in the public sector. The Georgetown Public Hospital Corporation alone delivers in excess of 6,000 babies annually, while the private sector in totality delivers about 1,000 or 1,200, at the most.
In order to conduct a termination of pregnancy procedure, practitioners must be so certified, which means that merely having a licence to practise as a doctor is not sufficient certification.
”There is a separate certification procedure where the practitioner has to be trained and certified to perform termination of pregnancies,” Dr. Persaud had earlier told this publication.
He explained that the safest period within which a pregnancy should be terminated at health facilities with limited resources is between eight and 12 weeks after the time of conception. However, the CMO noted that any such procedure between 12 and 18 weeks after the time of conception should be done in a hospital setting, since there may be need for anaesthetic input.
”We have all this detailed in the (1995 Medical Termination of Pregnancy) Act and we will observe all of these once we start (offering this service full-scale) in the public sector,” Dr. Persaud had revealed in 2014.
Senior Minister of Public Health, Dr. George Norton, speaking at the end of year presser too, sought to emphasize that contrary to common beliefs there have not been medical professionals found culpable for maternal deaths.
Dr. Norton explained, too, that with regards to reprimanding such practitioners, moves were for some time in the making for a Disciplinary Committee at the level of the Medical Council. The Committee, according to Minister Norton, was designed to be presided over by a practicing judge.
“That whole process took some time but we have got that person identified and we now have a Committee in place,” said Minister Norton.
This move was particularly necessary, Minister Norton noted, since in the past, medical practitioners who were found culpable would simply turn up with their lawyers to defend any accusations against them.
Although the Council too has its legal representation, Minister Norton related that “it was usually a battle at that level, hence the need for that active judge. So we have that person on board now and we think we will be in a position where we can openly say what has been the reprimand.”

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