The Tribune

EDITOR, The Tribune

A sure sign that it’s time for a Prime Minister to shuffle his cabinet is when individual ministers delude themselves into believing that they have a lock on a particular ministry.

Some amongst us have conveniently forgotten that we practise cabinet government. The cabinet acts collectively and all are responsible for the actions of any one.

Recent events have led to incoherent gibberish on social media and on the airwaves reflecting a misguided notion that only a medical doctor should head the Ministry of Health.

The logic seems to be that in the face of a pandemic, only a medical doctor will have the skill set needed to confront the challenge of keeping us safe and overseeing health care delivery.

While it is true that a medical doctor will more quickly grasp the science of virology and bacterium, no medical qualification is needed to be Minister of Health. The job is to execute the policies of the government and set the priorities for the department.

No Minister should be so intrusive as to second-guess the professionals in the delivery of medical care, but a minister must have the judgment to assess the advice given him by professionals. Assisting the Minister is a Permanent Secretary who, as the name implies, brings a degree of stability to the oversight of the Ministry, regardless of which party is in power.

We have a Chief Medical Officer, consultants and line directors who know their job responsibilities, one of which is advising the Minister.

Dr Merceline Dahl Regis has acquitted herself splendidly as a former CMO, now consultant in the Office of the Prime Minister, and our stock of confidence should be invested in her and other steady hands at the wheel: Dr Pearl McMillan, CMO, and Dr Delon Brennen, her deputy.

The situation becomes particularly problematic when a doctor turned minister refuses to discard his scrubs and tries to micro manage those on the front lines.

Doctors accept the need for a second opinion and even for peer review of their work. But that should not extend to those peers who exercise a purely political mandate. A search of the Constitution reveals that there is but one cabinet level job that requires professional qualifications. The Attorney General, the legal advisor to the government, must be a member of the Bar and therefore able to defend the government before the courts.

There are no such criteria to be Prime Minister, let alone Minister, except for being a member of either the House or, to a limited degree, the Senate.

One of the most effective Ministers of Health in our history was the first to occupy the post in the new PLP government in 1967. Founding father, businessman and civil rights champion Sir Milo Boughton Butler understood his brief better than most.

He wanted to improve access to health care for all citizens and he asked for nothing more from his cabinet colleagues than support for policies which expanded clinics into local communities and the Family Islands, training for more doctors, nurses and pharmacists, the latest medicines on the shelves of the dispensaries and better health outcomes from prenatal care to geriatrics.

To do so he used his power not to second guess doctors but to push his cabinet colleagues to adopt policies to eradicate outdoor latrines, to provide access to clean water and to give children proper nutrition. In recognition of his service one astute columnist recommended we rename the hospital from PMH to MBB.

Lawyer Loftus Roker, our own alpha Minister, similarly saw his role as that of advocating for health care advancement.

Since that time successive Prime Ministers have sought to give the Ministry to an elected medical doctor and, sadly, almost all of them quickly developed a love/hate relationship with the rank and file.

While it is true that these are parlous times, there are constructive ways for doctors turned politicians to play doctor. In Ireland the acting Prime Minister, a trained doctor, reregistered to work as a doctor and is now working one shift a week on the front lines of their Covid-19 fight.

The Minister of Health of Canada has a master’s degree in public administration while the Health Secretary in the UK is an economist but nonetheless takes political responsibility for the fight which is led by specialists in infectious diseases.

Our Prime Minister was confronted with a Sophie’s choice. No PM wants to lose an important general in the heat of battle. But with Dr. Dwayne Sands content to hoist himself on his own petard, the PM probably had no choice but to let him go and keep the focus on the virus, not the virtuoso creating a distraction.

The PM, also a doctor, should make his tenure as acting Health Minister as short as possible. When Covid-19 is vanquished or adequately mitigated, he will have to turn his full attention to the economy.

He should look beyond the physicians turned politicians that the chattering classes are advocating. Instead he should turn health over to one of his most experienced ministers.

Three come to mind: Dion Foulkes, Carl Bethel and Desmond Bannister. Bethel is mired in the law and Bannister is praying he gets a $500 million infrastructure fund.

As to who’s left: you whistle, I’ll point.

THE GRADUATE

Nassau,

May 10, 2020.