Minister describes PMH situation on Saturday as “a little slow”

By DNO Correspondent

Health Minister Julius Timothy has admitted that the system at the Princess Margaret Hospital (PMH) may have been “a little slow” when it responded to an accident over the weekend that left Grace Joseph of Kingshill dead.

“I will concede that the system may have been a little slow, but when we looked at what was put in place, it was well within the normal scheduling time … it seems that our normal scheduling time is a little slow and we are in the process of speeding that up,” he told a press conference Wednesday.

Joseph succumbed at the hospital in the wee hours of Saturday morning, after a vehicular accident on the Les Pointe road late Friday night.

Timothy said while the PMH is not to be blamed, measures are being put in place to speed up the life saving process at the facility.

“That is one of the reasons for putting in the 10 nurses so that a lot of people (Doctors/Nurses) will no longer be on call,” he said.

He explained that the ministry of health is in the process of ensuring that the nurses and doctors will be stationed at the PMH.

“We are all humans … If you are on call and you go and engaged in some private business, it may not always be easily to get you available and there is a lag time. If the person lives in Jimmit, they could be held up in traffic. We want to cut out that lag time and that is why we are in the process of employing more people in the service and getting more of our doctor’s specialized.” he added.

Timothy says the health services must not be blamed on the “madness” that takes place on the road.

“We must put the blame where it lies,” he added.

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  1. April 18, 2010

    The police who had to take my mentaly ill brother to the p.m.h had to wait over 30 mins at the emergency and accident unit just to get a write up before sending him to the mental unit to wait another 40 mins because the doctor who was on call was not in.that anger the police because they had call the unit to inform the on call doctor even before subduing him from a southern villiage.My brother ended up falling asleep on the floor of the unit. if he had remain agreesive all through the 40 mins the police would have to struggle with him all that time while they wait on the doctor.On call means on call and should be present on compound or within 5 mins of call.

  2. D/can Lady
    April 15, 2010

    mr Timothy (slow) means in driving terms 20 miles an hour not 20 years on the making.thats 2 deaths so for that makes me very very angry.Grace’s and the guy from Laudat the got hurt diving off the docks at purple turtle.
    Wake up tim.u will not feel it until it him home.

  3. are we for real?
    April 15, 2010

    I am following with interest what is being posted and I find myself getting angrier as I read these blogs: I left D/ca so many yrs ago and then these were the exact discussions on having ‘on call’ staff stay on site when on call. I HAVE SO MANY WHYS…….. Why do we still have these discussions? Why are we still LOOKING INTO IT!!!!!!!!! Are we truly for real??? WHY is the department called the accident and emergency department? and WHY don’t we have all trained personel and adeqaute equipment during an emergency. Absolutely no staff should work in a specialized department without specialized training. Putting 10 nurses must mean putting 10 highly trained/nurses specialized in ER patient care. People- when you look at ER on reality TV this is exactly what happens in the ER WHEN THERE IS AN EMERGENCY.This is a behavior that we should emulate. It’s life or death and health care personel preserves life at all cost!
    The minister appears so nonchalant in his observation;Timothy said while the PMH is not to be blamed, measures are being put in place to speed up the life saving process at the facility. This makes my stomach crawl
    Where is the ambulance service. An emergency like this should be radioed to the ER and the docs already there waiting for the pt. Thats 2010- that’s how its done. Just tooooooooo many excuses for our lack of insite. Are we waiting again for a handout to put this in place??

    Is the minister aware that if what is said happened to this patient really took place it constitutes NEGLIGENCE AND MALPRACTICE??

  4. only
    April 15, 2010

    This hospital needs to step it up and get serious rather than letting people die unnecessarily. Personnel and equipment need to be upgraded and available. Enough of this baloney.

    The govt. should provide housing withiin a block or so from the hospital if nothing is available onsite.
    It is time to get on the next level…..up, not down regarding health care on this island.
    Get moving govt. for something that will benefit the people because your life or someone in your family may be the next victim.

  5. saphire
    April 15, 2010

    All those people that saying well said Mr. Minister is because is not one of your relatives. You people are so cold. The girl suffered and died at a hospital and all you playing blame game. No respect for human life at all in this cunt-ry !!!!! We must take our blame and not send it else where. That same nonsense happens even when the person on call is in the health center.
    I went to the grand bay health center recently and th nurse on call was in. I called he never fart on me!!! I used my phone to call using an unknown number, she answered (annoyed eh) I told her i had a sick child that needed attention and that i have been banging and calling for t least 15 minutes, she old me she was coming. I waited 5 mins no nurse!!!! Well I go to my vehicle nd i blow my horn like a mad man because my child sick and nurse not coming.
    Then she finally emerge and she was more vex than me eh!!! 15 mins later. She take her precious time to watch me and my child a big cross eyes and open the gate well vex. Well I suck it to her. She attended to my child well vex.
    So i cannot agree with the minister and the people who say that the patient is wrong and the dostor must not always be around when on call. Because even when they in the building we have to beg like dogs!!!!

  6. Chawe
    April 15, 2010

    I agree with Da Man!!! Well said!!!

    Dominicans just ungrateful!!! When something happens they always know what happen although they were not there!!! I agree with the fact that PMH lacking resources but is not them nurses and doctors fault!!! Plus all you keep saying bout people dying at casualty!! How many people have died casualty for the year??? Do you know the extent of the injuries or if any underlying problems the individuals had that caused them to die??

    I want to say to the casualty staff you all are doing your best and don’t give up!!! I KNOW FOR A FACT that the nurses and doctors of casualty are one of the hardest working people in Dominica!!!

    To the health minister if they were too slow, put d proper equipments and more staffing!!!!

    To Dominicans, REPENT FROM YOUR SINS so you will be ready when God calls you home, cause if God agree today is your day to die no doctor or nurse can save you!!!


  7. Hardworking Dominican
    April 15, 2010

    The problem with Dominica and Dominicans in general is that there is no persistent agitation for improvement of fundamentally flawed processes at any level.

    Do you think that Martin Luther King and the members of the civil rights movement would have achieved anything by marching ONCE A YEAR for their rights? They marched and protested for over 2 full years NON-STOP until their nation heard them and their demands were met.

    We all know the pattern- most of you who write on this blog will forget about what you stand for until the next tragedy- no one will be held accountable and there will be no further discussion or follow-up of this crucial topic by either the public or media.

    It is rather unfortunate that the concept of ‘being on call’ is not at all understood bythe policy makers in the Ministry of Health in the year 2010 despite NUMEROUS rescources being made available to them- print media, internet, television, conferences etc, Has anyone heard of the ‘Golden Hour’ in Trauma medicine- I doubt it because no one seems to have a clue about Adult Trauma and Life Support Training which is a pre-requisite for ALL PERSONNEL working in a Fire and Ambulance or an A& E department ANY WHERE ELSE IN THE WORLD.

    Come on Dominicans, stop behaving like we live on a totally isloated island with no electricity, telephones, internet, television, air/seaport access, books, no interaction with the outside world.

    Let’s watch this space.

    • DominicaDIVA
      April 15, 2010

      well said…

    • Piper
      April 15, 2010

      HD, to do what you are asking requires a cultural change. When it comes to matters of safety, Dominican pay little attention to that. How many people wear setabelts while they are driving? Are there even any laws on teh books to punish those who choose to drive wothout a seatbelt? As simple as it is, that can save many lives in an accident. My grandfather died in an accident in Dominica years ago because he was not wearing a seat belt.

      • Laws
        April 15, 2010

        Yes there are laws since 1993. Check it out. $250 fine plus 2 weeks in jail max for not wearing your seat plus the driver responsible for any minor under 18 in the vehicle with same penalties. Time to buckle up or get charged!

      • Hardworking Dominican
        April 15, 2010

        So Piper, what you are saying is that we should accept the ‘ culture ‘ of less than basic health care in Dominica? Maybe you can afford to fly out of Dominica to experience a different ‘culture’ of health care should the need arise.

        Are you aware that even an injury dampened by wearing a seatbelt can deteriorate into a fatal injury if there is inadequate transportation to or care received at the hospital?

        Let me repeat myself:The problem with Dominica and Dominicans in general is that there is no persistent agitation for improvement of fundamentally flawed processes at any level. This can be applied to most institutions in DOminica:

        -poorly structured health care FOR DECADES- we call in to the talk show for 1 day then continue to accept the status quo, until the next tragedy………..
        -police force’s inadequate training, investigation/interrogation, enforcement of laws- make a fuss for 1 day on the talk shows, then same old continues……..
        -protests at Layou regarding the proposed asphalt plant? 6 months later, the same asphalt plant has been approved by planning and will be located where??? where are the people who protested with such vigour? Aphalt plant near a river??? Only in Dominica
        – poor customer service at any of the many institutions? we continue to patronize them, we seem to have no issues with being treated disrepectfully

        The fundamental problem here is that as Dominicans, the overwhelming majority of us do not take pride in whatever we do and see no need to hold people accountable to high standards. What does this say about our opinion of ourselves or our country?

        IF THE USA HAD ACCEPTED THE ‘CULTURE’ OF SLAVERY, RACISM, SEGREGATION, UNEQUAL OPPORTUNITIES FOR SOME RACES, RACKETEERING AND FRAUD IN CORPORATIONS (Enron), DISHONESTY IN GOVERNMENT ( WATERGATE COMES TO MIND), LACK OF WOMEN’S RIGHTS, FRAUD IN FINANCIAL INSTITUTIONS ( a.k.a. ‘Bobol’ in local lingo), CORRUPTION IN LAW ENFORCEMENT ( Have any of you seen the furor and subsequent police suspensions over the video of the Maryland police beating a universtiy student over the past 2 days on CNN?) it is highly likely that the many Dominicans who call the USA home would have had to find another country to call home and to send remittances from.

        A culture can be changed; through adequately qualified policy-makers who make decisions ( by this I mean degrees or other internationally recognized qualifications in the subject in which they are working), and UNIVERSAL enforcement and imposition of the rule of law.

        Come on Piper, Dominica is certainly not the poorest country in the world!!!

        Why should DOminica remain lawless in the year 2010?

        • Jayson
          April 15, 2010

          You get what you tolerate!

        • Piper
          April 15, 2010

          HD, you are not going to get an argument from me on this one because I agree with what you say. But I repeat, if we had a culture of demanding change and not stopping until we get change, things would be different – hence my statement.
          In the absence of that culture I would do what I can to give myself the best chance of survival. In the case of being on the road, wearing my seatbelt.

  8. Fanchiface
    April 14, 2010

    Mr. Minister tell us what happened to Dr. McIntyre who was doing a damn good job at the A&E. U all have some …cuban … Trust me the whole system need a revamp. At least thank God Dr. Thomas is still there but please bring back Dr. Mac; he’s the people’s doctor.

  9. Concerned
    April 14, 2010

    There’s no point in playing the blame game right now. This problem is in existence for a very long time and it needs to be rectified like yesterday. I believe this continues because no one is held accountable. It stands to reason that if an individual is being paid for being “on call” they cannot be on personal business at the time to the extent that they cannot be found when needed. This defeats the whole purpose of being “on call”.

    I’d like to understand though what is the rationale for the individual not being on the hospital compound or at the health centre in the out districts. Is it that facilities are not available, suitable or that the individual just does not want to stay at the facilities provided. Why then are they being paid “on call” allowance.

    Some employees in the government service carry around a mentality that they can do as they please but they cannot be fired. In fact some are bold enough to say “all they can do is put it on my file”. Unless someone in Dominica decides to go to the full extent of the law to establish accountability in incidences like this, I’m afraid this will continue.

    Now that this is again in the public eye let’s hope that we can see positive movement and change.

  10. Da man
    April 14, 2010

    People keep saying the staff on call should remain in the hospital but none of you are suggesting where in the hospital they can stay. The theatre nurses, the surgeons, the anaesthetists, the lab techs etc etc etc…
    And all the Dominicans complaining of shortage of doctors and nurses why don’t you go study as well to help fix the shortage?

    Now to the point of prevention….where is the enforcement on the roads?? Hardly anyone wears seatbelts. Maybe 1 out of every 50 riders has a helmet, drunk driving, no signalling. Anyhow…

  11. observer
    April 14, 2010

    Doctors are on call on the surgical and medical wards. Doctors in the Emergency Department work a shift system and should always be present during their shift. There is no reason why they should be out of the hospital compound. Too often people come into the emergency department and there is no doctor there and they have to wait for a doctor to be called. In almost all other countries the emergency department is always staffed with a physician that can respond to the emergency in the shortest time possible. At PMH you just have to hope and pray that there is a doctor in the casualty and you make it out alive

  12. 4u2c
    April 14, 2010

    After DLP make all the Specialist UWP had on island leave because they say it was too many Drs. now they saying they need more Specialist? You mean 12years later they realise they need better health professionals? What else did we throw away beacuse is another party who did it? Now we need and intl airport too……what a regressing country —-Tim tim comparing EMEGENCY with the statement little slow? You mean life means nothing? As per Tim Tim, if you can’t do the job don’t waste the country resources by killing the people…….In Jamaica more than heads would role—I hope the same happen when the ministers and their family fall sick or encounter an emergenvy —-Medical professionals take your time and go party while on call…DLP needs to DAMN GO!!!

  13. Jayson
    April 14, 2010

    I’ve never been a strong supporter of Mr. Timothy but what I understand but what he’s saying is that:

    1) the health service has been following the procedures that are currently in place and that
    2)those procedures are not working and people are paying for it with their lives, so
    3) he’s implementing measures to get the system working as it should be to avoid further pain and suffering.

    It’s been a very VERY long time since I’ve seen ANY minister directly address an issue without beating around the bush and give a direct answer about what is going to be done to prevent that issue from re occuring. Thank you Mr. Timothy!

    Timothy is correct in saying that what the health service needs is proper management. it’s a shame that he has to start micro-managing because middle-management has become so laid back and relaxed and don’t even appear to have a heart for the people they serve or for those hard working nurses.

    Give Tim Tim a chance I honestly think we will see many positive changes in the health service under his watch.

    • Piper
      April 15, 2010

      It isn’t so much that middle management is laid back and dont care. The problem stems from people being in a position for too long and not seeing what needs to be changed. It’s almost like living in a filthy house. At first you see the dirt, but if you don’t clean it up, you soon get used to it and very quickly you stop seeing that the place is filthy. What we need is a fresh set of eyes to make wholesale changes to the system.

      • Jayson
        April 15, 2010

        Point well taken!

    April 14, 2010

    Prevention is better than cure. We should all try our best not to get ourselves involved in such calamities. When driving on the road we have to remember to drive considering ourselves as well as the other drivers on the road. It’s a very simple rule to follow. Do Onto Others As You Would Want Be Done Onto You. If we try to follow that simple rule on the road and in every aspect of our lives the entire nation would be a different place. Dominicans, it’s time to get back to being Dominican. The friendliest people on earth.

  15. angry
    April 14, 2010

    This is utter rubbish Mr Minister. When i was on call and that is in the medical field; i had to stay home because that ‘s what on call is. One had to be prepared to be summoned at any time. One was being paid for the inconvenience. I remember there was a room set up upstairs the administrative building specifically for the doctor on call. What has become of that room. It was equiped with a bed, tv,and other stuff. Why pay personel when they do not make themselves available.Somebody needs to be made accountable for this misshap and this fella thinks it should start with the Minister,C.M.O, Hospital Services Co Ordinator right down to the nurse on call. Some heads need to roll. An example is to be made only then will we have accountability at the P.M.H

    • Even doctors too feeling it too!
      April 14, 2010

      I remeber when it was a Dr’s mother who fell sick and was brought to Casualty, the X-Ray person said she was not coming out to X-Ray her. The Dr had to refuse to see patients for the rest of the shift for a call to be made by the person in-charge of the hospital for the X-Ray Tech to come out while on-call. Imagine that. Even our local Dr’s getting hard time. No respect. I was there in all my pain but understood the docs protest.

    April 14, 2010

    We are priding ourselves lately on the boost in tourism that our country is experiencing. I hope that the minister, the government and Dominica on a whole realizes that accidents can happen to tourists too. I hope that this never happens, however, if it does happen, I do hope that by the grace of God and all that’s holy that our system isn’t still ” a little slow ” .

    • D/can Lady
      April 15, 2010

      trust me belz.doctors would crawl out the woodwork to take care of them tourists.even the airline would make an unschedule trip to take them off island if needed.It is ONLY our people that get this [email protected]% tretment.
      my dad appendicts ruptured inside and the nurse gave him pain medication and sent him home to DIE,she said there was no doc.on call.i started yelling and causing such a rucuss at the emergency room.dr.finally came took one look at my dad’s side and told the same nurse to get him ready for surgery.i simply told the doctor if he would please please send another nurse to help,he could not find one so an orderly came instead.,cause if that nurse had touched my father———–

  17. Anthony P. Ismael
    April 14, 2010

    Mr. Minister, I think you have it wrong. On call means that they are in an apartment or house within the hospital compound. As a result, when they’re needed, they are within walking distance of the Emergency Room.

    We are in 2010, these lame excuses are no longer acceptable. The mere fact that on-call emergency personnel are somewhere else besides PMHS is absurd. It would appear that we only respond after people die.

  18. Hardliner
    April 14, 2010

    Timorthy should shut his ………………………trap. It’s many years s*** happening. Just imagine the number of women who lost their babies because someone was at seamoon drinking scotch and never got 20 yrs plus.

  19. de caribbean change
    April 14, 2010

    Hey Tim, Tim, let’s get the fourth pillar project moving, by the chinese.

  20. Piper
    April 14, 2010

    It is all well and good for the minister to place the blame on the maniacs who roam the roads of Dominica. What the government needs to do is start enforcing the laws to punish those who chose to endange the lives of innocent people.

    If those laws are not on teh books, they need to pass new legislation to force drivers to alter their behaviour. There is too much lawlessness on the roads.

    Dominicans only seem to be in a hurry when they are behind the wheel of a vehicle. Fact is, given the number of curves and hills (up and down) they have to contend with, the average speed in Dominica is not that high. The problem occurs when drivers see a stretch of straight road less than half a mile long and they want to make up the lost time spent navigating the last few corners where they had to slow down. The time saved driving like maniacs, while they endanger people’s lives amounts to no less than a couple minutes per trip. It is not worth it.

      April 14, 2010

      Great point.

    • Eric Cartman
      April 14, 2010

      Spoken like a real driver. i second that and i always say the same thing myself.

      I’ve seen times where i ran the road hard only to save 5-10 mins on my usual time and burn a whole lot more gas. It’s not worth it for real.

    April 14, 2010

    “A Little slow” is absolutely ‘AN UNDERSTATEMENT’ Mr Health Minister and totally unacceptable!!!

    If this is how the health system is so laid back a total overhaul is required urgently to save lives.

    A contingency plan is required urgently for eventualities such as mass casualties in road accidents and disasters.

    Time is essentially crucial in any accident, and health professionals who are on call should be accessible at the sound of an alarm.

    I hope the authorities learn from this unfortunate road fatality that occured last weekend and measures put in place to expidite care when disasters/accidents occur.

    Life saving measures should be instituted at the site of the accident as fatalities are likely to occur from major external/internal haemorrhage.

    This is serious! We are too complacent in Dominica!!! Much too complacent!!! To damn complacent!!!

    These health professionalsshould be answerable for their actions!

    Policies must be implemented to ensure that personnel who are on call must remain within the hospital vicinity, since TIME IS VERY CRUCIAL TO EXPEDITE CARE AND HELP SAVE LIVES!!!

    A Concerned Dominican

    This system needs to be reviewed urgently!!!!

  22. D/can to the bone( foreign)
    April 14, 2010

    only in Dominica that happens. Where were the medical personnel s who were suppose to be on call? Mr Timothy we require an inquiry why the patient was left to die?

  23. Nathaniel Peltier
    April 14, 2010

    I must say that I glad with the points of betterment in the response and that it is being worked on. What is not clear to me is that you say that ” the health services must not be blamed on the “madness” that takes place on the road”.
    In my view no now is blaming the health service for what happen on the road but what happened at the hospital.
    Mr. Minister you should Understand what the word ACCIDENT means or do you not?

  24. LADY
    April 14, 2010

    Doctors on call should be at the hospital. That’s how it is done everywhere. I recall a time my mother in law was ill and went to the casualty to see a Dr…..the lady was bleeding. The nurses called the Dr. who was at his home sleeping and he said he is not coming in for that. Doctors are being paid extra to be on call but no one in Dominica is held accountable for anything so the Doctors play with people’s lives.

  25. Please
    April 14, 2010


  26. April 14, 2010


    • Anonymous
      April 14, 2010

      Only in Dominica? What planet are you from?

  27. Advancement
    April 14, 2010

    I agree Mr. Timothy….and please look into having the trauma team well trained too not just putting ten people at the A & E. Invest in specialists and two at a time not just one. One person tend to get tired too and do have a life outside work. Whilst investing recognize the work that it entails and complement the pay grade as well. If you see where this is going. The A & E should be the most equipped department in Roseau, Portsmouth, Marigot and Castle Bruce. Thank You

    • A&E
      April 14, 2010

      I agree we need a few more Specialized Drs. My question is why is it that when a some of our locals ask for assistance to specialize they get turned down like joke? I know of at least 4 of them who fall into that category but they still fought their way without help to go and specialize. (Within the last 2-6 yrs) And non of them were recipients of Cuban scholarships mind you. Is family sacrifices we talking about.

      Anyways I know we have local qualified Specialist to run the A&E so I wonder if they going to get offered a decent contract to return and run Casualty?

  28. wow
    April 14, 2010

    well said MR MINISTER…

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