THE LEGALITY of the structure of regional health authorities (RHAs) has been questioned by a task force set up by Health Minister Ruddy Spencer.

In its 215-page report, the Dr Winston Davidson-led task force said it appeared that the permission of Parliament might be needed to keep the current management structure of hospitals in place.

The report, which was completed one year ago, has never been made public. But yesterday, The Sunday Gleaner leaked aspects of it.

The task force describes as "flawed", the policy decision to remove the corporate board structure of Jamaica's hospitals by removing all boards of management and replacing them with a system where the senior medical officer and the director of nursing services of the institution report to the chief executive officer (CEO), who might not have medical knowledge.

The CEO then reports to a health committee chaired by an administrator.

"In a litigious jurisdiction, hospitals operating without a board of management and, therefore, without a universally acceptable corporate structure would be closed down without recourse," the report concluded.

"The implications for medico-legal consequences are far-reaching," the report outlined.

Meanwhile, Opposition Spokesman on Health Dr Fenton Ferguson said he has given Spencer until March 10 to release the report.

"Failure to make the document public within a reasonable time would be forcing the Opposition to make it public," Ferguson tells The Sunday Gleaner.

The report highlights as sick, the chain of command that requires medical professionals to report to non-medical persons as a critical problem affecting health-care delivery.

"Breaking the chain of professional command in patient care by having medical professionals reporting to administrators who may have neither knowledge of, nor competence in patient care, nor population medicine is not recommended," the report stated.

"This could create serious problems in health-service delivery with medico-legal consequences."

RHA history

The RHAs were established in 1997. The aim was to improve efficiency and accountability in the use of resources.

Four health authorities were established, each with its own system of management, which would allow autonomy in the decision making with a view to improve the delivery of health care to the public.

In the run-up to the 2007 general election, the Jamaica Labour Party, which was then in opposition, charged that the RHAs were inefficient and pledged in its manifesto to abolish the system if the party formed the Government.

Spencer commissioned a review of the RHAs in October 2007 but has kept the results out of the public domain.

daraine.luton@gleanerjm.com