Medical Negligence in T&T – Let’s Get the Law Right Before We Reform It

 

In the wake of the tragic death of young Jasher, emotions are understandably running high. The calls for reform of Trinidad and Tobago’s healthcare system are urgent and sincere. But if we are to achieve lasting change, our public conversation must be grounded in correct legal principles. Unfortunately, too many public statements – even by lawyers – muddle the law on medical negligence, vicarious liability, and accountability.

First, the Bolam test is not “the” standard for all medical negligence issues (cited by Pavitra Ramharack, head of chambers at Pavitra Ramharack Attorneys at Law in the Trinidad Guardian). Established in the 1957 English case Bolam v Friern Hospital Management Committee, it applies to clinical judgment and technique – diagnosis, treatment, and similar professional decisions – but it is not absolute. The Bolitho decision in 1997 refined Bolam, making clear that even if a body of medical opinion supports a doctor’s conduct, the court must be satisfied that opinion is logically defensible. In short, Bolam is not a blank cheque for the medical profession.

Second, when it comes to patient consent and risk disclosure, the United Kingdom Supreme Court in Montgomery v Lanarkshire Health Board (2015) replaced Bolam with a patient-centred test. A doctor must take reasonable care to ensure the patient is aware of any material risks and reasonable alternatives. Whether Trinidad and Tobago’s appellate courts have expressly adopted Montgomery is still to be determined, but it is wrong to write as though Bolam governs consent everywhere.

Third, the notion that “public sector doctors are protected by contracts” and therefore cannot be sued is legally incorrect. The Regional Health Authorities (RHAs) are statutory corporations and are routinely sued for medical negligence. They are vicariously liable for their staff. In some cases, doctors and other clinicians are named as individual defendants alongside the RHA. There is no legal blanket immunity simply because someone works for the public health service.

Fourth, the suggestion that healthcare workers should bear “some contributory negligence” for adverse outcomes misuses the term. In law, “contributory negligence” refers to the claimant’s own fault, which can reduce damages. The proper mechanism for sharing liability between defendants is “contribution” under the relevant statutes. Whether a clinician personally pays any damages depends on contribution orders and indemnity arrangements, not on a layperson’s redefinition of contributory negligence.

Fifth, public sector negligence claims already follow the principle of suing the body with primary liability – usually the RHA – and the courts have repeatedly confirmed this. What we lack is not a legal pathway for accountability, but an operational culture that enforces high standards across both public and private healthcare.

Finally, while it is tempting to speculate that “a few extra minutes” with a patient would have changed the outcome, in court such statements are meaningless without expert evidence. To succeed in a medical negligence case, one must prove breach of duty – judged by Bolam/Bolitho or Montgomery – and causation linking that breach to the harm. This requires admissible, qualified expert opinion, not post-hoc assumptions.

Public accountability in healthcare is achieved by naming and suing the correct defendants, holding professionals to the correct legal standard, and reforming systems to address repeated failures. Misstating the law does not help the cause of justice for Jasher or for the next potential victim.

If reform is truly the goal, it should be based on accurate understanding:

• Clinical judgment is assessed under Bolam/Bolitho.
• Consent and risk disclosure (in England and Wales) are assessed under Montgomery; T&T’s position is not definitively settled.
• RHAs are suable and vicariously liable; doctors can also be named.
• Apportionment between defendants is by contribution, not contributory negligence.
• Evidence, not speculation, wins negligence claims.

Getting the law right is the first step toward getting healthcare right. Reform based on flawed legal premises will fail. Reform based on precision and truth can save lives.

Citations

• Bolam v Friern Hospital Management Committee [1957] 1 WLR 582
• Bolitho v City and Hackney HA [1998] AC 232
• Montgomery v Lanarkshire Health Board [2015] UKSC 11
• NWRHA v Cheryl Miller (TT 2021 CA 33)
• Bevon Dollard v North Central RHA (TT 2019 HC 288)
• Kellman v Dowes & NCRHA
• State Liability and Proceedings Act (T&T)
• Singh-Weekes v South-West RHA [2025] UKPC 10

Analysis of Commissioner Guevarro's Language and Its Implications

Commissioner of Police Guevarro’s statement to the press, delivered shortly after assuming office, is littered with deflective phrasing, institutional buck-passing, and strategic vagueness. This style of public communication—commonly referred to as using weasel words—is not only damaging to public confidence but fundamentally at odds with the standards of public accountability, command responsibility, and constitutional leadership.

1. Abdication of Command Responsibility through Deflection

His repeated assertion that “disciplinary or administrative action... lies solely with the PolSC” is legally correct under section 123 of the Constitution of Trinidad and Tobago. However, the overemphasis on this legal limitation comes across as an attempt to distance himself from the moral and operational responsibility that comes with office.

➤ He is not merely an administrator of reports. He is the Commissioner of Police.
Leadership requires more than notifying the Police Service Commission—it requires taking a firm ethical stance, demonstrating public confidence, and leading by example.

2. Evasive Language Obscuring the Gravity of the Allegations

Guevarro’s phrasing—“certain acts were carried out against him” and “he felt it was bordering on criminal conduct”—is dangerously non-committal. The implication is that this is merely a matter of perception by the complainant (Brent Thomas), rather than a serious allegation of criminal abuse of power by a Deputy Commissioner.

This is institutional gaslighting by omission. When the public is told there is a criminal allegation involving high-ranking officers, clarity is not optional—it is obligatory.

3. The Illusion of Transparency

By repeatedly saying “we are transparent” or “we have nothing to hide,” without actually providing substantive details, the Commissioner engages in rhetorical self-justification rather than accountability.

This is contradicted by:

• The absence of a timeline for the investigation.

• The refusal to identify the nature of the allegation.

• The fact that DCP Martin remains in post despite a potential criminal matter against her.

Transparency is demonstrated by actions, not by repeated verbal affirmations. Saying “we are transparent” is not the same as being transparent.

4. Leadership by Euphemism

The refusal to even name the allegation (widely understood to involve misconduct, unlawful detention, or other abuse of power linked to international legal controversy) is telling. It reinforces the impression that the TTPS lacks the moral courage to confront internal wrongdoing publicly and forthrightly.

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Advice to Commissioner Guevarro

As the Commissioner of Police, your office is not merely administrative; it is symbolic. Every word you speak either restores or erodes trust. It is your responsibility to:

• Speak plainly and truthfully. Avoid legalistic hedging and sanitised language.

• Affirm command responsibility even where your powers are limited. You may not suspend the DCP, but you can recommend, publicly and forcefully, that she be removed pending investigation.

• Acknowledge institutional failings instead of hiding behind procedural correctness.

• Set timelines and report progress regularly to build public trust in the investigation.

The public does not want a bureaucrat. It wants a Commissioner who acts like a leader—not a spokesperson for the system’s evasions.

The relevance of the PCA

It is deeply concerning when an institution that is supposed to hold law enforcement accountable, such as the Police Complaints Authority (PCA) in Trinidad and Tobago, fails to take meaningful action following investigations of serious allegations, including extrajudicial killings and police misconduct. Based on available information, the PCA has indeed faced significant criticism over the years for its lack of effective follow-through and transparency regarding its investigations.

While the PCA is mandated to investigate complaints against police officers, including allegations of misconduct and extrajudicial killings, the authority’s actions (or lack thereof) have often been scrutinised by both the public and advocacy groups. The PCA’s annual reports have, at times, highlighted the number of complaints and investigations undertaken, but there have been very few instances where those investigations resulted in tangible outcomes such as disciplinary actions, prosecutions, or public accountability.

Key Issues with the PCA’s Effectiveness

1. Lack of Transparency: One of the main criticisms of the PCA is its perceived lack of transparency. Despite having investigated numerous allegations over the years, there is often little public information on the results of those investigations. Victims and their families are left without answers, and the public loses confidence in the authority's ability to act decisively.

2. Delayed or Inactionable Outcomes: In many cases, investigations seem to drag on indefinitely without any clear resolution. Allegations of extrajudicial killings, in particular, have been prominent, yet no significant action appears to have been taken. This can lead to a perception of impunity within the police force, undermining the public’s trust in both the PCA and the police.

3. Political Influence and Institutional Resistance: The PCA's role as an independent body is meant to ensure that law enforcement officers are held accountable without political interference. However, the influence of political actors and institutional resistance within the police force has often been cited as a barrier to the PCA’s effectiveness. This creates a lack of political will to take strong action against police officers, especially in high-profile or sensitive cases.

4. Limited Resources and Powers: The PCA’s ability to hold police officers accountable may also be limited by insufficient resources, legal powers, or support from other state institutions. For instance, the PCA does not have the same powers of prosecution as the Director of Public Prosecutions (DPP), which limits its ability to enforce actions based on its findings. Its role is largely investigative, but without the power to prosecute or make binding decisions, its impact can be limited.

Extrajudicial Killings and the PCA

The issue of extrajudicial killings by police officers has been a longstanding concern in Trinidad and Tobago. While the PCA has been tasked with investigating these serious allegations, many of these cases remain unresolved or have not resulted in the prosecution of officers involved. The lack of convictions or meaningful disciplinary actions sends a troubling message that there are few consequences for police officers who engage in unlawful killings or other misconduct.

Examples of Criticism and Public Sentiment

Over the years, human rights organisations, civil society groups, and the media have repeatedly criticised the PCA for its inaction. There have been public calls for greater oversight and reform, but the response from both the PCA and government institutions has often been insufficient. The perception of a "culture of impunity" among the police, especially in cases of extrajudicial killings, only deepens when investigations by the PCA result in no concrete actions or outcomes.

Moving Forward

For the PCA to become a truly effective body in ensuring accountability for police actions, it must:

• Ensure transparency in its investigations and outcomes, providing the public with regular updates and clear explanations of its actions.

• Strengthen its legal and operational capacity, perhaps by seeking the ability to make binding recommendations or refer cases directly to the courts for prosecution.

• Reform the institutional and political environment that may be preventing the PCA from acting independently, ensuring that the police are held to account in all cases, including extrajudicial killings and other serious misconduct.

• Engage with civil society to foster a stronger relationship of trust and accountability between the public, law enforcement, and oversight bodies.

Unfortunately, there seems to have been a persistent failure to take action in cases of police misconduct in Trinidad and Tobago, leading to widespread disillusionment with the PCA's effectiveness. Until there is a substantial shift in both the operational capacity of the PCA and the political will to hold the police accountable, it is unlikely that public confidence in the institution will be restored.

No, You Don’t Get to Breach Copyright Because Your Husband Was Black Stalin

 

I’ve read Abdon Mason’s hand-wringing letter [https://trinidadexpress.com/opinion/letters/have-mercy-on-stalin-s-widow/article_da11ca3f-141f-42ab-a57e-bd2e5de22edf.html] about the copyright judgment against Black Stalin’s widow. Let me say what he wouldn’t: it’s legally illiterate nonsense.

A woman used a copyrighted photo of her late husband in a promotional campaign for a public tribute concert. She didn’t have the photographer’s permission. That is copyright infringement. It doesn’t matter who her husband was.

Leroy “Black Stalin” Calliste was a national treasure, yes. But fame does not override the law. It never has and never will. No amount of nostalgic calypso lyrics, funeral tributes, or patriotic flag-waving makes theft of intellectual property magically lawful.

Let’s deal with the facts.

The photographer, Angelo Marcelle, owns the rights to the image. It had been licensed before. It had value. Using it again, publicly and commercially, without consent, breached those rights.

The widow didn’t defend the legal action. She didn’t respond. She didn’t instruct a lawyer. So the court entered a default judgment. That’s not heartlessness. That’s civil procedure. Ignore a claim and lose—simple.

Mason calls this “tone-deaf” and “asinine”. I call it lawful. If you want to honour your late husband, you don’t do it by trampling on someone else’s legal rights. You certainly don’t rally public outrage to gaslight the courts.

This is not about punishing grief. It’s about protecting creators who—unlike the subject of the photo—are still alive and working. Photographers, artists, musicians—every one of them deserves control over their work, whether or not the person pictured is famous.

The argument that this is “just one image” is pitiful. That’s like stealing one painting and saying it’s fine because the artist painted more. It’s not only wrong, it’s insulting.

Mason asks if this is the nation we’ve become. I hope so—a nation where copyright means something. A nation where creators aren’t sacrificed on the altar of nostalgia.

And let’s be honest—what’s actually “tone-deaf” is using Stalin’s legacy to excuse unlawful conduct. Stalin sang truth to power. He stood for fairness and rights. His name should not be dragged into a campaign to vilify someone for protecting their intellectual property.

Respect the dead—but obey the law. No one is above it. Not even the widow of a legend.

A Systems Failure in Trinidad and Tobago

The problems plaguing Trinidad and Tobago are systems problems. Systems thinking is a separate field, evolved from handling complexity and problems that cannot be resolved through simplifying. It looks at variables and connections/interrelationships, and looks at where small iterations or influence can affect meaningful change. Trinidad and Tobago suffers from many such complex problems, but each of those problems are connected to the other so you can see that there are systems nested within systems, or sitting parallel to the systems. Complexity and chaos is the result. It is not helped by corruption, lack of critical thinking and downright stupidity. The last 10 years of political governance is a prime example.

Let us deal with national security. I note that Roger Alexander is already mouthing off. Nothing surprising there. His internal character was on full display during his television programme – a bully, lack of critical thinking skills (and probably qualifications), and resorting to the "brute squad" mentality of the Randolph Burroughs era. It seems he did not learn anything from Gary Griffith. Shutting your mouth and go about your job quietly. I trust that we will soon see police officers wearing and using body cams and full investigations for all these extrajudicial killings.

Firearms users licences – I suppose soon we can load up the "matic" and empty the clip. There is a disturbing shortsighted thinking coming from the newly installed Prime Minister. She seems bent (from her actions so far) in following the failed USA (Ministry of homeland security? Please!). The solution is not more guns, but the opposite. Statistics and real-world examples abound where countries that do not have armed citizens are safer. In fact, many of these countries do not even have armed police. What we need is more effective policing. Over the last 20 years I have written that the purported solve rate of serious crimes is 6%. This itself is a misleading figure because the robustness of evidence presented to the court for a conviction remains at 1% of that 6%. This means that the police are either not trained sufficiently to gather forensic evidence in a robust manner sufficient enough to satisfy the court and rules of evidence, or that the police force remains generally lazy and prone to shortcuts and corruption. The public sphere is inundated with cases of police officers taking bribes to forego prosecution. There is also a notable lack of will to take disciplinary action against police officers by its leadership.

In terms of the economy, the entire countries know that we are in for a hard time. Clearly, the country is bankrupt or nearly so. Billions have gone missing with no explanation. The former minister of finance was an arrogant pompek. There is more than one prima facie case of corruption sitting in his lap. Steps must be taken to diversify income streams, decentralise public services, build/repair the decades-neglected infrastructure, find ways to bring wages to match living costs without further bankrupting the country. Reduce national debt, manage the collection of income tax, and put a curb on imports. A harsh measure, I know, but a temporary solution.

Remove egos from all members of the new government. Accept criticism, chew on it and digest it. It is a sign of maturity and growth to do this. Take on-board that you do not know everything, and members of the public may have solutions also. You are not expected to have all the answers. But you can seek answers from those with the correct expertise. In doing so, do not use it as a means of corrupting the process, by hiring unqualified family and friends.