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.

Fear, Favouritism, and the Fall of a Nation – A Rebuttal to Lynette Joseph’s PNM Hagiography

In her recent commentary [Daily Express https://tinyurl.com/2x4rbhda], Lynette Joseph offers readers a lyrical but profoundly misleading take on the upcoming 2025 general election. She champions Professor Hamid Ghany’s polling analysis but then veers into a full-throated defence of the People’s National Movement (PNM)—not as a political party, but as a fixed point in national destiny. Her piece masquerades as political insight; in truth, it is a partisan hymn to a ruling elite who have governed without vision, without transparency, and without accountability.

Let us confront the facts: Trinidad and Tobago is not thriving. It is treading water in a sea of missed opportunities, systemic patronage, and elite impunity.

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The Real Legacy of the PNM: Cronyism, Cutbacks, and Captured Institutions

Lynette Joseph’s portrayal of the PNM as an inclusive, reformist movement would be laughable—if it were not so offensive to the thousands of citizens who have been shut out, let down, and sold short by this administration.

1. The Dismantling of Educational Opportunity

Under the PNM, access to higher education has been gutted. The Government Assistance for Tuition Expenses (GATE) programme, once a passport to progress for working-class families, has been rolled back. Postgraduate students have been pushed out, and those from middle-income households now face crippling fees. Meanwhile, those with political connections receive scholarships in secret, with no application process, no criteria, and no requirement to repay.

One scandalous example: Laurel Lezama-Lee Sing, a former PNM senator, received over TT$500,000 in state funds for overseas education. This “scholarship” was never publicly accounted for, raising red flags in the Auditor General’s 2010 Report. The lack of transparency violated the principles of natural justice and fiduciary duty—yet not a single minister was held accountable.

This is not governance. It is state-sanctioned nepotism.

2. The Institutionalisation of Crony Contracts

The PNM has entrenched a system of state contracts awarded not on merit, but on loyalty, family name, and political proximity.

• The Young family, including the Prime Minister’s brother, has been linked to security contracts with NGC and Heritage Petroleum. No competitive tendering. No public scrutiny.

• The Al-Rawi family, with substantial real estate holdings, has benefitted from state leases, housing consultations, and untendered legal briefs.

• Projects in Point Fortin, Moruga, and EMBD land developments have exploded in cost—often doubling initial estimates—without explanation or consequence. Where are the audits? Where is the procurement oversight?

These are not isolated incidents. They are symptoms of a system designed to reward insiders and exclude the rest.

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Silencing the Watchdogs, Stalling the Law

The PNM deliberately starved the Procurement Regulator’s office of funding, delaying the enforcement of legislation that could curb precisely the abuses listed above. It has hollowed out independent offices, discouraged transparency, and actively undermined Parliamentary Joint Select Committees, refusing to answer hard questions or produce key documents.

This is government by evasion, not oversight.

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The Myth of Inclusivity

Joseph claims the PNM “welcomes all and sundry”. But inclusivity is not a slogan—it is a practice. In reality:

• Dissenters face blacklisting.

• Whistleblowers are silenced or sidelined.

• Only those who “play the game” are rewarded with jobs, contracts, or housing allocations.

In contrast, she paints the United National Congress (UNC) as merely “salivating over crossover citizens”. Yet it is the UNC that has opened its candidate slate to youth, women, and professionals from across the social spectrum. Has it made mistakes? Certainly. But unlike the PNM, it is no longer operating as a closed family firm.

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A Nation in Decline, A Future at Risk

Joseph closes by suggesting the 2025 election is “not about ethnicity or religion” but about “who will wake up and smell the fearsome IMF coffee”. On this, we agree—but she fails to mention that it is the PNM’s economic mismanagement that brewed that coffee in the first place.

With oil and gas revenues volatile, and no serious economic diversification, Trinidad and Tobago stands on a precipice. Corruption, brain drain, and inequality are not abstract risks—they are daily realities. This is not just bad politics. It is an existential failure of leadership.

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Conclusion: Reject Fear, Demand Accountability

Lynette Joseph’s article asks us to ignore history, forgive betrayal, and accept the status quo as inevitable. But we must reject nostalgia for a past that never served all of us equally. The 2025 election is not a coronation. It is a chance to reclaim the republic from a political cartel that governs by favour, not fairness.

We are not powerless. Our votes are not valueless.

Let us vote not for party, but for principle. Let us rebuild a nation not for the connected few—but for the many who have waited too long for justice, jobs, and dignity.

Gun control vs Accountability

 

This letter rebuts recent public comments (especially by PM in waiting Stuart Young [Daily Express 12/04/25]) suggesting that the solution to Trinidad and Tobago’s violent crime crisis may lie in expanding access to firearms for law-abiding citizens and in the creation of elite police squads. While these proposals may sound appealing to a fearful public, the evidence—both local and international—overwhelmingly shows that such approaches are ineffective and potentially dangerous. What is urgently needed is not more guns, but more justice.

Guns do not solve crime—they escalate it.
The United States offers a cautionary tale. It leads the developed world in both gun ownership and gun-related homicides. The 2023 Small Arms Survey estimates over 393 million civilian-held firearms in the US—more than one gun per person. Yet, rather than feeling safer, Americans face a gun death rate 25 times higher than other high-income countries (Everytown for Gun Safety, 2023). Rather than acting as a deterrent, widespread gun availability often escalates conflict and leads to tragic outcomes—whether in domestic disputes, community altercations, or mistaken identity.

Arming the public not only increases the number of firearms in circulation but also increases the chances of those firearms ending up in the wrong hands—through theft, trafficking, or loss. It is no coincidence that studies show more guns equals more gun crime. Trinidad and Tobago’s focus should not be to emulate failed models, but to learn from them.

The real crisis is not lack of firepower, but lack of justice.
Trinidad and Tobago suffers from a chronic collapse in law enforcement effectiveness. According to recent figures, the detection rate for homicides hovers around 6%. Worse still, the prosecution rate is just 1% of that 6%—an effective prosecution rate of roughly 0.06%. This means that nearly all perpetrators know they are unlikely to face any consequences. No society can claim to be governed by the rule of law when the odds of being caught and punished are that low. The problem is not the absence of weapons in citizens’ hands—it is the near-total absence of consequences for violent crime.

Rather than introducing more firearms into an already volatile environment, the Government should prioritise:

• Judicial reform to ensure speedier and more efficient prosecutions;

• Investment in forensic and investigative capacity so that evidence gathered is robust and admissible;

• Training and oversight of the police to improve professionalism, reduce corruption, and increase detection rates;

• Public trust and community policing, which are the true foundation of sustainable security.

Elite squads and undercover units may have a place in specific tactical operations, but they cannot replace a police force that the population trusts and a judiciary that delivers timely justice. Additionally, the proposal for legal immunity for undercover officers involved in criminal acts raises grave constitutional and human rights concerns and must be subject to robust legal safeguards—not political promises.

Conclusion: A nation armed is not a nation safe.
If Trinidad and Tobago truly wishes to combat violent crime, it must resist the false comfort of arming its populace. Guns are not justice. Swift detection, credible evidence, and timely, transparent trials are the only sustainable deterrents to violent crime. Without these, even the best-equipped elite squads will be chasing shadows while the streets remain unsafe.

A flawed analysis

Mr Noble Philip's argument [Sunday Express, 6 April 2025] that Israel Khan SC’s protest actions—including the symbolic destruction of a photograph of the Chief Justice—undermine the judiciary is seriously flawed. Rather, his actions should be understood as a legitimate and necessary exercise of constitutional freedoms aimed at restoring public trust through accountability.

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1. Khan’s Protest Falls Within Constitutional Freedom of Expression

Section 4(i) of the Constitution of Trinidad and Tobago guarantees:

“freedom of thought and expression.”

This includes symbolic speech and protest. Courts have long recognised the right to express dissent—even when that expression is provocative or discomforting—provided it does not incite violence or hatred. The European Court of Human Rights has consistently held that freedom of expression protects even those views that “offend, shock or disturb” (see Handyside v. United Kingdom (1976) 1 EHRR 737).

Khan’s symbolic act—destroying a photograph—may be uncomfortable to some, but it remains within the scope of protected political and symbolic expression. It does not amount to criminal conduct, nor does it legally amount to contempt or defamation absent malicious falsehoods.

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2. It Is Illogical to Blame Khan for Damage to the Judiciary

The assertion that Khan has “deflated the institution of the Chief Justice” misunderstands the root cause of public mistrust. The integrity of the judiciary is not damaged by protest or critique, but by allegations of misconduct that remain uninvestigated, such as:

• The controversial role of the CJ in the Marcia Ayers-Caesar fiasco;

• Allegations of improper influence regarding Housing Development Corporation (HDC) allocations;

• The CJ’s association with convicted fraudsters, which has been reported but not publicly refuted or transparently investigated.

To suggest that a protester is the cause of institutional decline is to confuse diagnosis with disease. As the JCPC held in Archie v Law Association of Trinidad and Tobago [2020] UKPC 23, public allegations against a Chief Justice can undermine the judiciary, and these concerns are legitimate if raised responsibly.

Khan’s long-term protest is rooted in legitimate concerns. His method may be dramatic, but it is designed to highlight inaction, not to erode the rule of law.

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3. Criticism of the CJ Is Not an Attack on the Institution

The argument falsely equates the person of the CJ with the institution of the Chief Justice. But they are distinct. The office must be respected—but so too must its occupant be held to account. As Lord Bingham stated in Sharma v DPP [2006] UKPC 57 at [27], where there is a “potentially credible report of serious misconduct,” the Prime Minister must act.

Respecting the institution requires investigation, not silence. Accountability strengthens public confidence, not weakens it. It is the failure to investigate or to initiate Section 137 proceedings that has left the institution in disrepute, not the protest of one SC.

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4. Conflating Symbolism With Legal Wrongdoing Is Misleading

To argue that Khan’s actions are somehow defamatory without evidence or a legal finding is irresponsible. Trinidad and Tobago’s defamation laws require publication of false statements that harm reputation. Symbolically burning a photograph is not defamation unless it is accompanied by false statements of fact. No evidence has been produced to show this threshold has been met.

Furthermore, there has been no legal action by the CJ or the Law Association against Mr Khan. Silence in response to a supposed defamation claim may suggest that the allegations are either:

• True (truth is an absolute defence), or

• Not legally actionable.

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5. Protest Serves a Democratic Function

Protest, especially by legal professionals, serves a vital democratic role. Mr Khan, as Senior Counsel, has a professional and ethical obligation to act in the public interest and uphold the rule of law. The Judiciary’s legitimacy depends on public confidence, and public confidence can only be restored by truth-seeking mechanisms, not enforced silence.

As Baroness Hale once noted:

“Judges are not above criticism. A healthy democracy must allow for the questioning of judicial conduct, particularly when trust is in doubt.”
(Lecture on Judicial Independence, 2018)

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6. Where Are the Other Voices? That Is Precisely the Problem

The original author laments the lack of “more voices being raised.” But this is not an argument against Mr Khan’s protest. Rather, it underscores how essential his protest has been—precisely because others have remained silent. Silence in the face of alleged misconduct is not neutrality; it is complicity.

Khan’s lone stance since 2017 is not an embarrassment to the Bar—it is an indictment of its inertia.

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Conclusion: Khan’s Protest Is Justified and Constitutionally Protected

Rather than undermining the judiciary, Mr Khan SC is acting to restore public trust by drawing attention to the fact that serious allegations have gone unaddressed.

The failure to trigger section 137 of the Constitution is a constitutional breach by the Executive. Mr Khan’s protest may be unconventional, but it has forced a necessary public reckoning. The symbolic act—burning a photograph—is not unlawful, defamatory, nor institutionally corrosive in law. What corrodes public trust is impunity, not protest.