and then there were six
Boss Swap

No regrets

When Yeoh Eng-kiong resigned from the government, I expressed doubts about the logic of this. I will freely admit that I did this without having reading any of the reports into last years SARS outbreak, basing my argument on the general principle that it is a bad idea for people to resign simply in order to satisfy public opinion.

The following day, the chairman of the Hospital Authority also resigned, but defiantly insisting that he had nothing wrong. Brian Walker, writing in Spike magazine, puts forward a very persuasive argument that he had made serious mistakes:

Dr Leong Che-hung said, “I need to stress that the Hospital Authority has made no mistake,” on the day he resigned as head of the board. The remaining 23 members of the board, true as ever to their nature, decided not to resign should Dr Leong go after promising they would. Why not?

What actually happened that required the HA to be examined so closely? Members have “learned a lot” from “bitter experience” and made a lot of improvements. Bravo! I suppose the situation was unique and therefore it is only to be expected that a balls-up was made. Such is a learning experience. Hang on a bit, though, I thought we were dealing with an outbreak of an infectious illness, which spread like wildfire, killing at random? Something like smallpox, for example? Or influenza A? Or TB? Or HIV?

So what was the new learning experience that flummoxed the HA and caused two blameless men to resign, and 23 equally blameless leaders of the HA to bravely stay on in position? It certainly would not have been the basic lessons of contagion, control and epidemiology, because those lessons are learned in medical school.

When you have a contagious disease on the prowl, you isolate the clinical cases. Then you let epidemiologists loose, whose function is to chase down the clinical cases, identify the organism(s) and the mode of transmission.

Powerful stuff. I am not a doctor, and won't pretend to understand the details, but to a layman it seems fairly clear that some very serious mistakes were made.

When Hong Kong was being overwhelmed by Sars, and when we had need of genuine assistance from people of expertise, what did you endorse? That we all wear facemasks – a notably inefficient viral filter, incapable of preventing the spread of the corona virus.

You might have made that connection earlier when facemask-wearing staff caught the virus. But no, you carried on with that recommendation. Indeed, you are still recommending that action. Why?

Are you not aware that the only function of a surgical facemask is to prevent the operator sneezing nasal material on to a wound, or prevent blood spatter from reaching the face? If even that basic medical fact escapes you, why are you still in positions of authority?

And when the most eminent of the world authorities said that the use of ribavarin in treating Sars was not only useless but might also be responsible for the greatly increased death toll in Hong Kong, did you take action and stop using the drug? No, you did not. Even now you support that policy.

Has no one on the HA ever queried why Hong Kong should have had the highest death rate for Sars in the world? A look across the border would have shown you a death rate much lower, and you might have surmised that perhaps the other countries which avoided ribavirin may have had a point. But you did not.

I wouldn't criticize the HA for trying ribavrin in the first place - at the time that the first SARS patients were admitted to hospital no-one knew what treatments might work - but it seems very odd if nothing is being done to compare the results here with other countries where different treatments were used. If it is effective then other countries should be using it, if it isn't then it shouldn't be used in Hong Kong.

The resignations seem irrelevant to me - what is much more worrying is that no-one seems willing to admit that they made mistakes. Which is one reason why I have concerns about pressure on people to resign. That pressure probably makes people more reluctant to admit their mistakes, and what really matters is that action is taken to avoid these mistakes happening again.

I would much prefer to have these people stay on and put things right than to have the absurd situation where we have a token resignation accompanied by these defiant statements that they had done nothing wrong. If someone makes a serious mistake and then refuses to acknowledge it then that is certainly grounds for them to be dismissed. It's not the mistakes themselves, it's the way you deal with them.


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