Part Two; Critical Comment: Globe And Mail Says Ontario's Chief Coroner's Office Must Be Made Accountable;

"IT WAS THE JOB OF DR. YOUNG AND DEPUTY CHIEF CORONER JAMES CAIRNS NOT TO BE FOOLED;

THEY WERE THE ONES IN CHARGE, NOT DR. SMITH;

AND THE EVIDENCE WAS BEFORE THEIR EYES - IN A JUDGE'S SCATHING RULING AS EARLY AS 1991, IN A PIECE OF CRUCIAL EVIDENCE THAT WOUND UP IN DR. SMITH'S SHIRT POCKET, RATHER THAN AS A COURT EXHIBIT, IN MEDIA EXPOSES - IF ONLY THEY HAD CARED TO LOOK;
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EDITORIAL;
GLOBE AND MAIL;
MARCH 31, 2008;
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One of the themes that has emerged from the Goudge Inquiry is the necessity for accountability on the part of those who take on senior roles in the public service.

The Globe and Mail did not mince words when it tackled that theme in a hard-hitting editorial which appeared last month;

"For mealy-mouthed denial after causing life-destroying harm, the Ontario Chief Coroner's Office (OCCO) set such a lofty standard last week that all abdications of responsibility should now be measured against it," the editorial begins;

"Leaders of the Eastern Health Authority in Newfoundland and Labrador, however, whose agency made mistakes that may have actually killed people, are showing signs that they may one day surpass the Ontario standard with their own denials," it continues;

"It was the job of Ontario Chief Coroner James Young to supervise Charles Smith, the province's top scientist in charge of investigating baby deaths.

Dr. Smith of Toronto botched that job so badly over a 13-year period ending in 2004 that as many as 20 people were wrongly accused or convicted of crimes, up to and including murder, and one went to jail for as long as 12 years.

Children were taken away from their families permanently because parents were wrongly accused of abuse.

And the response from the chief coroner's office, in its final submission to Mr. Justice Stephen Goudge of the Ontario Court of Appeal, was to say Dr. Smith made such a good personal impression that he fooled them.

"Aside from Dr. Smith's reputation as an expert in the field of pediatric forensic pathology, he was also someone who exuded confidence and self-assurance, which had a positive impact on those working with him for OCCO," the office says in its brief.

"It would have been difficult and perhaps even unreasonable, under the circumstances, for OCCO to anticipate a situation in which a world-renowned pathologist who was considered to be the top in his field - and who presented as highly competent - would fail the system in the manner that is the subject of this commission of inquiry."

Presented as highly competent?

It was the job of Dr. Young and Deputy Chief Coroner James Cairns not to be fooled.

They were the ones in charge, not Dr. Smith.

And the evidence was before their eyes - in a judge's scathing ruling as early as 1991, in a piece of crucial evidence that wound up in Dr. Smith's shirt pocket, rather than as a court exhibit, in media exposés - if only they had cared to look.

But partly on the strength of Dr. Smith's inflated reputation, the coroner's office itself grew in the public's esteem.

And so the office turned a blind eye to his failings.

Dr. Smith, for his own part, while accepting some measure of responsibility for some mistakes (which included acting as the prosecution's advocate in the courtroom, more a willful misreading of his duty than a simple mistake), pointed a finger back at the coroner's office for failing to supervise him properly, as if to say, "It's not my fault I can't be trusted on my own."

In Newfoundland and Labrador, meanwhile, a separate inquiry is examining how the Eastern Health Authority misread crucial laboratory tests for 383 cancer patients from 1997 to 2005.

At least one woman underwent a double mastectomy when she did not have breast cancer because of the inaccurate tests; others were denied medication that might have helped them.

Joan Dawe, the head of Eastern's board, testified at the inquiry that she saw no reason to question whether all affected patients had been notified of the faulty test results, in spite of news reports that should have raised alarm bells.

Massive breaches of public trust will not be healed by denials of responsibility.

The medical establishment in the Ontario Chief Coroner's Office has proven be a collection of emperors with no clothes, and Newfoundland and Labrador's public health officials may soon be shown in a similar state.

Creating a culture of accountability in the medical establishment is job number one for these inquiries.

NEXT POSTING: Globe and Mail columnist Christie Blatchford goes to the defence of former Chief Coroner, Dr. James Young, and former Deputy Chief Coroner, Dr. James Cairns;


Harold Levy...hlevy15@gmail.com;