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The Medical Association of Jamaica views with concern the statements made by the Minister of Heath Dr. The Hon. Christopher Tufton and the President of the Nurses Association of Jamaica Mrs. Carmen Johnson on the Special Feature entitled “Prescriptive Rights” aired on the TVJ Prime Time News on Wednesday 4th July 2018.

The Minister stated that changes to the Nursing and Midwifery Act to allow prescriptive rights for Nurse Practitioners have been accepted.  Accepted by whom?  It was the Medical Council of Jamaica along with the Medical Association of Jamaica under the Medical Act, who approved the implementation of the Nurse Practitioner Program in the late 1970’s.  This was done because there was an acute shortage of doctors at the time due to migration and there was a move towards Primary Health Care with the staffing of 345 Health centers.  It was also agreed that this would be a temporary measure until more doctors were available and the policy was made very clear to the Nurses Association of Jamaica at the time, that prescriptive rights could never be given to nurses because they had not fulfilled the formal medical training to have competences necessary to practice as doctors.  However, we would like to commend the nurse practitioners who filled the gap and thank them for working in collaboration and under supervision by a medical doctor. The Minister also alluded that the change will happen before we even know it, but the Medical Association of Jamaica will be vigilant and active to ensure that this does not happen.

Fast forward forty years later and our medical school is now graduating over 300 doctors annually, some of whom cannot get a job with Government after internship.  In addition, technology has vastly improved over the years with smartphones, computers and internet services.  This would make it easier for the nurse practitioners to contact the doctors and discuss a case with them.  Prescriptions can now be countersigned online.

In this modern era, all doctors and nurses are required to continue ongoing training through continuing medical education or by attending conferences and workshops.  The President of the Nurses Association of Jamaica stated that the Nurse Practitioners do not require further training to be given prescriptive rights, which is contrary to modern day medical practice.  We are very concerned about this statement as it places the patient’s safety at risk.  The time has come to reduce the number of Nurse Practitioners being trained and to focus more on training more Critical Care nurses.



Dr. Clive Lai