QUESTION

In no more than 60 words, discuss the image's effectiveness in making the claim.

Read the argument below and answer the question that follows.

We must do better with public healthcare

By Garth Rattray

Published in the Jamaica Gleaner on Sunday, February 23, 2025

1.     Let me begin by categorically declaring that I never set out to bash any government official whenever I criticise our public healthcare system. I have no ulterior motives. I am [simply] extremely concerned for the welfare of hundreds of thousands of my fellow Jamaicans who have no choice but to access our public healthcare system. Even as a physician in private practice since 1983, I have seen innumerable cases of the failure of our public healthcare facilities that lead to severe sickness and premature death.

2.     Just recently, a 40-something-year-old man was struck from behind by a motor vehicle as he walked on the sidewalk in his community. The impact threw him into the air, and he was rendered unconscious. When he regained consciousness, he was in a public hospital and in a lot of pain. He was told that his right leg was badly fractured and required internal fixation to realign and stabilise the bones so that they could heal properly. They put on a plaster cast and gave him a prescription for the hardware needed to do the surgery.

3.     He has been unable to work since the crash and he is from a poor family. None of them can afford the hardware. He has been on crutches and the last X-rays reveal that the bones are very badly misaligned and attempting to heal in that position. This will eventually leave him with a shortened and very deformed lower limb – all because he is poor, and our ‘no-user-fee’ system is unable to supply the hardware to repair his fracture.

4.     Last year, a patient who was seeing me for over 30 years fell and broke one of his hips. He was in his early 60’s and, being poor, he went to one of our public hospitals. He was seen, investigated, and admitted pending surgery for the broken hip. But there was a big problem, neither he nor his family could afford the hardware needed to replace the broken hip. Consequently, he was placed on a bed and left on traction. After six weeks of this, he developed hospital-acquired pneumonia and died.

5.     He died because he was poor. He died because, despite Jamaica being an upper-middle-class income country, our ‘no-user-fee’ system could not afford to supply the hardware to replace his hip. The family was given a prescription for the hardware, but they could not raise the money since their combined income can barely keep body and soul together. That is a disgrace, but the optics emanating from the relevant ministry portray an alternate reality.

 6.     Then there is the very recent case of a gentleman in his early seventies who was admitted to one of our public hospitals. On admission he was severely dehydrated and malnourished. He had had several falls and loss of consciousness. He was placed on a bed on a ward with regular drip infusion… sometimes. He had no appetite, was weak and unable to feed himself. Yet, as confirmed by neighbouring patients, the hospital staff always brought meals and set them down beside him. He was only able to take one or two forks, then collapse back into the bed. The remaining portions of the meals were dutifully removed. This went on for several weeks. Consequently, this gentleman lay in a bed and became weaker and weaker while admitted into one of our public hospitals. His relative was confined to restrictive visiting hours and was not able to ‘spoon feed’ him regularly. His relative (a son) was also unable to bathe him regularly. Towels, rags, and some clothing left for him became community property and vanished repeatedly.

7.     The medical staff requested a badly needed CT scan, but this major public hospital outsourced the investigation. His relatives could not come up with the money. This Jamaican citizen remained, withering away on a bed in one of our public hospitals. No one attempted to tube feed him or supply nutrients intravenously. No one would meet with his relatives to explain his situation. The visiting times and the times when doctors did their rounds did not coincide. On one occasion, I was lucky to speak with the nursing staff on the ward by telephone, but the group consulted among themselves and told me that they could not give the attending physician(s) my telephone number so that I may speak with any of them about my patient. After many weeks of slow and painful deterioration on a bed in one of our public hospitals, this gentleman developed hospital-acquired pneumonia and gave up the ghost. Just prior to his demise, his son was called for a ‘family meeting’– the badly needed communication was far too little and far too late.

8.     I do not understand this ‘no-user-fee’ system. We are told that it does not pay for some investigations, no matter how basic, urgent, or lifesaving they may be. We were made to believe that there were arrangements with some private facilities to provide expensive investigations. We were told that new scanners were here. We were told of the Ministry of Health and Wellness compassionate fund; but then, why are citizens suffering and dying in our public hospitals for lack of needed surgical hardware and investigations?

 9.     I don’t want any defensive or deflective responses to my concerns, I just want us to do much better for our poor and ‘ordinary’ citizens. They are as human as the rich and connected among us. Poverty should not carry a possible death sentence.

__________________________________________________________________________________________________________________________

Garth Rattray is a medical doctor with family practice, and author of ‘The Long and Short of Thick and Thin’.

Which of the following is NOT a premise provided by the writer of the passage?

QUESTION

Read the argument below and answer the question that follows.

We must do better with public healthcare

By Garth Rattray

Published in the Jamaica Gleaner on Sunday, February 23, 2025

1.     Let me begin by categorically declaring that I never set out to bash any government official whenever I criticise our public healthcare system. I have no ulterior motives. I am [simply] extremely concerned for the welfare of hundreds of thousands of my fellow Jamaicans who have no choice but to access our public healthcare system. Even as a physician in private practice since 1983, I have seen innumerable cases of the failure of our public healthcare facilities that lead to severe sickness and premature death.

2.     Just recently, a 40-something-year-old man was struck from behind by a motor vehicle as he walked on the sidewalk in his community. The impact threw him into the air, and he was rendered unconscious. When he regained consciousness, he was in a public hospital and in a lot of pain. He was told that his right leg was badly fractured and required internal fixation to realign and stabilise the bones so that they could heal properly. They put on a plaster cast and gave him a prescription for the hardware needed to do the surgery.

3.     He has been unable to work since the crash and he is from a poor family. None of them can afford the hardware. He has been on crutches and the last X-rays reveal that the bones are very badly misaligned and attempting to heal in that position. This will eventually leave him with a shortened and very deformed lower limb – all because he is poor, and our ‘no-user-fee’ system is unable to supply the hardware to repair his fracture.

4.     Last year, a patient who was seeing me for over 30 years fell and broke one of his hips. He was in his early 60’s and, being poor, he went to one of our public hospitals. He was seen, investigated, and admitted pending surgery for the broken hip. But there was a big problem, neither he nor his family could afford the hardware needed to replace the broken hip. Consequently, he was placed on a bed and left on traction. After six weeks of this, he developed hospital-acquired pneumonia and died.

5.     He died because he was poor. He died because, despite Jamaica being an upper-middle-class income country, our ‘no-user-fee’ system could not afford to supply the hardware to replace his hip. The family was given a prescription for the hardware, but they could not raise the money since their combined income can barely keep body and soul together. That is a disgrace, but the optics emanating from the relevant ministry portray an alternate reality.

 6.     Then there is the very recent case of a gentleman in his early seventies who was admitted to one of our public hospitals. On admission he was severely dehydrated and malnourished. He had had several falls and loss of consciousness. He was placed on a bed on a ward with regular drip infusion… sometimes. He had no appetite, was weak and unable to feed himself. Yet, as confirmed by neighbouring patients, the hospital staff always brought meals and set them down beside him. He was only able to take one or two forks, then collapse back into the bed. The remaining portions of the meals were dutifully removed. This went on for several weeks. Consequently, this gentleman lay in a bed and became weaker and weaker while admitted into one of our public hospitals. His relative was confined to restrictive visiting hours and was not able to ‘spoon feed’ him regularly. His relative (a son) was also unable to bathe him regularly. Towels, rags, and some clothing left for him became community property and vanished repeatedly.

7.     The medical staff requested a badly needed CT scan, but this major public hospital outsourced the investigation. His relatives could not come up with the money. This Jamaican citizen remained, withering away on a bed in one of our public hospitals. No one attempted to tube feed him or supply nutrients intravenously. No one would meet with his relatives to explain his situation. The visiting times and the times when doctors did their rounds did not coincide. On one occasion, I was lucky to speak with the nursing staff on the ward by telephone, but the group consulted among themselves and told me that they could not give the attending physician(s) my telephone number so that I may speak with any of them about my patient. After many weeks of slow and painful deterioration on a bed in one of our public hospitals, this gentleman developed hospital-acquired pneumonia and gave up the ghost. Just prior to his demise, his son was called for a ‘family meeting’– the badly needed communication was far too little and far too late.

8.     I do not understand this ‘no-user-fee’ system. We are told that it does not pay for some investigations, no matter how basic, urgent, or lifesaving they may be. We were made to believe that there were arrangements with some private facilities to provide expensive investigations. We were told that new scanners were here. We were told of the Ministry of Health and Wellness compassionate fund; but then, why are citizens suffering and dying in our public hospitals for lack of needed surgical hardware and investigations?

 9.     I don’t want any defensive or deflective responses to my concerns, I just want us to do much better for our poor and ‘ordinary’ citizens. They are as human as the rich and connected among us. Poverty should not carry a possible death sentence.

__________________________________________________________________________________________________________________________

Garth Rattray is a medical doctor with family practice, and author of ‘The Long and Short of Thick and Thin’.

We must do better with public healthcare

By Garth Rattray

Published in the Jamaica Gleaner on Sunday, February 23, 2025

1.     Let me begin by categorically declaring that I never set out to bash any government official whenever I criticise our public healthcare system. I have no ulterior motives. I am [simply] extremely concerned for the welfare of hundreds of thousands of my fellow Jamaicans who have no choice but to access our public healthcare system. Even as a physician in private practice since 1983, I have seen innumerable cases of the failure of our public healthcare facilities that lead to severe sickness and premature death.

2.     Just recently, a 40-something-year-old man was struck from behind by a motor vehicle as he walked on the sidewalk in his community. The impact threw him into the air, and he was rendered unconscious. When he regained consciousness, he was in a public hospital and in a lot of pain. He was told that his right leg was badly fractured and required internal fixation to realign and stabilise the bones so that they could heal properly. They put on a plaster cast and gave him a prescription for the hardware needed to do the surgery.

3.     He has been unable to work since the crash and he is from a poor family. None of them can afford the hardware. He has been on crutches and the last X-rays reveal that the bones are very badly misaligned and attempting to heal in that position. This will eventually leave him with a shortened and very deformed lower limb – all because he is poor, and our ‘no-user-fee’ system is unable to supply the hardware to repair his fracture.

4.     Last year, a patient who was seeing me for over 30 years fell and broke one of his hips. He was in his early 60’s and, being poor, he went to one of our public hospitals. He was seen, investigated, and admitted pending surgery for the broken hip. But there was a big problem, neither he nor his family could afford the hardware needed to replace the broken hip. Consequently, he was placed on a bed and left on traction. After six weeks of this, he developed hospital-acquired pneumonia and died.

5.     He died because he was poor. He died because, despite Jamaica being an upper-middle-class income country, our ‘no-user-fee’ system could not afford to supply the hardware to replace his hip. The family was given a prescription for the hardware, but they could not raise the money since their combined income can barely keep body and soul together. That is a disgrace, but the optics emanating from the relevant ministry portray an alternate reality.

 6.     Then there is the very recent case of a gentleman in his early seventies who was admitted to one of our public hospitals. On admission he was severely dehydrated and malnourished. He had had several falls and loss of consciousness. He was placed on a bed on a ward with regular drip infusion… sometimes. He had no appetite, was weak and unable to feed himself. Yet, as confirmed by neighbouring patients, the hospital staff always brought meals and set them down beside him. He was only able to take one or two forks, then collapse back into the bed. The remaining portions of the meals were dutifully removed. This went on for several weeks. Consequently, this gentleman lay in a bed and became weaker and weaker while admitted into one of our public hospitals. His relative was confined to restrictive visiting hours and was not able to ‘spoon feed’ him regularly. His relative (a son) was also unable to bathe him regularly. Towels, rags, and some clothing left for him became community property and vanished repeatedly.

7.     The medical staff requested a badly needed CT scan, but this major public hospital outsourced the investigation. His relatives could not come up with the money. This Jamaican citizen remained, withering away on a bed in one of our public hospitals. No one attempted to tube feed him or supply nutrients intravenously. No one would meet with his relatives to explain his situation. The visiting times and the times when doctors did their rounds did not coincide. On one occasion, I was lucky to speak with the nursing staff on the ward by telephone, but the group consulted among themselves and told me that they could not give the attending physician(s) my telephone number so that I may speak with any of them about my patient. After many weeks of slow and painful deterioration on a bed in one of our public hospitals, this gentleman developed hospital-acquired pneumonia and gave up the ghost. Just prior to his demise, his son was called for a ‘family meeting’– the badly needed communication was far too little and far too late.

8.     I do not understand this ‘no-user-fee’ system. We are told that it does not pay for some investigations, no matter how basic, urgent, or lifesaving they may be. We were made to believe that there were arrangements with some private facilities to provide expensive investigations. We were told that new scanners were here. We were told of the Ministry of Health and Wellness compassionate fund; but then, why are citizens suffering and dying in our public hospitals for lack of needed surgical hardware and investigations?

 9.     I don’t want any defensive or deflective responses to my concerns, I just want us to do much better for our poor and ‘ordinary’ citizens. They are as human as the rich and connected among us. Poverty should not carry a possible death sentence.

__________________________________________________________________________________________________________________________

Garth Rattray is a medical doctor with family practice, and author of ‘The Long and Short of Thick and Thin’.

In one paragraph of approximately 60 words, evaluate the writer's use of logos appeal.

Read the argument below and answer the question that follows.

We must do better with public healthcare

By Garth Rattray

Published in the Jamaica Gleaner on Sunday, February 23, 2025

1.     Let me begin by categorically declaring that I never set out to bash any government official whenever I criticise our public healthcare system. I have no ulterior motives. I am [simply] extremely concerned for the welfare of hundreds of thousands of my fellow Jamaicans who have no choice but to access our public healthcare system. Even as a physician in private practice since 1983, I have seen innumerable cases of the failure of our public healthcare facilities that lead to severe sickness and premature death.

2.     Just recently, a 40-something-year-old man was struck from behind by a motor vehicle as he walked on the sidewalk in his community. The impact threw him into the air, and he was rendered unconscious. When he regained consciousness, he was in a public hospital and in a lot of pain. He was told that his right leg was badly fractured and required internal fixation to realign and stabilise the bones so that they could heal properly. They put on a plaster cast and gave him a prescription for the hardware needed to do the surgery.

3.     He has been unable to work since the crash and he is from a poor family. None of them can afford the hardware. He has been on crutches and the last X-rays reveal that the bones are very badly misaligned and attempting to heal in that position. This will eventually leave him with a shortened and very deformed lower limb – all because he is poor, and our ‘no-user-fee’ system is unable to supply the hardware to repair his fracture.

4.     Last year, a patient who was seeing me for over 30 years fell and broke one of his hips. He was in his early 60’s and, being poor, he went to one of our public hospitals. He was seen, investigated, and admitted pending surgery for the broken hip. But there was a big problem, neither he nor his family could afford the hardware needed to replace the broken hip. Consequently, he was placed on a bed and left on traction. After six weeks of this, he developed hospital-acquired pneumonia and died.

5.     He died because he was poor. He died because, despite Jamaica being an upper-middle-class income country, our ‘no-user-fee’ system could not afford to supply the hardware to replace his hip. The family was given a prescription for the hardware, but they could not raise the money since their combined income can barely keep body and soul together. That is a disgrace, but the optics emanating from the relevant ministry portray an alternate reality.

 6.     Then there is the very recent case of a gentleman in his early seventies who was admitted to one of our public hospitals. On admission he was severely dehydrated and malnourished. He had had several falls and loss of consciousness. He was placed on a bed on a ward with regular drip infusion… sometimes. He had no appetite, was weak and unable to feed himself. Yet, as confirmed by neighbouring patients, the hospital staff always brought meals and set them down beside him. He was only able to take one or two forks, then collapse back into the bed. The remaining portions of the meals were dutifully removed. This went on for several weeks. Consequently, this gentleman lay in a bed and became weaker and weaker while admitted into one of our public hospitals. His relative was confined to restrictive visiting hours and was not able to ‘spoon feed’ him regularly. His relative (a son) was also unable to bathe him regularly. Towels, rags, and some clothing left for him became community property and vanished repeatedly.

7.     The medical staff requested a badly needed CT scan, but this major public hospital outsourced the investigation. His relatives could not come up with the money. This Jamaican citizen remained, withering away on a bed in one of our public hospitals. No one attempted to tube feed him or supply nutrients intravenously. No one would meet with his relatives to explain his situation. The visiting times and the times when doctors did their rounds did not coincide. On one occasion, I was lucky to speak with the nursing staff on the ward by telephone, but the group consulted among themselves and told me that they could not give the attending physician(s) my telephone number so that I may speak with any of them about my patient. After many weeks of slow and painful deterioration on a bed in one of our public hospitals, this gentleman developed hospital-acquired pneumonia and gave up the ghost. Just prior to his demise, his son was called for a ‘family meeting’– the badly needed communication was far too little and far too late.

8.     I do not understand this ‘no-user-fee’ system. We are told that it does not pay for some investigations, no matter how basic, urgent, or lifesaving they may be. We were made to believe that there were arrangements with some private facilities to provide expensive investigations. We were told that new scanners were here. We were told of the Ministry of Health and Wellness compassionate fund; but then, why are citizens suffering and dying in our public hospitals for lack of needed surgical hardware and investigations?

 9.     I don’t want any defensive or deflective responses to my concerns, I just want us to do much better for our poor and ‘ordinary’ citizens. They are as human as the rich and connected among us. Poverty should not carry a possible death sentence.

__________________________________________________________________________________________________________________________

Garth Rattray is a medical doctor with family practice, and author of ‘The Long and Short of Thick and Thin’.

We

must do better with public healthcare

By Garth Rattray

Published in the Jamaica Gleaner on Sunday,

February 23, 2025

1.    

2.    

3.    

4.    

5.    

 6.    

Then there is the very recent case of a gentleman in his early seventies

who was admitted to one of our public hospitals. On admission he was severely

dehydrated and malnourished. He had had several falls and loss of

consciousness. He was placed on a bed on a ward with regular drip infusion…

sometimes. He had no appetite, was weak and unable to feed himself. Yet, as

confirmed by neighbouring patients, the hospital staff always brought meals and

set them down beside him. He was only able to take one or two forks, then

collapse back into the bed. The remaining portions of the meals were dutifully

removed. This went on for several weeks.

7.    

8.    

9.    

__________________________________________________________________________________________________________________________

Garth Rattray is a medical doctor with family

practice, and author of ‘The Long and Short of Thick and Thin’

In approximately 60-80 words, and by giving at least 2 examples, comment on ONE language strategy or device used by the writer to make his argument more effective.

We must do better with public healthcare

By Garth Rattray

Published in the Jamaica Gleaner on Sunday, February 23, 2025

1.     Let me begin by categorically declaring that I never set out to bash any government official whenever I criticise our public healthcare system. I have no ulterior motives. I am [simply] extremely concerned for the welfare of hundreds of thousands of my fellow Jamaicans who have no choice but to access our public healthcare system. Even as a physician in private practice since 1983, I have seen innumerable cases of the failure of our public healthcare facilities that lead to severe sickness and premature death.

2.     Just recently, a 40-something-year-old man was struck from behind by a motor vehicle as he walked on the sidewalk in his community. The impact threw him into the air, and he was rendered unconscious. When he regained consciousness, he was in a public hospital and in a lot of pain. He was told that his right leg was badly fractured and required internal fixation to realign and stabilise the bones so that they could heal properly. They put on a plaster cast and gave him a prescription for the hardware needed to do the surgery.

3.     He has been unable to work since the crash and he is from a poor family. None of them can afford the hardware. He has been on crutches and the last X-rays reveal that the bones are very badly misaligned and attempting to heal in that position. This will eventually leave him with a shortened and very deformed lower limb – all because he is poor, and our ‘no-user-fee’ system is unable to supply the hardware to repair his fracture.

4.     Last year, a patient who was seeing me for over 30 years fell and broke one of his hips. He was in his early 60’s and, being poor, he went to one of our public hospitals. He was seen, investigated, and admitted pending surgery for the broken hip. But there was a big problem, neither he nor his family could afford the hardware needed to replace the broken hip. Consequently, he was placed on a bed and left on traction. After six weeks of this, he developed hospital-acquired pneumonia and died.

5.     He died because he was poor. He died because, despite Jamaica being an upper-middle-class income country, our ‘no-user-fee’ system could not afford to supply the hardware to replace his hip. The family was given a prescription for the hardware, but they could not raise the money since their combined income can barely keep body and soul together. That is a disgrace, but the optics emanating from the relevant ministry portray an alternate reality.

 6.     Then there is the very recent case of a gentleman in his early seventies who was admitted to one of our public hospitals. On admission he was severely dehydrated and malnourished. He had had several falls and loss of consciousness. He was placed on a bed on a ward with regular drip infusion… sometimes. He had no appetite, was weak and unable to feed himself. Yet, as confirmed by neighbouring patients, the hospital staff always brought meals and set them down beside him. He was only able to take one or two forks, then collapse back into the bed. The remaining portions of the meals were dutifully removed. This went on for several weeks. Consequently, this gentleman lay in a bed and became weaker and weaker while admitted into one of our public hospitals. His relative was confined to restrictive visiting hours and was not able to ‘spoon feed’ him regularly. His relative (a son) was also unable to bathe him regularly. Towels, rags, and some clothing left for him became community property and vanished repeatedly.

7.     The medical staff requested a badly needed CT scan, but this major public hospital outsourced the investigation. His relatives could not come up with the money. This Jamaican citizen remained, withering away on a bed in one of our public hospitals. No one attempted to tube feed him or supply nutrients intravenously. No one would meet with his relatives to explain his situation. The visiting times and the times when doctors did their rounds did not coincide. On one occasion, I was lucky to speak with the nursing staff on the ward by telephone, but the group consulted among themselves and told me that they could not give the attending physician(s) my telephone number so that I may speak with any of them about my patient. After many weeks of slow and painful deterioration on a bed in one of our public hospitals, this gentleman developed hospital-acquired pneumonia and gave up the ghost. Just prior to his demise, his son was called for a ‘family meeting’– the badly needed communication was far too little and far too late.

8.     I do not understand this ‘no-user-fee’ system. We are told that it does not pay for some investigations, no matter how basic, urgent, or lifesaving they may be. We were made to believe that there were arrangements with some private facilities to provide expensive investigations. We were told that new scanners were here. We were told of the Ministry of Health and Wellness compassionate fund; but then, why are citizens suffering and dying in our public hospitals for lack of needed surgical hardware and investigations?

 9.     I don’t want any defensive or deflective responses to my concerns, I just want us to do much better for our poor and ‘ordinary’ citizens. They are as human as the rich and connected among us. Poverty should not carry a possible death sentence.

__________________________________________________________________________________________________________________________

Garth Rattray is a medical doctor with family practice, and author of ‘The Long and Short of Thick and Thin’.

Which of the following BEST describes the writer's purpose in paragraph 8?

We must do better with public healthcare

By Garth Rattray

Published in the Jamaica Gleaner on Sunday, February 23, 2025

1.     Let me begin by categorically declaring that I never set out to bash any government official whenever I criticise our public healthcare system. I have no ulterior motives. I am [simply] extremely concerned for the welfare of hundreds of thousands of my fellow Jamaicans who have no choice but to access our public healthcare system. Even as a physician in private practice since 1983, I have seen innumerable cases of the failure of our public healthcare facilities that lead to severe sickness and premature death.

2.     Just recently, a 40-something-year-old man was struck from behind by a motor vehicle as he walked on the sidewalk in his community. The impact threw him into the air, and he was rendered unconscious. When he regained consciousness, he was in a public hospital and in a lot of pain. He was told that his right leg was badly fractured and required internal fixation to realign and stabilise the bones so that they could heal properly. They put on a plaster cast and gave him a prescription for the hardware needed to do the surgery.

3.     He has been unable to work since the crash and he is from a poor family. None of them can afford the hardware. He has been on crutches and the last X-rays reveal that the bones are very badly misaligned and attempting to heal in that position. This will eventually leave him with a shortened and very deformed lower limb – all because he is poor, and our ‘no-user-fee’ system is unable to supply the hardware to repair his fracture.

4.     Last year, a patient who was seeing me for over 30 years fell and broke one of his hips. He was in his early 60’s and, being poor, he went to one of our public hospitals. He was seen, investigated, and admitted pending surgery for the broken hip. But there was a big problem, neither he nor his family could afford the hardware needed to replace the broken hip. Consequently, he was placed on a bed and left on traction. After six weeks of this, he developed hospital-acquired pneumonia and died.

5.     He died because he was poor. He died because, despite Jamaica being an upper-middle-class income country, our ‘no-user-fee’ system could not afford to supply the hardware to replace his hip. The family was given a prescription for the hardware, but they could not raise the money since their combined income can barely keep body and soul together. That is a disgrace, but the optics emanating from the relevant ministry portray an alternate reality.

 6.     Then there is the very recent case of a gentleman in his early seventies who was admitted to one of our public hospitals. On admission he was severely dehydrated and malnourished. He had had several falls and loss of consciousness. He was placed on a bed on a ward with regular drip infusion… sometimes. He had no appetite, was weak and unable to feed himself. Yet, as confirmed by neighbouring patients, the hospital staff always brought meals and set them down beside him. He was only able to take one or two forks, then collapse back into the bed. The remaining portions of the meals were dutifully removed. This went on for several weeks. Consequently, this gentleman lay in a bed and became weaker and weaker while admitted into one of our public hospitals. His relative was confined to restrictive visiting hours and was not able to ‘spoon feed’ him regularly. His relative (a son) was also unable to bathe him regularly. Towels, rags, and some clothing left for him became community property and vanished repeatedly.

7.     The medical staff requested a badly needed CT scan, but this major public hospital outsourced the investigation. His relatives could not come up with the money. This Jamaican citizen remained, withering away on a bed in one of our public hospitals. No one attempted to tube feed him or supply nutrients intravenously. No one would meet with his relatives to explain his situation. The visiting times and the times when doctors did their rounds did not coincide. On one occasion, I was lucky to speak with the nursing staff on the ward by telephone, but the group consulted among themselves and told me that they could not give the attending physician(s) my telephone number so that I may speak with any of them about my patient. After many weeks of slow and painful deterioration on a bed in one of our public hospitals, this gentleman developed hospital-acquired pneumonia and gave up the ghost. Just prior to his demise, his son was called for a ‘family meeting’– the badly needed communication was far too little and far too late.

8.     I do not understand this ‘no-user-fee’ system. We are told that it does not pay for some investigations, no matter how basic, urgent, or lifesaving they may be. We were made to believe that there were arrangements with some private facilities to provide expensive investigations. We were told that new scanners were here. We were told of the Ministry of Health and Wellness compassionate fund; but then, why are citizens suffering and dying in our public hospitals for lack of needed surgical hardware and investigations?

 9.     I don’t want any defensive or deflective responses to my concerns, I just want us to do much better for our poor and ‘ordinary’ citizens. They are as human as the rich and connected among us. Poverty should not carry a possible death sentence.

__________________________________________________________________________________________________________________________

Garth Rattray is a medical doctor with family practice, and author of ‘The Long and Short of Thick and Thin’.

Match each statement to the rhetorical appeal it primarily represents:

We must do better with public healthcare

By Garth Rattray

Published in the Jamaica Gleaner on Sunday, February 23, 2025

1.     Let me begin by categorically declaring that I never set out to bash any government official whenever I criticise our public healthcare system. I have no ulterior motives. I am [simply] extremely concerned for the welfare of hundreds of thousands of my fellow Jamaicans who have no choice but to access our public healthcare system. Even as a physician in private practice since 1983, I have seen innumerable cases of the failure of our public healthcare facilities that lead to severe sickness and premature death.

2.     Just recently, a 40-something-year-old man was struck from behind by a motor vehicle as he walked on the sidewalk in his community. The impact threw him into the air, and he was rendered unconscious. When he regained consciousness, he was in a public hospital and in a lot of pain. He was told that his right leg was badly fractured and required internal fixation to realign and stabilise the bones so that they could heal properly. They put on a plaster cast and gave him a prescription for the hardware needed to do the surgery.

3.     He has been unable to work since the crash and he is from a poor family. None of them can afford the hardware. He has been on crutches and the last X-rays reveal that the bones are very badly misaligned and attempting to heal in that position. This will eventually leave him with a shortened and very deformed lower limb – all because he is poor, and our ‘no-user-fee’ system is unable to supply the hardware to repair his fracture.

4.     Last year, a patient who was seeing me for over 30 years fell and broke one of his hips. He was in his early 60’s and, being poor, he went to one of our public hospitals. He was seen, investigated, and admitted pending surgery for the broken hip. But there was a big problem, neither he nor his family could afford the hardware needed to replace the broken hip. Consequently, he was placed on a bed and left on traction. After six weeks of this, he developed hospital-acquired pneumonia and died.

5.     He died because he was poor. He died because, despite Jamaica being an upper-middle-class income country, our ‘no-user-fee’ system could not afford to supply the hardware to replace his hip. The family was given a prescription for the hardware, but they could not raise the money since their combined income can barely keep body and soul together. That is a disgrace, but the optics emanating from the relevant ministry portray an alternate reality.

 6.     Then there is the very recent case of a gentleman in his early seventies who was admitted to one of our public hospitals. On admission he was severely dehydrated and malnourished. He had had several falls and loss of consciousness. He was placed on a bed on a ward with regular drip infusion… sometimes. He had no appetite, was weak and unable to feed himself. Yet, as confirmed by neighbouring patients, the hospital staff always brought meals and set them down beside him. He was only able to take one or two forks, then collapse back into the bed. The remaining portions of the meals were dutifully removed. This went on for several weeks. Consequently, this gentleman lay in a bed and became weaker and weaker while admitted into one of our public hospitals. His relative was confined to restrictive visiting hours and was not able to ‘spoon feed’ him regularly. His relative (a son) was also unable to bathe him regularly. Towels, rags, and some clothing left for him became community property and vanished repeatedly.

7.     The medical staff requested a badly needed CT scan, but this major public hospital outsourced the investigation. His relatives could not come up with the money. This Jamaican citizen remained, withering away on a bed in one of our public hospitals. No one attempted to tube feed him or supply nutrients intravenously. No one would meet with his relatives to explain his situation. The visiting times and the times when doctors did their rounds did not coincide. On one occasion, I was lucky to speak with the nursing staff on the ward by telephone, but the group consulted among themselves and told me that they could not give the attending physician(s) my telephone number so that I may speak with any of them about my patient. After many weeks of slow and painful deterioration on a bed in one of our public hospitals, this gentleman developed hospital-acquired pneumonia and gave up the ghost. Just prior to his demise, his son was called for a ‘family meeting’– the badly needed communication was far too little and far too late.

8.     I do not understand this ‘no-user-fee’ system. We are told that it does not pay for some investigations, no matter how basic, urgent, or lifesaving they may be. We were made to believe that there were arrangements with some private facilities to provide expensive investigations. We were told that new scanners were here. We were told of the Ministry of Health and Wellness compassionate fund; but then, why are citizens suffering and dying in our public hospitals for lack of needed surgical hardware and investigations?

 9.     I don’t want any defensive or deflective responses to my concerns, I just want us to do much better for our poor and ‘ordinary’ citizens. They are as human as the rich and connected among us. Poverty should not carry a possible death sentence.

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Garth Rattray is a medical doctor with family practice, and author of ‘The Long and Short of Thick and Thin’.

In one paragraph of approximately 60-80 words and by giving at least two reasons, discuss the credibility of the evidence used to support the author's claim and the reliability of the sources of information.