How UHWI's Effort to Reform Itself Was Defeated by an Internal Power Struggle Involving Its Chief Doctor, Carl Bruce.
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The University Hospital of the West Indies (UHWI) is facing mounting pressure over poor patient care, management and governance failures, and procurement irregularities.
The state-run institution was the site of a recent protest by nurses who claim that because of inadequate bed space and resources at the Accident and Emergency Department, patients were being resuscitated on the floor.
Now, minutes of UHWI board meetings show that, as these problems were festering, an effort to recruit a transformational CEO in 2023 collapsed amid internal resistance from the hospital’s chief doctor Carl Bruce and then-Acting CEO Fitzgerald Mitchell.
The minutes submitted to the Parliament’s Public Accounts Committee (PAC) and obtained by 18° North raise questions about whether entrenched interests blocked reforms that could have addressed the deficiencies of the teaching hospital.
Mitchell ultimately secured the top post despite placing last or second-to-last in the interview process, according to Wayne Chai Chong, who served as board chairman between December 2022 to December 2023. Mitchell is now on accrued leave amid a fraud squad investigation following a damning Auditor General’s report in January 2026 into procurement breaches and has declined to comment or appear before the PAC probing the allegations against UHWI. Eric Hosin acted in the role until June 10, and Lt. Colonel Dr. Sydney Powell is now the new interim CEO.
The minutes from 2023 show that the Chai Chong-led board underwent an extensive process using an external recruiter which shortlisted six candidates. Mitchell had only been added to the pool because he was already acting in the role.
By round robin —where votes were submitted by email rather than at a meeting —the minutes show a majority of the board decided to proceed with Dorothy Hosein who had a “tremendous resume,” according to Chai Chong.
Hosein’s LinkedIn profile shows a transformational leader who served as CEO and in other leading roles at major British hospitals, including teaching ones.
However, when she came to Jamaica to meet with key stakeholders and senior management to ensure she was up to the challenge before contract signing, the minutes show Bruce, referred to as the Senior Director, Clinical Services (SDCS), didn’t meet with her. They also show Hosein felt Mitchell—who was being considered for a Deputy CEO role— was uncooperative. Mitchell said “no comment,” and
Bruce didn’t respond to an emailed set of questions.
Due to the perceived hostile environment, Deputy Chairman of the board and Chairman of its HR subcommittee Dr. Andre Foote, reported at the Oct. 3, 2023 meeting, the CEO Designate had turned down the offer. “Had the Senior Director of Clinical Services taken the time to meet with the CEO Designate, the outcome would have been different today,” he stated.
Another board member, Dr. Ronald Robinson, wanted confirmation that Hosein had in fact turned down the offer as a result of not meeting with the SDCS and the assumed hostility from the Acting CEO, and “Dr. Foote replied in the affirmative and asked the Chairman to comment on the matter.”
In commenting, Chai Chong noted that in discussions with Hosein, she felt she would have been undermined by both Mitchell and Bruce. He also mentioned that she had become familiar with “a campaign” against her employment.
Robinson argued that Hosein’s reasons were “flimsy” and momentarily turned his attention to Hosein’s required pay being above the prescribed government salary for UHWI’s CEO of J$12.96 million (US$83,618), and that the Ministry of Finance and the Public Service (MoFPS) hadn’t agreed to the board’s plan of soliciting supplemental funds from the private sector.
Returning to the issue, board member Andrea McNish said it would be incumbent on any new CEO to bring people together despite initial pushback.
However, another board member, Roger Anderson, felt that Hosein’s reasons shouldn’t be discounted and believed Bruce should be asked to respond, given that if the hospital were a private entity, a person not meeting with an incoming CEO would have been asked to resign.
Bruce’s Reason for Not Meeting With The CEO Designate
In response, Bruce said he didn’t meet with Hosein because he was home on sick leave and didn’t wish to invite her to his home.
However, he said that though he originally gave both the Chairman and the Deputy Chair his “unequivocal support” and also suggested how the CEO could be successful, he felt that the Vice Chancellor (VC) of the University of the West Indies (UWI) or his designate should have been more involved in the negotiations given the need for knowledge transfer and the fact that the last two CEOs were paid by both UHWI and UWI and the position automatically gets a board seat on key university committees.
Bruce admitted seeing an email from the Chairman that the VC or the Principal had been consulted with, but he still thought the VC should have been given time to comment and, therefore, “he refused to move forward.”
He also pointed to missing dates on the candidate’s CV, concerns about her being over 65, and no due diligence report provided despite one having been requested.
The Reaction To Bruce’s Reasoning
Bruce’s rationale didn’t go over well with Chief Medical Officer at the Ministry of Health & Wellness, Dr. Jacquiline Bisasor-McKenzie, who said she didn’t hear a valid reason why Bruce didn’t meet with Hosein and saw no reason why this wouldn’t happen again. “As a Senior Officer within the institution,” she said, “Dr. Bruce could not act this way and think it was okay.”
Board member Joanna Banks-Holmes asked Bruce if he would meet with any other candidate that was brought in, but Bruce had two main conditions — that the board needed to get written approval from the MoFPS on the compensation package being bolstered by the private sector, and that UWI’s leadership needed to give its blessing.
On his first condition, the board agreed — and minutes from the next board meeting show a no-objection letter was eventually received from the MoFPS. However, on his second condition, Bisasor-McKenzie said the board didn’t report to UWI and had no obligation to be in agreement on this matter, so the board needed to determine if it would move forward with the CEO selection process or continue to be held ransom by Bruce’s requests.
The board agreed to approach the next candidate in line—an Australian.
Why is Bruce Opposed?
It’s not clear why Bruce was so stuck on UWI’s Vice Chancellor or Principal being in agreement with the selection of the CEO when even before that October meeting, the addendum to the Sept. 20, 2023 minutes show that the Chairman didn’t just meet with the Principal and VC on two occasions at Bruce’s request but also that “the Principal had indicated that he was satisfied with the process and had communicated same to Sir Hilary Beckles [the VC].” Still, Bruce stated he wasn’t satisfied that the issue of knowledge transfer had been properly ventilated with them.
UWI is also already represented on the UHWI board, responsible for appointing eight of its 18 members, and Bruce, himself, had acknowledged that UWI had stopped paying the UHWI CEO “at some point.” (Chai Chong says he never approached UWI about helping to pay the CEO Designate and doesn’t know of it helping to pay the CEO in the past either.)
Part of the reason appears to have been Bruce’s desire to maintain control.
He was recorded to have said in the Sept. 20 2023 minutes that the process after the interviews were conducted was a “disaster”, and “there was no way a CEO could learn the Hospital and transform it within 3 years.”
One senior doctor, who preferred to go unnamed, also said that while Mitchell was in the CEO seat, Bruce was the de facto head of the hospital, where, even on one occasion, the doctor saw Bruce overturn a decision by Mitchell.
The 1948 UHWI Act specifies that the Chair of the Hospital Medical Committee —a position held by the SDCS —should serve as an ex-officio member of the board, but there’s no provision in the Act for the CEO to be a board member.
In May 2026, a review committee set up in the wake of the Auditor General’s findings said this situation creates obvious potential for conflict and “mission creep” where the lines get blurred as to who is responsible for driving the institution’s strategic vision and hiring staff.
It recommended that this anomaly be eliminated and the scope of responsibility for both positions be clearly articulated. Other senior directors at UHWI report to the CEO.
It also suggested two-term limits for the Chair of the Hospital Medical Committee similar to those for heads of departments and deans at UWI and also recommended that an independent third-party provider of international reputation be hired for at least a year to provide fulltime board support to institute changes.
In his submission discussed at the PAC hearing on May 12, 2026, Chai Chong said the governance conflict with the SDCS was the reason why the CEO Designate, ultimately didn’t sign the contract as she wanted assurances this would change.
The issue was discussed at the board meeting on Oct. 3, 2023, but the minutes show it wasn’t resolved.
Failed Effort to Move to Second-Choice CEO Candidate
As to what happened with the board’s second choice for CEO, Chai Chong told 18° North that his board was dissolved before seeing that selection through.
He submitted to the PAC that the dissolution occurred after the health minister overturned a decision by his board to end the tenure of then Acting CEO Mitchell and to allow another senior director to act in the role while the permanent CEO hunt continued. However, to that claim, Health Minister Dr. Christopher Tufton at a June 10 post-Cabinet press briefing, responded, “Ministers don’t appoint CEOs.”
It’s not clear the process by which Mitchell was later permanently appointed, and why he, having underperformed the other candidates during interviews, was installed in the role. 18° North has written to the PAC asking it to retrieve from UHWI the minutes with that information since the ones submitted didn’t cover December 2023 when Mitchell’s interim appointment was supposed to end.
Bruce, meanwhile, is facing a revolt from many of his fellow senior doctors, who have claimed he is responsible for operational problems that are contributing to the dysfunction of the hospital and overcrowding in the A&E. Patients face long delays in receiving treatment.
Following a no-confidence letter addressed to management in January that they say hasn’t been acted on, seventeen clinical heads and subheads have now put their request to Prime Minister Dr. Andrew Holness requesting that the SDCS position be advertised so someone else can be installed in that role. They say because Bruce had taken up a fulltime position at UWI around 2021 and can’t keep two fulltime posts, he’s merely acting in the role.
No word yet on what has become of that latest letter. One senior doctor had told
18° North, however, that if the prime minister doesn’t act, the doctors will consider industrial action.
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Editing help by ChatGPT.
Exchange rate used is $154.99, the average sell rate on the Bank of Jamaica’s website for 2023.
Editor’s Note: