The appointment of suspended Fiji Corrections Service Commissioner Dr Jalesi Nakarawa’s wife as acting medical officer violated the professional and legal distinction between doctors and nurse practitioners.
President of the Fiji Medical Association Dr Alipate Vakamocea told the tribunal inquiring into Dr Nakarawa’s alleged misconduct that both professions serve essential but distinct roles.
He said nurse practitioners’ function is to support doctors by providing general care, conducting basic medical tests, and prescribing certain limited medications, but not to act as a full medical officer or perform unsupervised clinical or diagnostic procedures.
He stated that such an arrangement, especially within the corrections service, pose a risk to inmates’ health and safety since they are entirely dependent on medical staff for treatment.
He said the association also expressed concern about salary inconsistencies, noting that Mrs Nakarawa’s salary as a nurse practitioner within FCS was $114,845, while Dr Rayman Singh, as a senior medical officer, was previously paid $103,619. By comparison, a Ministry of Health nurse practitioner earns around $55,508, and a medical officer earns $66,757.
He referred to an incident that, in the association’s view, demonstrated Mrs Nakarawa’s lack of medical competence and breach of professional scope.
He said the association received documentation showing that Mrs Nakarawa had ordered a drug screening test for MDMA on a corrections officer suspected of drug use. The test result returned positive, leading to the officer’s dismissal.
However, the laboratory that conducted the test advised that MDMA results can also return false positives from certain over-the-counter medications.
He said this demonstrated Mrs Nakarawa’s limited understanding of pharmacological testing and that her decision to proceed without medical oversight had serious professional implications.
Dr Vakamocea said the association concluded that she had acted beyond her scope of practice and had likely misled Dr Nakarawa regarding the clinical significance of the result.
On January 26 this year, he said, the association received a complaint from Dr Singh alleging he had been terminated without just cause and that Dr Nakarawa had subsequently appointed his own wife, a nurse practitioner, to act as the medical officer in charge of the Corrections Health Service.
He said the association immediately reviewed the matter because it raised serious concerns about professional ethics, conflict of interest, and patient safety within the Corrections Health Division.
After examining the documents provided by Dr Singh, including his termination letter and internal correspondence, the FMA determined that the matter required official intervention.
He said Dr Singh’s termination took effect the same day Mrs Nakarawa was introduced to staff — during a meeting where Dr Singh was still present.
This, he said, created a perception that the termination had been prearranged and lacked transparency.
The association, he said, then wrote to the Constitutional Officers Commission, reminding them that nurse practitioners must work under the supervision of a registered medical officer and cannot independently diagnose, prescribe, or conduct advanced medical tests.
The second letter was addressed to Justice Minister Siromi Turaga on February 20, 2025, raising concerns about a racist email that Dr Singh had received from his supervisor, Alivio Turaga, and that the doctor’s termination appeared to have occurred soon after that complaint.
The FMA also copied the Human Rights and Anti-Discrimination Commission and the Fiji Independent Commission Against Corruption (FICAC), seeking oversight and transparency.
He further noted that this was the first time that a medical officer had been terminated under such circumstances.
The hearing continues today.
