I hope the demand will not result in a quick fix that does not address the root causes. I support investigating and correcting Delaware's defective prison performance, but have serious concerns regarding independent investigations, the enormity of determining and implementing adequate medical care in an abusive system, and independent monitoring.

My concerns stem from personal and professional experience, starting as an inmate working in a prison infirmary; later researching the effects of imprisonment and selection of quality correctional officers; and more recently assisting in the development of national health care standards by the Graduate Medical Education National Advisory Committee.

Independent investigation in public affairs implies balancing differing partisan factions. My experience suggests the jury model of objectivity (is your mind open?), reason (just give me facts), and integrity and guts (I don't know about the rest of you but ...).

The importance of a better selection process than top-down appointments is evidenced by Gov. Minner's decision to talk only to elected officials about prison issues.

Guesstimating the health needs of prisoners underestimates the required time, effort and expense. We cannot rely on the extraction of Delaware records to assess the medical needs of prisoners because of missing entries, falsified data and low standards of care.

Amassing data for my work required scores of physicians over many days to evaluate all disorders as to incidence visits, referrals, procedures, etc. Multiply this by different data for minimum to maximum security prisons for determining physician supply and we've got a problem.

Deeper yet is a complex assessment of dysfunctional prison health programs within a total system of abuse and neglect. Demanding that individuals be removed, while soul-satisfying, only results in cosmetic surgery when basic life-and-death care remains in jeopardy. That the system has persisted over decades and administrations underscores the fact that prison abuse involves more than the number of staff, but climate and culture.

It's crucial to have independent monitoring of all governmental funding. Two recent monitoring efforts failed to protect the Delaware prison population from neglect, abuse and falsified documents. That providers' testimony arose only after leaving prison employment lays bare the need for a contracted monitor to adhere to the Civil Rights of Institutionalized Persons Act protecting whistleblowers.

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