Dangerous precedent set with Brown-Darrell ruling
The Bermuda Health Council’s severe reduction in fees, in some cases as much as 87 per cent, for MRI and CT scans came into effect on June 1, 2017 and has resulted in Brown-Darrell Clinic’s recent announcement that it will close its CT scan service, effective January 31, 2018.
That this was clearly a targeted political attack on the businesses owned by a political adversary of the One Bermuda Alliance administration, along with the reality that the island could be without a back-up to the only CT scan facility at the hospital, has led to impassioned calls for justice and healthcare options.
Outside of King Edward VII Memorial Hospital, Brown-Darrell Clinic is the only facility that performs CT scans and Bermuda Healthcare Services is the only facility that performs MRIs — both facilities are owned and operated by the former premier, Ewart Brown. On June 1, 2017, when diagnostic imaging fees were cut, the hospital received an increase in its operating room fees. This was a benefit that obviously would not be afforded to Brown’s clinics, meaning that for more than seven months, BHCS and BDC operated at a significant deficit. The health council that decided to cut the fees comprised two OBA candidates, Simone Barton and Andrew Simons. They were joined on the council by Richard Ambrosio, political adviser to the MP Trevor Moniz.
The incontrovertible matter of fact is that Brown’s clinics were the only local private practices affected by these severe cuts. You may find that the synchronicity of timing, events and individuals involved was not a matter of happenstance but, instead, evidence of a carefully orchestrated, direct political attack against a political adversary and his businesses.
If the health council was serious about cutting healthcare costs, why would it start with diagnostic imaging, which, according to the Bermuda Health Accounts Report 2014, amounts only to approximately 5.5 per cent of total healthcare expenditure? To justify its decision, the health council stated that Bermuda is above the average in Organisation for Economic Co-operation and Development countries for CT scanners.
We must bear in mind that Bermuda is not an individually listed OECD country; our statistics are perhaps included under the United Kingdom. In Bermuda, we have epidemic levels of diabetes and, as a jurisdiction, we suffer from mortality rates from prostate cancer that are higher than all OECD countries — Bermuda’s prostate cancer rate is 37.1 per 100,000; the OECD countries’ is 22.8 per cent.
Further, our demographic is very different from most OECD countries, as we have far more black people and, unfortunately, much more disease. It must also be noted that CTs in private settings such as Brown-Darrell Clinic are not included in OECD statistics. In sum, the health council’s conclusion that the two CT scanners at one KEMH site is sufficient for Bermuda is disingenuous at best and ought to be re-examined.
You should also know that for the past ten years, Brown-Darrell has been the only facility on the island that performs complicated cardiac CT imaging, a highly preferred means of detecting heart disease. KEMH did not perform these tests on its CTs, but, unsurprisingly, the day after Brown-Darrell Clinic is scheduled to close, the hospital tentatively has scheduled its very first cardiac CT imaging tests. This ordeal has nothing to do about cutting costs; this is about closing a black-owned business.
The questions have been asked: what will we, the Progressive Labour Party, do to address this blatant injustice? Moreover, what will we, the PLP do to ensure that Bermudians have optimal healthcare options on island and that there is an alternative to KEMH’s CT scan facility?
The PLP government granted financial supplements to the Brown-Darrell Clinic and Bermuda Healthcare Services to mitigate the significant and crippling loss suffered by a political decision to slash rates by such significant amounts. But, even with the supplements, Brown-Darrell is still experiencing cuts up to 78 per cent. The hospital also received this supplement, but remember that the hospital already received an increase in the operating-room fees at the same time the cuts to MRI and CT scan fees were made — seven months prior, on June 1, 2017. The reality is that the Government will always keep the hospital running, regardless of what its deficit may be.
This government contends that to address the OBA’s blatant political targeting of a black-owned business and ensure that the only other on-island CT scan facility can stay open by reverting the diagnostic imagining fees to the pre-June 2017 rates would increase residents’ health insurance premiums by $23.03 a month — and cost the Government an additional $8.6 million. You may find the Government’s reasoning to be an incredibly unpalatable suggestion, having regard to diagnostic imaging rates having remained the same for ten years and there is nothing changing. Or is there?
Perhaps we should consider that it is the Bermuda Health Council’s recent decision to include palliative care, oral chemotherapy drugs, and limb and amputation care to the standard health benefits that is the real reason health premiums will rise.
The reality is that diagnostic imaging was viewed by the OBA administration and the Bermuda Health Council as “low-hanging fruit” that had to be cut so that Pals, which has long since operated as a volunteer charity providing palliative care, could benefit from receiving funding from the SHB. After all, that is what will happen now.
There is no dispute that Pals is well deserving of community support, but you may ask why it would need to receive additional funding for services that were already adequately being provided for through charitable donations. Respectfully, most medical professionals and indeed members of the community would agree that we should not add benefits to the SHB that will not drive down costs or save lives — the resources should be focused on diagnostic imaging, the preventive-care method that can save lives and ultimately long-term healthcare costs. This is especially important in Bermuda, with regard to our high incidence of disease.
You may find that the decision to channel the funding to the charity was the brainchild of Ambrosio, the former head of the charities commission, who sat on the health council at the time these changes were made. Remember that Ambrosio was political adviser to Moniz, the former attorney-general, who initiated proceedings on behalf of the OBA government against Lahey clinic, alleging untoward dealings with Brown.
While Ambrosio and Moniz were reviewing Brown’s personal documents and bank statements, Ambrosio and his colleagues were cutting Brown’s fees at the health council. I trust that you see that this has less and less to do with healthcare costs and pursuing the ends of true justice and has more to do with a personal issue.
The ultimate consideration for the Government of Bermuda must be: what is in the best interest of Bermudians?
The Government must identify opportunities to improve access, quality and outcomes of healthcare delivery, but targeting diagnostic imaging and allowing our only other CT scan service provider to close is not the solution. The Government is invited to reconsider the recent inclusions to the SHB. The real cause of that insurance premium will rise and reintroduce the pre-June 2017 rates because Bermudians deserve healthcare options and failing to rectify the consequences of a clear political attack and justifying it under the guise of healthcare costs sends the message that such acts by public representatives will be tolerated.
If that is the case, we are setting a dangerous precedent. Today it’s the targeting of Brown and his businesses, tomorrow it could be you and me.
• Eron Hill, who can be contacted at email@example.com, is studying for an LLB Law Hons degree at the University of Law (Manchester)
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