Medical mischief

CAMBRIDGE, St James — Concerned that there is an abuse of a public-private outsourcing diagnostic programme implemented three years ago to provide services not available within the island’s public health system, Minister of Health and Wellness Dr Christopher Tufton says he has asked for an audit.

“I have asked the permanent secretary to write to the auditor general to do an audit of the programme because I need to satisfy myself that the programme is not being abused,” the minister said.

He was speaking during Thursday’s official reopening of the Cambridge Health Centre in St James, which was recently renovated at a cost of just under $61 million.

Three years ago, the Enhanced Healthcare Delivery Project was created to outsource procedures to private players who offer diagnostic services such as CT scans and MRI to help alleviate what was a crisis in the public health-care system due to malfunctioning equipment.

Since then, 139,000 patients have benefited from the programme at a cost of nearly $5 billion to taxpayers.

On Thursday the minister argued that while the programme has been a benefit to many, it has outlived its purpose in many ways and is now potentially the subject of abuse, which must be dealt with.

“I am concerned that equipment within the hospitals is breaking down too easily. And it leads me to wonder if some of that breakdown is not a function of neglect, complacency or deliberateness. I know that I am criticising myself, but this minister is not afraid to take on issues where it needs to be taken on,” said Tufton.

“This programme was designed to help the people; not to waste taxpayers’ money. We have to help the people and I am concerned about that. So, part of that audit is going to have to be… If you have a new CT scan or a new X-ray, what is the service level arrangement that you have in place to deal with that? Why would it be breaking down so often as reported by patients?” the minister continued.

Tufton also spoke of the possibility of some employees using their position to derive personal benefit from actions or decisions made in their official capacity.

“The other problem I have, and I must tell you the truth, is the potential for conflict of interest. Because I get the sense that some of the very practitioners in the public health system have an interest in some of these outsourcing entities. And it is a concern. I can’t stop people from investing in anything they want to invest [in] but we have to declare some of those interests to the extent that the value for money proposition is maintained not only for the taxpayer but for the patient,” he said.

“When I look at how the numbers are evolving, it’s quite clear that some people are doing far more tests than they probably need. It looks that way. I am not casting any aspersions or judgement. And, some of the equipment is just not being maintained properly,” added the health minister.

Tufton noted that while many have benefited from the programme, it is not the long-term solution. He said a decision was made to engage in a leasing arrangement where entities will place the equipment in the hospital and maintain them so the downtime becomes minimal, which will also benefit patients.

He said that by now and next quarter, the ministry will be in a position to make awards which are dependent on the procurement process.

The health minister made it clear that this does not mean that there will not be some level of outsourcing diagnostic taking place.

“You will always have margins of error. So, some of those arrangements will take place. You will still maintain some level of external partnerships but we cannot have a hospital that must have an X-ray functioning unit and it is down more than it is up. Something is wrong with the management of that institution on that particular piece of equipment and we have to find a way through service level agreement to solve the problem,” stated Tufton.