Government is considering rules which would require precertification before medical diagnostic procedures are performed in an effort to reduce unnecessary tests.

Health Minister Patricia Gordon-Pamplin said Government was currently in the consultation phase and stressed that only elective procedures would require certification, but Shadow Health Minister Zane DeSilva said such an initiative would amount to “death by delay”.

“The precertification is a move by the Minister of Health and the OBA Government to introduce management mechanisms for diagnostic testing and who knows how many tests, whether it’s X-rays, whether it’s ultrasounds. MRIs, CT scans? That has yet to be seen,” the Progressive Labour Party MP said.

“Word is, and it’s good word, is that if this legislation is passed, what it will mean is before any test can take place that your doctor may prescribe you, you have to get permission from someone else.”

Mr DeSilva said that diagnostic tests account for only a small fraction of health costs and that Government should instead aim for bigger targets such as health insurance.

“With diagnostic imaging not even being two percent of the healthcare cost in this country, why are you going this way?” he asked. “It puts everybody at risk. Everybody. Bermudians are at risk.”

He also alleged that Cabinet had overruled recommendations of the Bermuda Hospitals Board and Health Council, suggestions that Ms Gordon-Pamplin said were “patent nonsense”.

“The Health Council was tasked by me to advise me what does precertification look like and what do guidelines look like,” she said. “When the Health Council brought me the report regarding precertification versus guidelines, I weighed up the pros and cons of each and chose the situation regarding precertification for approval.

“The Cabinet overruled nothing. The Cabinet supported me. I put a position forward and the position was accepted.”

She said Government was currently engaged in the consultative process, saying: “I don’t make decisions or look at information in isolation.

“I consult with people who are in the field, hence the consultation process. I’m meeting with the doctors so I can hear first hand. There are some decisions that are too big to make in isolation and I don’t want to go on that path.”

Ms Gordon Pamplin said, based on the information she received, that precertification would not apply to emergency procedures, only elective diagnostic tests, and said the system would be minimally restrictive and minimally time consuming.

She also said that she was not ignoring health insurance as a major factor in the cost of healthcare on the Island, saying: “There is no stone that will be left unturned.

“When I hear that certain doctors are being incentivised when diagnostic testing is done, and these are comments that are coming from the staff that work with certain doctors, that gives me cause for concern.

“That gives me grave cause for concern because we have significant healthcare costs in this country, and we have to get a handle on it.”

PLP MP Lovitta Foggo expressed some concern that adding a certification process could increase the cost of healthcare, along with the potential impact on doctor-patient confidentiality.