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Dialysis nurse: no improper conduct

Irene Ashton

A nurse who lost her consultancy with the hospital amid controversy over a conflict of interest has rebutted allegations of an improper inside deal.

The Bermuda Hospitals Board (BHB) also came to the defence of Irene Ashton, who had to back out of her consultancy once it was picked up in the House of Assembly.

Ms Ashton, a registered nurse from the United States who is married to local doctor Michael Ashton, said she was in tears when she had to leave King Edward VII Memorial Hospital in the midst of her work with dialysis patients.

“If I had known at the beginning what a fiasco this would turn into, I would not have done it,” she said.

“It’s still very stressful, for me, my husband and the patients — it has been very accusatory and it doesn’t have to be like this.”

The issue was first raised in the House on May 29, by Progressive Labour Party Member of Parliament Zane DeSilva, who told MPs that BHB had paid someone $10,000 a month to start their own business.

It was reiterated the following week, later becoming the subject of parliamentary questions by Kim Wilson, the Shadow Minister of Health, for Health Minister Jean Atherden.

The Opposition called on the minister to investigate, with PLP MP Michael Scott referring to “egregious conflicts of interest and an environment in which corruption can thrive”.

Ms Ashton called the allegations “bizarre.”

She told The Royal Gazette she had been requested to collaborate with the hospital before she set up her own business.

“It wasn’t my husband trying to get me a job — Michael is not sitting on any board that appointed me,” she said.

With long experience running peritoneal dialysis, otherwise known as home dialysis, Ms Ashton dreamed of bringing the service to the Island when she and her husband moved here in 2011 but the project never took off with BHB. A BHB spokeswoman confirmed that the board had been “keen to set up a peritoneal dialysis service for many years, but did not have the internal resources to support the work”.

After three years of inaction, Ms Ashton “figured it wouldn’t happen unless I did it myself” and pitched her business successfully to the Bermuda Health Council (BHeC).

Home dialysis is cheaper and in many cases less stressful for patients, she said, and the BHeC approved her business plan.

“Their decision was they wanted to make sure we collaborated with the hospital and all played nice,” Ms Ashton said. “I would work with them for six months to get them started before going ahead with my own clinic.”

The Island’s need for more dialysis services was urgent enough to obviate the question of competition for business, she added: “It’s all about the patients and giving them the options. Where I worked in New Haven, Connecticut we had two clinics and patients coming to one or the other. The patients decide.”

Her consultancy with BHB started on April 13, but was terminated on June 12 after allegations of malfeasance surfaced.

Stressing that well-trained staff was key to getting home dialysis successfully running, Ms Ashton readily admitted to getting paid $10,000 a month but called it a bargain compared to sending three nurses overseas for training.

Nor was she working separately as a staff nurse during her consultancy, she said. Although “good progress” had been made on home dialysis for the hospital, it came to a halt once the issue turned contentious — despite the BHB spokeswoman saying that “all approvals for hiring the consultant went through the appropriate governance channels, none of which involved the consultant’s spouse”.

Ms Ashton said: “People tried to discredit it because they thought I would take revenue from the hospital, but it’s not a big deal at all — the hospital’s unit is already over capacity. Everybody knows that.”

Admitting that her ardour for getting the service in place may have ruffled some feathers, she also said her status as a non-Bermudian was something “not everyone looks at favourably”.

Questioned in the House, the minister said she didn’t know if BHB’s consultant had received supplies for her own business — but Ms Ashton refuted this, saying: “I was asked what they would need, and made a list, but I didn’t use their ordering system or have access to it.

“I’m sorry I am married to someone who’s employed at the hospital, but if I wanted to have my business approved I had to collaborate with BHB and I still want to.”

While MPs questioned if her husband would gain from the private practice, Ms Ashton said he worked in the entirely different field of infectious disease, and was expressly forbidden from making self-referrals.

Meanwhile, with her private practice approved, the Ashtons hope to open Bermuda Home Dialysis Services in Hamilton later on in the summer.

In the last sitting of the House of Assembly, the minister said the consulting job had involved “training BHB nurses, establishing BHB education materials, and ordering supplies for BHB”.

Added Ms Atherden: “This programme was approved on the basis of the cost savings and the fact that it would benefit patients.”

The Bermuda Hospitals Board last night expressed regret over the loss of a consultant after accusations of impropriety were raised in Parliament.

“BHB can confirm that the contract with Mrs Irena Ashton was ended by mutual consent after two months,” a spokeswoman told The Royal Gazette.

“We are disappointed that the contract is ending early, before the BHB peritoneal dialysis programme is established. During this time, with the expertise of Mrs Ashton, an amazing amount has been achieved. However, given the nature of concerns that have been raised, both parties agree it would be prudent to end the contract. BHB will therefore commit to finish establishing the programme on its own.

“We will continue to work closely with Mrs Ashton for the benefit of the patients. Both parties remain committed to ensuring that patients receive the best of care. BHB remains committed to the provision of safe high quality care to our community in collaboration with all providers.”