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Publication of medical scans data resisted

Gitanjali Gutierrez, the Information Commissioner (Photograph by Blaire Simmons)

The number of medical scans carried out every year by individual doctors does not have to be made public by health service regulators, the Information Commissioner has decided.Gitanjali Gutierrez said the Bermuda Health Council was right to refuse to release the records after a public access to information request from The Royal Gazette.The commissioner wrote: “The identities of the health service providers and information on the type of diagnostic imaging tests that they have ordered relates to the affairs of the health service providers. “Because the health council obtained the information from the health insurers, the information also relates to the affairs of the health insurers.”Ms Gutierrez said in a decision released last week that she agreed with the health council that it got the information as part of its legal duty to licence health insurers, which made it exempt from disclosure under Pati.The request was submitted to the BHeC in April 2017 after the Government took legal action against the Lahey Clinic in Massachusetts, which claimed that the hospital colluded with Ewart Brown, a doctor and former premier, in his alleged ordering of “excessive, medically unnecessary and frankly dangerous scans” at his two clinics. Lahey and Dr Brown denied the allegations.The civil case, filed in the United States and later dismissed by a US district court judge, claimed the alleged “corrupt enterprises” of Dr Brown and Lahey contributed to an increase in healthcare costs in Bermuda.The Pati request asked for the number of diagnostic tests ordered every year by individual doctor, as well as records that showed the name of the doctor for patients who had more than five tests in a single year. The health council rejected the request, though it did release information on the number of tests ordered without identifying the doctors.The regulator released information on the number of diagnostic tests per patient after the decision was referred to the Information Commissioner’s Office.The records showed that between April 2016 and March 2017, there were 6,588 patients, aged between 12 and 102, who had between five and ten diagnostic scans.There were 1,439 patients, aged 5 to 102, who had more than ten. The patients who had more than five scans over the period had multiple healthcare providers.Ricky Brathwaite, the BHeC’s chief executive, said in a 2016 interview on healthcare regulations that the regulator had spoken to a small number of doctors who had ordered high numbers of tests.He said: “We just look at the trend and say ‘OK, well it seems like you are ordering more than people in your class of physician. Is there something that’s going on?’”Dr Brathwaite said: “We’ve looked at the numbers, so we’ve had the conversations.”A long-running police investigation into the alleged overuse of medical scans by Dr Brown and Mahesh Reddy, the medical director at his Bermuda Healthcare Services clinic in Paget continues.Both doctors deny any wrongdoing and no charges have been brought.Dr Brown said in 2016 that Dr Reddy often ordered more tests than other doctors who made referrals for scans to BHCS because he was an excellent doctor who “makes very good use of the diagnostic imaging available to him”.He added he had not heard that insurance companies were concerned about the referrals.Dr Brown said: “I haven’t heard it from patients and I haven’t seen it from my work overseeing the practice. Why would the police be concerned with medical tests?”Dr Brown said the BHeC had “never” approached him to discuss excessive ordering of tests at BHCS and that he did not think they had talked to Dr Reddy.• To view the Information Commissioner’s decision on the Bermuda Health Council, the press release and the Pati data on patient encounters, click on the PDF links under “Related Media”.• On occasion The Royal Gazette may decide to not allow comments on a story that we deem might inflame sensitivities. As we are legally liable for any libellous or defamatory comments made on our website, this move is for our protection as well as that of our readers.