Bermudians may be inadvertently driving up healthcare costs by using the hospital's new MRI machine more out of convenience than necessity, Shadow Health Minister Michael Dunkley has claimed.

But the hospital said the machine has been a success, both financially and medically.

Mr. Dunkley spoke in the wake of the machine's one-year anniversary at the King Edward VII Memorial Hospital (KEMH) two weeks ago.

"They said they did 1,700 exams in the first 12 months, and there was $1,500 saved per MRI," he told last week. "When I heard that, I said, 'I can't believe this'."

In 2002, when the $3.5 million MRI machine's arrival in Bermuda was announced, it was reported that 700 patients have to fly overseas every year to get the treatment, which was not previously available on the Island.

And, said Mr. Dunkley, when the idea of bringing the machine to Bermuda was being discussed, doctors and insurers were led to believe the maximum number of MRI's to be done and paid for was 750 to 800.

"Now, one year later, that number has doubled," he said. "Have we over-used this machine? And who is paying for it?"

An MRI at the hospital costs $1,245, he said, while overseas the price tag is $700 or more.

"When you factor in airfare and a hotel, that brings the cost of going overseas within the ballpark of the cost of doing it here. So how have they saved $1,500? It's just not the case."

Every employed insured person pays money into the mutual reinsurance fund, a fund set up to help subsidise items such as extended hospital care, renal dialysis, HIP and the MRI, said Mr. Dunkley.

"People say, 'it's insured, I'll use it'. That drives up the cost of healthcare, and the price ... when the MRI came in place, premiums increased by 25 percent," he said.

In other areas, competition usually leads to a decrease in prices, he said.

However, in healthcare, the more services are available, the more they are used ? driving the cost of healthcare up instead of down.

"I'm not saying the use is not proper and fitting," he added. "I don't want to sound like I don't support the treatment.

"I'm saying we may be using the service just because it is there. And we use it at the cost of the mutual reinsurance fund, and every employed person. This is a very expensive treatment and therefore it is a concern.

"It creates a real hardship on the needy who can't afford it... If we keep utilising it when it's not necessary, we're going to really have a situation that is going to get out of hand."

But Bermuda Hospitals Board CEO Joan Dillas-Wright defended the use of the MRI, saying it made both financial and healthcare sense.

The number of patients travelling overseas each year for the treatment alone, about 700, made the machine financially viable, she said.

And in terms of healthcare, "this was a simple choice", Mrs. Dillas-Wright explained. "Introduction of the MRI machine has been an unqualified success, both financially and medically.

"More than 1,700 examinations have been performed," she confirmed. "This is excellent news for the patients who have previously travelled overseas, those who would have endured less comfortable methods of diagnosis (including invasive treatment), and especially those who may not have sought treatment when needed.

"As MRI technicians have gained experience, they have been able to perform a greater number of examinations. Bermuda now has a highly skilled team of specialists efficiently operating and diagnosing using the MRI service.

"This is a great step forward for healthcare in Bermuda."

Mr. Dunkley also suggested abolishing the mutual reinsurance fund, saying it was time to make procedures such as the MRI carry their own weight.

Originally, the mutual reinsurance fund was set up to carry new services until their cost could be ascertained, he said.

"But now it just seems to be a slush fund.

"It has a great deal of money in it. We have to make sure we're accountable for it."

Wages increase by two to three percent yearly, he said, whereas insurance increases by ten to 15 percent yearly. "We're not going to be able to fund increases in healthcare... We have to let the professionals deal with it (in a Health Council), or we are going to be in a serious situation."

Mr. Dunkley is standing by his numbers after claiming Government has spent three quarters of a billion dollars on Health since the Progressive Labour Party came to power.

With the PLP's sixth Budget looming, Mr. Dunkley gave a recent review of the Health Ministry over the past few years, saying that for a price tag of $750 million, not much had been done.

His criticism targeted the hospitals in particular. Mr. Dunkley estimated nearly half a billion dollars had been spent on the hospitals alone, yet: "For that amount of money, one would expect more," he said.

His estimates, beginning from the PLP's first Budget (1999-2000) included conservative estimates for the PLP's sixth Budget (2004-2005), due out on February 13.

Last year Health received a budget of $132 million; this year Mr. Dunkley estimated that will come to $140 million. Last year the hospitals received a budget of $79 million; this year Mr. Dunkley estimated they will receive $80 million.

With those estimates, his figures for total spending within the entire Health and Social Services Ministry since the PLP came to power came out to $760 million, while figures for the hospital were approximately $440 million ($60 million short of the half billion he originally stated).

"My numbers are correct," he told this week. "We can't keep wasting money. As the Opposition, I want to stimulate change, positive change. I'm tired of people doing studies ... I want action. It's just important."