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Alternative use sought for Lamb Foggo site

Another healthcare provider may take over the site of the Lamb Foggo Urgent Care Centre, according to Health Minister Patricia Gordon-Pamplin.

The Southside, St George's facility, which opened to fanfare in April, 2009, is being closed down due to low use and high costs.

Ms Gordon-Pamplin yesterday announced that she was “working with Bermuda Hospitals Board to review alternative uses of this facility”.

Saying she planned to issue a full statement on the matter in today's House of Assembly, Ms Gordon-Pamplin said the service had cost $2.5 million a year to run.

BHB expects to save about $250,000 annually by closing it.

The Minister pointed out that primary care providers — meaning those who deal with common medical ailments — would be less expensive than emergency department staff.

“We want to see if we can maintain some degree of coverage for the East End,” she said.

Asked if she planned to attend a town-hall meeting organised last night by the Progressive Labour Party MP for St David's, Lovitta Foggo, Ms Gordon-Pamplin said she hadn't been invited.

“I don't think they wish to be confused with the facts,” she added.

However, the Minister said she was “100 percent agreeable” to having BHB release its business cases, giving the hard figures behind the centre's performance.

“Nobody wants to think that we spent $5 million in public funds to construct, plus $2.5 million in funding to put machinery in place, and then find out it does not work,” she said. “That's quite a painful decision that has to be made.”

She continued: “You have to be pragmatic. With the new hospital wing going up and limited money in the community, somebody has to pay for the services being offered.”

Yesterday's press conference was devoted to expanding on health and seniors issues raised in last week's Throne Speech.

The Minister said Government intends to strengthen the law behind the Senior Abuse Register following consultation with Director of Public Prosecutions Rory Field, who highlighted “several shortcomings” in the current legislation.

Government has been advised to make senior abuse an indictable offence.

“At the moment, the offence of Senior Abuse is a summary only offence,” she said. “This places unreasonable time limits on the investigators to complete an investigation and to present a file to the DPP for review. Such an amendment will remove time restraints, and will allow for more severe penalties in the most serious of cases.”

Police may also receive enhanced powers to remove a senior citizen from a home if they have reasonable grounds to believe they are suffering abuse.

Government will consider amending the law to create Secure Treatment Orders, she said — empowering courts to order the medical or psychiatric assessment of a senior, in situations where caregivers or relatives refuse to sign a medical waiver.

Government also plans to create a Vulnerable Persons Act to bring clarity to legal protections afforded to those between the ages of 19 and 64 who may be subject to abuse.

And Ms Gordon-Pamplin said her Ministry would be working on a long-term care strategy for the elderly, disabled and others in need of lengthy care.

Additionally, plans to tighten controls over the importation of high-cost medical technology to the Island will be led by the Bermuda Health Council, Ms Gordon-Pamplin said.

“This will not have an impact on access to healthcare,” she said. “Our current capacity will not be affected — the focus of the health technology review will be on efficacy and value for technology.”

Applications to import machinery will be reviewed by the BHeC on collaboration with the Department of Health and the Chief Medical Officer.

“Technologies posing minimal risk and or with minimal cost implications will be fast-tracked,” Ms Gordon-Pamplin explained. “High cost, high risk medical equipment will undergo a full review process to determine health system need. If approved, a certificate of entry will be issued and importation will be allowed.”

Her announcement came as BHB chairman Jonathan Brewin addressed concerns about the closure of Lamb Foggo before Sandys Rotary Club.

Mr Brewin said that with the hospitals already absorbing a $14 million loss on its Continuing Care Unit, the mainly “minor ailments” addressed at Lamb Foggo couldn't justify the expense.

Addressing “the safety of the people in the East End”, the chairman said: “Most of the 14 people a day who accessed the Urgent Care Centre had minor ailments that could either be appropriately managed by their GP, or would not be made worse by the 15 to 20 minute drive to the Emergency Department at the hospital. Quite simply, there are good alternatives and options for these people.”

Causeway closures, he added, were “a rare occurrence”.

Mr Brewin said the Lamb Foggo closure had come at the start of BHB's evaluation of its services, against a backdrop of possible debts.

A new charge for work permits, for instance, will cost BHB $650,000 annually, while the opening of the new hospital wing next year also means the beginning of service payments and additional operating costs.

“BHB cannot afford to maintain the status quo,” Mr Brewin said. “More importantly, Bermuda cannot afford it.”

Health Minister Patricia Gordon Pamplin. (Photo by Akil Simmons)
<p>Doctors to be told to get second opinion</p>

Doctors’ referrals for diagnostic testing will be vetted by other physicians in a move to cut back on healthcare costs, Health Minister Patricia Gordon Pamplin said yesterday.

Asked if Government was contemplating pre-certification — a procedure confirming eligibility for medical procedures — the Minister confirmed that Government hoped to introduce it in the year ahead.

“I’ve made the decision — the next step is the consultative process,” she told The Royal Gazette. “We’re not at the stage of legislation at this point.”

She said the checking process wouldn’t override the decisions of doctors.

“Doctors are able to make their evaluation. If they get a patient showing up with certain symptoms, nobody is going to say you can’t do an MRI — we’re not trying to stymie doctors,” she said.

“It’s really to avoid overuse. Some of the reports that we’ve had which led me to my decision show that in certain instances, diagnostic testing is given when it might not be needed.”

Because of the high expense of running sophisticated medical imaging technology, Government has moved to regulate the industry in a bid to rein in costs.

Ms Gordon-Pamplin said it wasn’t Government’s place to train doctors on when and when not to order diagnostic imaging, however.

“That’s for the medical professionals to do,” she said. “They know what’s required to treat their patients. It would be presumptuous for the Minister of Health to suggest that give our doctors more training.”

She said the move toward pre-certification was strictly “an attempt to continue to get ahold of costs in healthcare”.

In an address to Sandys Rotary Club this week, Bermuda Hospitals Board CEO Venetta Symonds said BHB was making sure tests were carried out “when they are supported by evidence-based practices — this avoids the cost of inappropriate referrals”.

She added: “For example, clinical evidence suggest that an individual suffering from low back pain does not need an MRI unless the pain lasts longer than six weeks or there are potential warning signs such as fever, cancer history, or progressive neurological compromise.”

Guidelines could help cut down on “inappropriate imaging”, Ms Symonds said.

“Adhering to such guidelines is standard practice in most jurisdictions. But if only BHB implements them, all that will happen is business will be directed to the unregulated private healthcare providers. And Bermuda loses out on an opportunity to control costs.”

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Published November 14, 2013 at 12:34 pm (Updated November 14, 2013 at 5:43 pm)

Alternative use sought for Lamb Foggo site

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