An arms-length relationship between doctors and clinics offering special testing services should be established, MPs heard yesterday.

Shadow Finance Minister Grant Gibbons said: "There are frequently conflicts of interest in physician-owned diagnostic facilities.

"I'm not saying everybody does it, but there is a temptation to over-prescribe the services which need to be done.'' Dr. Gibbons told the House of Assembly that Colonial Insurance was owned by his family -- but that his connection was not a direct one.

He added that insurance might only cover a small part of tests -- leaving patients to pick up the rest of the bill.

And he pointed out that between 1993 and 1997, the cost of private testing and diagnostic facilities had increased on an annualised basis by more than 13 percent a year -- compared to inflation rates of around two percent.

Dr. Gibbons said: "This hasn't declined at all -- it's still going on at about that rate and the typical increase in the cost of living is around two percent.'' He was speaking as Health and Social Services Minister Nelson Bascome introduced a new Act aimed at enforcing standards in private testing services offering blood tests, mammograms, radiology and ultrasound treatments.

Shadow Health and Social Services Minister Kim Young told the House that specific standards of quality of care were required in all areas of health care.

Ms Young said: "You and I need to know that when we go to any facility, that facility is of the highest standard.

"And we need to know that the results we get are accurate and we don't have that.'' Ms Young said she had worked "for years'' to have mammography properly regulated.

She added that now more men were beginning to suffer from breast cancer, action might now be taken.

Ms Young said breast cancer was a killer and had to be detected early.

She added: "These cancers can be as small as a pinprick and if anything goes wrong along the way, we could have a disaster.'' Ms Young said the elderly people were increasingly being put in nursing homes -- making top-class standards even more important.

She added: "It's important for the people of Bermuda that we explain the standards to each and every one of us so wherever we go for diagnostic tests, when we put our parents in nursing homes, we can be reassured.'' Progressive Labour Party backbencher Ottiwell Simmons said Bermuda had, in former years, a variety of hospital and clinics spread across the Island, partly due to the presence of overseas military forces.

And he called for services to be decentralised and once more spread across Bermuda.

Mr. Simmons added that home care as an alternative to hospitals for the elderly was "one of the most reliable forms of alternative care to hospitals''.

He added: "This Ministry and this Government should look at that very carefully indeed. The cost of hospital care is very high and in Bermuda, it's very high indeed.'' Mr. Simmons also called for more investigation of alternative medicine -- although he said conventional medicine appeared to be very suspicious of it.

He added: "It's not just for the sake of cost, but for the sake of care because there is a lot of evidence that alternative treatments have had success.'' Renee Webb -- once Shadow Health Minister -- said it was interesting that the issue of conflict of interest had been raised for doctors.

She added that former Tourism Minister David Dodwell owned a hotel and that could have been interpreted in the same way.

And Ms Webb said people trusted professionals like doctors and lawyers to have high standards and stick to them.

She added: "We all know that conflict of interest exists in Bermuda, but we hope there is a certain amount of integrity with physicians.'' And she said insurance companies charged high premiums -- but were reluctant to pay out.

Ms Webb added: "If we're looking at control on the one hand, we need to look at controlling the insurance companies on the other.''