The Tribune

By NEIL HARTNELL

Tribune Business Editor

nhartnell@tribunemedia.net

The proposed Public Hospitals Authority (PHA) medical supplies consortium was yesterday branded “a very slippery slope”, the FNM’s deputy chairman arguing that the projected savings did not justify “devastating” the private sector.

Dr Duane Sands told Tribune Business that the consortium plan developed by Pedro Roberts, the CDM Group’s chief executive, threatened to “open the doors to anything goes” by seemingly seeking government approval to “run roughshod” over established Bahamian medical equipment and pharmaceutical distributors.

And his party leader, Dr Hubert Minnis, promised that the Opposition would “absolutely” start investigating the ‘consortium’ proposal and wider issues concerning the PHA’s medical supply contracts and delayed Critical Care Block opening.

Branding the proposal as “fishy”, especially as Mr Roberts had declined to divulge the consortium’s members, Dr Minnis, the former minister of health, questioned whether it was serving self-interests or political interests.

Accusing the Christie administration of abandoning the “transparent” procurement process its predecessor had left in place to acquire the Critical Care Block’s medical equipment, Dr Minnis said this may have been driven because the Government felt some Bahamian agents/distributors “did not share their political persuasion”.

The comments by Messrs Sands and Minnis will likely increase the pressure on both the PHA and the Government to provide a detailed explanation on both the equipment procurement process and why the Critical Care Block opening has been delayed.

The main losers from this saga are the Bahamian people, whose access to much-needed quality, affordable healthcare is being both delayed and denied. It suggests that the Government needs to postpone its National Health Insurance (NHI) ambitions and sort out this situation first.

One source told this newspaper: “It’s one big mess with everyone circling to take up the spoils.

“The net result is patients are not getting into the operating rooms, there are people in wards still on ventilators, and the people that are suffering can least afford it, as they don’t have the money or insurance to make it into the private sector.”

Mr Roberts, defending his proposal, told Tribune Business yesterday that all distributors were welcome to participate in the consortium, which he believed would reduce the Government’s costs and create “a sustainable” business model for the future.

He accused other medical equipment and pharmaceutical suppliers of tainting his proposal with “politics”, adding that their claims of “mistreatment” stemmed from the fact they would no longer get “the lion’s share” of the PHA and Critical Care Block business.

However, Dr Sands told Tribune Business of Mr Roberts’s proposal: “I think it’s a very slippery slope.

“If you are suggesting that we should abandon, as a state-sanctioned policy, distributorships which are legally and financially established, boy, you are opening the doors to anything goes in this country.”

Dr Sands said there was “a safer, better legal approach” that could satisfy both the Government’s and private sector’s objectives than the consortium proposal.

Mr Roberts is suggesting a lease arrangement, where the PHA would rent all its medical equipment from the group for a five-year period.

Such an arrangement, he suggested, would lower the PHA’s (and the Government’s and Bahamian taxpayer’s) up-front capital costs associated with equipment purchases, and free it from annual maintenance costs and depreciation expenses.

However, Dr Sands said there was an alternative way to “maximise efficiencies for the Government without destroying the private sector and running rough shod over existing agreements”.

This, he suggested, simply involved establishing “reasonable range” mark-ups which, while covering the private sector’s costs and profit needs, also avoided 300-500 per cent margins being imposed on the Government.

“The road to hell is paved with good intentions,” Dr Sands told Tribune Business of the consortium plan. “In this instance, you’re looking at something that’s penny wise and pound foolish.

“The end does not justify the means. To save $2 million over 48 months and justify devastating several businesses makes no sense. Is this how we want the Government to do business, destroying the middle class and the business class?”

Mr Roberts’s consortium plan, as pointed out by Tribune Business yesterday, appears to contemplate being the exclusive supplier of all the PHA’s medical equipment and pharmaceutical needs, seemingly squeezing out all other Bahamian distributors.

Industry sources also questioned whether it was a true public-private partnership (PPP), as Mr Roberts has presented it, because there is no government equity or ownership in the consortium.

The ‘concept paper’ suggests the consortium will be owned by its member companies, plus financial institutions and private sector investors.

Dr Sands, meanwhile, said he had “great concerns” over the failure to open Princess Margaret Hospital’s Critical Care Block despite construction of the building being completed one year ago.

“There is no excuse that can be given to explain why the building is not open for clinical use,” he added, noting that it was placing the Bahamian people’s access to quality healthcare in jeopardy.

“Every day patients face challenges with a hospital filled to the gills, whose capacity was exceeded many years ago,” Dr Sands said.

“The place is lying fallow, it is not being used, and the problems that led to the Critical Care Block’s creation continue. It has now gone into an absurd mockery of itself. Here we are, in mid-2014, and even the chairman of the PHA is unable to stick his neck out and say when it could probably open.”

Dr Minnis, meanwhile, blamed the Christie administration for abandoning the Critical Care Block equipment procurement process left behind by the former government.

He said the Beck Group, headed by Bahamian chief executive, Fred Perpall, had selected the equipment consultant. This firm then met with doctors and nurses to get their input into the process, before determining the Bahamian agents and distributors the chosen equipment had to be ordered through.

“That’s the proper way to do it,” Dr Minnis said. “Not get some consortium, group put together where we don’t know who the participating entities are. It sounds fishy.

‘The proper way would have been the way we would have done it. It would have been completely transparent and done professionally.”

Dr Minnis said that under the Ingraham administration, the Critical Care Block equipment had been identified, and the consultant had met with the Bahamian agents to ensure the products were sourced from the right manufacturers.

“They [the Christie administration] dismantled the entire process,” he told Tribune Business. “They may have felt some of the distributors and agents were not of their political persuasion.

“Because of these delays, the equipment will be even more costly today than yesterday. The waiting times and shortage of beds is being caused by the delays to the Critical Care Block.”

Dr Minnis also warned that healthcare costs, and those to the Bahamian taxpayer, would increase as a result of the consortium proposal, as excluding the established agents would eliminate access to discount pricing and other benefits.