The Tribune

By NEIL HARTNELL

Tribune Business Editor

nhartnell@tribunemedia.net

An ex-MP whose entire $1 million investment has been endangered by the never-ending wait for Government approvals says: “The system has decided I don’t fit in the Bahamas.”

Anthony Miller, the former south Eleuthera MP, told Tribune Business he had been forced to close Integra MRI Center and lay-off all eight staff after the continuing 18-month wait for approvals for his “pioneering” cancer diagnosis technology left the business financially strapped.

With all their capital tied up in the still-unused Positron Emissions Tomography (PET) scanner, Mr Miller said he and his joint venture partners had no cash flow/replacement income to repair their MRI machine, which broke down in December 2014.

Integra, he explained, had been hit by the ‘perfect storm’ of having both its business lines closed down. He blamed this on the Hospital and Healthcare Facilities Licensing Board’s inability to tell the company whether the PET technology will ever be approved for use.

Mr Miller has yet to obtain an answer either way from the Board following an 18-month odyssey of letter writing and correspondence. And his pleas for help to the Prime Minister, Deputy Prime Minister Philip Davis and health minister, Dr Perry Gomez, merely produced a sole ‘receipt acknowledgement’ from Perry Christie’s permanent secretary, Creswell Sturrup.

A disillusioned Mr Miller told Tribune Business he was now considering selling a business that would provide Bahamians with quality healthcare at home, stemming the outflow of foreign exchange, while also stimulating medical tourism from other Caribbean nations.

Admitting that he had been “worn down” and “beaten” by the regulatory system, the ex-MP turned businessman said his plight proved the ‘Stronger Bahamas’ and ‘Bahamas for Bahamians’ catch-lines were “a farce and a bad joke”.

And Mr Miller told Tribune Business that if he, a former politician and someone who knows how government works, cannot obtain the necessary answers, then “God help” the small Bahamian entrepreneuer trying to start a business Over-the-Hill.

“Waiting for this has really destroyed my business. It has put me out of business. The system has put me out of business,” Mr Miller said of the regulatory process.

“I don’t believe in all the ideas of the concept of a ‘Stronger Bahamas’ and the focus on Bahamians. It’s a farce. It’s a joke. I’m a clear indication. There’s no safety net for Bahamians. There’s no system in place for a Bahamian investor who has put all their money into a business.

“I’m a Bahamian who invested $1 million into my business. I understand I didn’t invest $3.5 billion [Baha Mar], but I feel like I put all I had into my country,” he added.

“I invested this money to the benefit of Bahamian citizens, and I would have thought the system would have been willing to see this succeed for the benefit of the Bahamian people.

“The system has decided I don’t fit in the Bahamas. The system has said to a Bahamian citizen: You don’t fit. You don’t count. That’s how I feel. It’s unfortunate.”

Suggesting that his treatment provides a warning tale for other Bahamian investors, Mr Miller added: “As one who knows the system, who is a former MP, who knows the leader of the Government and who, I believe has the ear of the Government and ear of the system; if I am going through Hell, then I say God help the fella in Bain Town who sets up a little business, or the fella Over-the-Hill who may not have access. I say: ‘God help them’.”

Mr Miller showed Tribune Business copies of the numerous letters he has sent to the Board seeking approval for the PET machine since January 2014.

The PET, which was installed at Integra’s Sandyport premises in February last year, works via injecting isotopes into the human body. The machine then employs gamma rays to detect cancer cells, “lighting them up like a sun”.

The isotopes are not dangerous, and exit the human body naturally within 24 hours. Yet Mr Miller said he received no reply from the Licensing Board until almost a year after sending his first letter.

He showed Tribune Business the January 8, 2015, fax that contained two letters written to him by Board chairman, Dr Yasmin Williams-Robinson. These were dated March 15, 2014, and September 25, 2014, respectively, but Mr Miller maintains he received neither until that fax was sent.

The first letter informed Mr Miller that the Board would need “to collaborate with regional partners” to conduct an inspection of Integra’s PET facilities. It warned him not to use the technology until it was approved.

Dr Williams-Robinson’s second letter conceded that there were no Bahamian standards governing PET technology, and the Board would have to apply regional/international standards to certify Integra.

She conceded that there had been an administrative delay in organising an inspection of the company’s facilities, which was blamed on the Ministry of Health.

And Dr Williams-Robinson said the Board could not accept two consultants’ inspections that Integra had organised itself, insisting that it must conduct its own investigation.

Mr Miller said Integra was prepared to cover all the Board’s inspection costs, including those of any international consultants/inspectors it required.

The Healthcare Facilities Licensing Board’s position, saying neither ‘yes’ nor ‘no’, appears to be a common position that innovative entrepreneurs encounter when seeking Bahamian regulatory approval for technologies that have no existing policies, standards and regulations governing their use.

When faced with such applications, regulatory agencies often seem unwilling to move them forward due to a ‘fear of the unknown’ – and the potential repercussions if things go wrong after approvals are granted.

Applications such as Mr Miller’s are thus left to languish indefinitely, with government agencies seemingly hoping they will eventually go away. Yet the resulting uncertainty creates havoc for both Bahamian and foreign investors, and could undermine this nation’s attraction as a place to do business.

Mr Miller also showed Tribune Business copies of two inspection reports conducted on Integra’s PET scanner and facilities. Both gave the company a ‘clean bill of health’, making only “minor recommendations that I can implement today”.

The reports were completed by Orlando-based Fusion Physics, a PET equipment supplier, and Dr Collie Miller, a renowned Jamaican physician and radiation safety specialist.

Dr Miller, in his report, wrote: “I would like to congratulate Mr [Anthony] Miller for his pioneering work in installing the first PET/CT scanner in the English-speaking Caribbean.

“This is a major effort to contribute to the advancement of the medical practice in the region, particularly in the diagnosis and management of cancer.”

Mr Miller told Tribune Business: “I thought this was an excellent idea that everyone would be on board with.

“I’m prepared to listen to the Government, for them to tell me what to do with the PET machine sitting there. If the standards of the US do not meet your local standards, tell me what your local standards are.

“I’m getting ready to lose my house, my home, and live on the streets. As a Bahamian investor in my country, I believe that if I had taken this down to another Caribbean country, it would have been in operation,” he added.

“I thought I was helping the system, but maybe I pissed the system off. Maybe I should have sat on my laurels and used my funds to pay other bills. It hurt my heart to let my people go. They relied on me for their salaries, their families, and now they’re all sat at home.”

Some observers may question why Mr Miller and his partners took the risk of investing in the PET without first gauging the likelihood of obtaining the necessary approvals to operate it.

Yet the ex-MP, who represented south Eleuthera up until 2002, said Integra was already licensed by the Board as a Diagnostics Facility for its MRI scans.

The company, which was an approved provider for Family Guardian’s BahamaHealth network, also wrote to the Healthcare Facilities Licensing Board asking whether its license covered scanning and if there were any PET-related protocols in the Bahamas. It received no reply.

Mr Miller said the inspiration to start Integra came from “personal circumstances”. He suffered a stroke in 2004 that temporarily prevented him from walking, and among the necessary rehabilitative procedures were MRI scans.

The four MRI ‘brain and spine’ scans cost him $6,000, which the former MP had to finance in the absence of insurance. Yet the same services in Florida would have cost $1,800, less than one-third of the price.

Mr Miller further investigated the cost disparity with the Bahamas, and the number of Bahamians – and associated family members – who travelled to Florida and the US annually for MRIs and similar procedures.

“Once I got back on my feet I did my research,” he explained. “I checked out all the MRI centres in Florida, and checked out the volume from a business perspective.”

He linked up with US joint venture partners to acquire Integra’s MRI machine, which was installed in October 2010 and began operating in May 2011.

“It took me almost a year to get licensed for the MRI,” Mr Miller recalled. “I fought them, and it took me that long to get it done. We operated the MRI successfully until it broke in December 2014.”

With the MRI broken, and Integra unable to operate the PET scanner, Mr Miller said the company had to “close the doors and lay-off all Bahamian staff”.

“With approval for the PET, the MRI would have been fixed now with income coming in from that,” he added. “From a business perspective, where do I go as a Bahamian who invested in my business, invested in my country.

“Where do I turn? God forbid if this is the way businesses are treated by the system. I don’t know where to turn.”

Mr Miller said he had gone beyond what was required for safety, telling Tribune Business: “I took the standard to the highest level possible. I did not have to do what I did.” He added that the PET would have been operated by personnel from US-based Molecular Imaging Resources, who would have travelled to the Bahamas twice weekly.

He added that the idea to expand into providing PET diagnostic services, a first for the Caribbean, came from his wife who is a cancer survivor. With the machine, which cost $20,000 just to install, sitting idle in Sandyport, he has even invited the Government to take over its operation.

“Right now, everybody that needs to have their cancer managed has to fly to Miami to have their PETs done,” Mr Miller told Tribune Business. “My facility is right here in the Bahamas and was going to reduce healthcare costs for cancer patients. The cost involved in going to Miami and staying in a hotel, all that would have been cut.”

The ex-MP said all cancer patients had to undergo PETs to determine whether the illness was in remission or not, once it had been treated.

Apart from reducing healthcare costs for Bahamians and advancing local medical practices, Mr Miller said Integra’s PET facility could have further spurred medical tourism given the high cancer rate both locally and in the wider region.

He added that it would have been especially attractive to other Caribbean nationals, especially Jamaicans, who often encountered problems in obtaining US visas.

“I had spoken to a number of insurance companies in Jamaica, and they had even made offers once I was up and running to send their persons to the Bahamas for a PET rather than go elsewhere,” Mr Miller told Tribune Business.

“It’s true medical tourism, and we help out other nations in the Caribbean region.”

For now, that dream is on hold, with the ex-MP and his attorney now contemplating whether to accept an offer made to purchase Integra’s business and assets by an unnamed buyer.

“Over the last 16 months, the system has worn me down,” Mr Miller said. “In business I’ve always been very persistent and had the resilience, but the system has worn me down to the point where I’m considering selling the business and walking away from a dream I had as a Bahamian, and a dream I believed would have a positive impact on my country.

“I am not a physician, but one who understands imaging and scanning, and that MRIs and PETs are necessary for physicians to properly treat their patients. That’s the role I want to play in the development of my country.

“There’s no MRI in the public hospital, and no PET system in the Commonwealth of the Bahamas. But I have to do what I have to do, and maybe I’ll accept the sales offer and take a big hit and big loss.”

Mr Miller is not the first to complain about the prolonged wait for medical industry approvals. Tribune Business recently revealed how Doctors Hospital’s chairman had blasted the “many bureaucratic obstacles” it has faced in obtaining approvals for its medical tourism initiatives.

Joseph Krukowski implied that this played a key role in driving a 190 per cent year-over increase in Doctors Hospital’s net losses for the year to end-January 2015.

He wrote in the company’s annual report: “The medical tourism programme has had many bureaucratic obstacles, as we await approvals for a number of different programmes that will have a very positive effect on our financial position.”