By TANYA SMITH-CARTWRIGHT
FOR decades, Princess Margaret Hospital has struggled to provide a first-class health service for the thousands of patients it cares for.
Hamstrung by budgets swallowed up almost entirely by the hospital’s wage bill, out of date and broken equipment, wards left closed for years due to hurricane damage - the PMH staff faced a daily battle to do the best they could.
Imagine then an opportunity comes along to change all that. An opportunity to provide The Bahamas with a world-first, top-of-the-line medical facility operated by one of the world’s leading hospitals. Who could say no?
So, how did this all start? When the FNM was elected in 2017 as is normal a whole new raft of appointments was made to the boards which oversee our public services.
This included the Public Hospitals Authority and among the tasks it was assigned was to explore the possibility of a massive upgrade to the hospital in New Providence.
Based upon an inquiry from the Deputy Chairman of the Public Hospital’s Authority Board if Johns Hopkins Medicine and/or Hopkins Bloomberg School of Public Health might be interested in managing a new facility based upon the Beck Group’s strategic master plan and they hoped The Walt Disney Company’s “Team of Heroes” Global Children’s Hospital initiative funded potentially by the US EXIM Bank and other private expat benefactors a new Children’s Hospital & Women Health Centre, Level 1 Trauma Centre, Radiology Department & EMS facility described as ‘the likes of which the world hasn’t seen’.
Senior management from Johns Hopkins made a number of visits to Nassau and all seemed to be progressing until then-Health Minister Dr Duane Sands said the project would not be proceeding.
What had happened to kill the project? Somehow the ‘deal of a lifetime’ was shelved and has left many involved pointing fingers at each other.
Acting on a tip from a high-ranking FNM insider, Insight has confirmed from the Office of the Prime Minister that no one can recall ever seeing a Cabinet Memorandum on the project.
The insider alleged that Dr Sands, “sat on” the deal and intentionally held the proposed collaboration of the PHA, Johns Hopkins and Disney deal from advancing to Cabinet for a decision to be made on it.
“Our economy is going to be in a state of rot for some time before we see any light,” the FNM insider said. “This could have been avoided if Sands had just presented the Hopkins proposal to Cabinet, gotten it approved and put us on the map. Medical tourism could be booming right now, but his interest was elsewhere. Robert Carron did all that hard work getting Johns Hopkins on board and then Sands killed the deal.”
The Tribune contacted both Dr Sands and Mr Carron - who was then deputy chairman of the PHA - and both had similar stories of how Hopkins became interested in The Bahamas. Dr Sands’ alma mater is Johns Hopkins’ University, School of Medicine, and Mr Carron spent an extended period at Johns Hopkins when his child was ill.
“In the manifesto (FNM) there is a commitment to build a new tower at Princess Margaret Hospital,” Dr Sands said. “For the last three years, one of my missions was to get that to happen. So we have had formal discussions with Baylor, Johns Hopkins and University of Miami. Johns Hopkins, because of it being my alma mater and the then-deputy chairman of PHA, Mr Robert Dupuch-Carron, whose son spent a year at Hopkins, asked if he could pursue that angle. So we had a series of discussions. We had a whole group come down from Hopkins.”
Dr Sands has categorically denied the FNM insider’s claim, saying he had no support from PHA and that is why the proposal did not advance.
“There was nothing to present!” Dr Sands said adamantly. “It was just a concept. The one proposal that Hopkins presented at the end was a draft proposal presented to the PHA. That proposal never got any vetting by the PHA that says, ‘Hey! Yes! We are interested’. Then, like I said, we moved into Dorian and then COVID and it fell by the wayside.
“The challenge of medicine in The Bahamas is where US trained physicians are considered outsiders. And if you are a UWI trained physician, the belief is that the UWI physician is the be all and end all. And the thinking is that ‘these American trained physicians always trying to bring their US influence into The Bahamas, which we don’t need’. So you have to walk a very fine line. You know when you have support and when you don’t have support for certain things.”
Dr Sands said the idea of The Bahamas catapulting itself as a world leader in healthcare, to him, made a whole lot of sense.
“It is a biggity and audacious idea,” he continued. “But you need to have people who believe it. And, if they don’t believe it you are going to get tepid support. That doesn’t stop you from looking at ideas. If you ask me if that (Hopkins) was an excellent model to pursue. Yes! Would I pursue it again? Yes!”
Prime Minister Dr Hubert Minnis received his primary training from a West Indian institution. A spokesperson at the Office of the Prime Minister said the proposal was never presented there, therefore no commentary of the matter was given.
For PHA’s consideration, Johns Hopkins submitted a framework for a “Nation Services Agreement” collaboration, addressed to Robert Carron. The goal of the project was to create a Centre of Excellence for Caribbean and ultimately rebrand each Dept of Public Health Family Island Clinic into an Urgent Care Centre - propelling The Bahamas into a regional leader in medical tourism; as well as, focus on tropical and non-communicable disease research.
Mr Carron told Insight: “I’m sorry but I have no other knowledge other than what you’ve already been informed by the Office of the Prime Minister, former Minister of Health and current PHA chairman Julian Rolle.
“I was appointed the deputy chairman of the Public Hospital Authority and National Emergency Management Service and asked to assist Dr Minnis’ Administration and the then Minister of Health to transform the delivery of healthcare in our nation..
“Having spent 561 days at John Hopkins with my wife and my son I became quite friendly with people in leadership there. I followed through on the President of Hopkins statement that they would be interested in coming to The Bahamas and become the centre of excellence for the Caribbean.”
Mr Carron said after this, the BECK group, which is headed by a Bahamian, had been engaged to do some designs and he reached out to Disney, because it has a $100m initiative for hospitals.
“The idea to approach Disney’s Team of Heroes came from a group of nurses and head of PMH Medical Records Dept after they’d visited hospitals in the Orlando area,” he added.
“Since Disney Cruise Line generates millions of dollars in revenue from The Bahamas we thought they might be willing to collaborate with a John Hopkins managed, Disney and Beck designed hospital of which the president of the John Hopkins and Bloomberg School of Public Health said the likes of which the world has never seen. So we put together a plan and we submitted it and it was rejected,” said Mr Carron.
Asked why the plan was rejected, Mr Carron said: “As I recall, Dr Sands informed the Board that the project was rejected by Cabinet,” he stated.
“My responsibility on the Board was to submit it to the Ministry of Health and then they conduct the process and we were informed some weeks later that it was not approved,” continued Mr Carron.
Mr Carron expressed surprise that it had been suggested the project had no support within the PHA.
“No support?” he replied. “(Laughing) Please I’m not responding to a ‘red herring’ like that... Have a look at the pics in the press and count the heads of TUC, other trade associations, US Charge D’Affaires, PHA Board members and others who came to the welcome dinner, meetings and various other events to get your answer.
“What I feel people should know is that Dr Minnis and his Cabinet colleague deserve credit for supporting the PHA’s chairman and Board’s unorthodox efforts which have resulted in the tremendous progress that’s been made to transform delivery of public healthcare in our nation after so many years of unconscionable neglect under Senator Darville & Co.
“Yeah, there’s lots more work still to done, but least we got a hospital with a roof, windows, AC, digital X-rays, CT scanner, renovated wards, beds, maternity suite, upgraded A&E department and laundry (fingers crossed) and the best bread in the world!!”
Also contacted by The Tribune to fill in the blanks, PHA’s chairman, Julian Rolle was very tightlipped about the entire process.
“I wouldn’t have any comment on it,” Mr Rolle said. “Those items would have had to have gone to Cabinet before they came to the Board. I don’t know that they were. We did not receive any instructions to pursue the same.”
Pressed further, Mr Rolle said he was not willing to comment any further.