The Tribune

By NEIL HARTNELL

Tribune Business Editor

nhartnell@tribunemedia.net

Doctors believe the Government’s hiring of a world-renowned KPMG executive is the last chance to demonstrate it is serious about “meaningful consultation” over National Health Insurance (NHI), amid concerns his report will simply be ignored if the findings are unfavourable.

Tribune Business can reveal that the Christie administration has contracted Dr Mark Britnell, chairman of the accounting firm’s 4,000-strong global health practice, as its latest NHI consultant.

He was introduced at a Tuesday night meeting at the Prime Minister’s Office, attended by representatives from the Medical Association of the Bahamas (MAB) and other healthcare organisations, plus Cabinet ministers on the Government’s NHI sub-committee and members of the scheme’s implementation team

Sources familiar with what occurred said Dr Britnell’s ‘brief’ from the Government is to accomplish three tasks.

Apart from reviewing the data and conclusions presented by the Christie administration’s first consultants, Sanigest Internacional, Dr Britnell will then meet with industry stakeholders the likes of doctors and insurance companies - to hear the concerns over NHI, and what they believe it and universal health coverage (UHC) should look like.

Dr Britnell’s final task will be to supply the Government with recommendations on a strategic plan for NHI’s implementation.

One doctor, speaking on condition of anonymity, told Tribune Business: “We will take a wait and watch approach, and see what happens.

“These additional steps will determine the Government’s resolve to have meaningful consultation with all stakeholders.”

They added that Dr Britnell and KPMG had indicated “they will take this week to find their footing on the ground and look at the current issues, and begin to engage all stakeholders next week”.

These ‘stakeholders’ will include the MAB, Bahamas Insurance Association (BIA) and the trade unions.

Dr Britnell was described to Tribune Business as “a heavy hitter” in the world of healthcare consulting by one Bahamian doctor, and his KPMG biography certainly backs this up.

He is said to have worked in 60 countries since 2009, “helping governments, public and private sector organisations with operations, strategy and policy.

“He has a pioneering and inspiring global vision for healthcare in both the developed and developing world, and has written extensively on what works around the world,” the KPMG biography adds.

“Mark has dedicated his professional life to healthcare, and has led organisations at local, regional, national and global levels.”

Dr Britnell was also chief executive of a UK hospital, University Hospitals in Birmingham, and is said to have led construction of the largest new hospital built under Great Britain’s National Health Service (NHS) - one of the models providing inspiration for the Christie administration’s NHI.

He also ran a major part of the UK’s NHS, and joined its management board as a Director-General.

But, while praising Dr Britnell’s “impeccable credentials”, one Bahamian physician questioned why the Government always felt the need to seek a ‘stamp of approval’ from foreign consultants for NHI and other schemes.

Dr Duane Sands, who is also the FNM candidate for Elizabeth, suggested that it was a sign of “low self-esteem” for the Government to constantly ignore the great amount of expertise and experience among Bahamian healthcare professionals in devising NHI.

And he questioned whether the Government would simply ignore Dr Britnell’s final report and recommendations if they did not support its NHI model.

The Christie administration appears to have done exactly that with the report by its second consultants, PricewaterhouseCoopers (PwC), which warned that the NHI scheme as-is “has the potential to seriously destabilise both the private and public sectors of the healthcare system”.

“There’s no question about his impeccable credentials and qualifications,” Dr Sands said of Dr Britnell. “I’m sure within his country and throughout the world he’s earned plenty of admiration and respect among the healthcare community. But I think this is more fundamental than that.

“Within the context of the Bahamian healthcare reality, are his credentials any more relevant, germane and pertinent to the issues on the ground?”

Dr Sands said the Government’s continued hiring of foreign consultants to advise on, and give approval, to its NHI design “points to a low level of self-esteem or self-hatred that’s exhibited by our government and by our Prime Minister.

“He, on the one hand, speaks about his belief in Bahamians, but in reality he believes nothing can be adjudicated without a foreign consultant,” he added.

“We continue to rediscover the wheel, and it is astonishing that we can have individuals who can collectively contribute to the advancement of the healthcare system in the Bahamas, but their ideas and views are not only not sought but dismissed.

“Most importantly and sadly, our Prime Minister will demonstrate to every Bahamian boy and girl why they can never expect recognition and respect in their own country. He will demonstrate that whatever a Bahamian says, it’s not good enough.”

With the Government having already begun NHI registration, seeking to launch its $100 million primary care phase by April 2016, Dr Britnell has little time in which to complete his work.

Dr Sands said that for all his undoubted expertise, Dr Britnell would likely know “precious little about what’s happening on the ground in the Bahamas”, and have to be guided by industry stakeholders.

And he warned that Dr Britnell’s findings might be ignored by the Government in any event if they did not support its chosen NHI model.

Pointing out that the Government had form for doing this, not just with the PwC NHI study but on issues such as the Rubis gas leak, Dr Sands said: “We’ve seen that the Government is able to selectively release or suppress information that is not consistent with the message they wish to send. Or they may wish to sample from a document that is never released.”