Cancer-treatment conflict - Gov’t physicist gets contract to treat patients at his private practice

Published: Sunday | January 15, 2012 Comments 0
Dr Fenton Ferguson
Dr Fenton Ferguson
Tanny Shirley
Tanny Shirley
Dr Eva Lewis-Fuller
Dr Eva Lewis-Fuller

Tyrone Reid, Senior Staff Reporter

The Ministry of Health’s chief physicist, who gives technical advice to help shape the Government’s cancer-treatment policy, is also a senior principal of a company that will receive a multimillion-dollar payout to treat the patients on behalf of the state, Sunday Gleaner investigations reveal.

Late last week, the Government announced that it would pay $28 million under a public-private partnership that would see 55 cancer patients receiving treatment at a privately owned oncology-treatment centre. What Minister of Health Dr Fenton Ferguson did not tell the nation were the details of the public-private sector arrangement.
Health-sector sources have raised questions about the apparent conflict of interest and the slow pace at which the Government was moving to acquire better equipment for public institutions.
The decision to engage the Radiation Oncology Centre of Jamaica (ROCJ) came about because the cobalt unit at the state-owned Kingston Public Hospital is broken. When the unit failed two weeks ago, the 55 patients were left without treatment. The cobalt unit is expected to be repaired within the next two weeks to the tune of US$300,000. The almost 20-year-old cobalt unit will be renovated, retrofitted and given a new radiation source.
Last Friday, it was reported that Ferguson, the recently installed health minister, said that after consultations with the chairman of the South East Regional Health Authority, Tanny Shirley; chief medical officer, Dr Eva Lewis-Fuller; permanent secretary in the ministry, Dr Jean Dixon; and the sole physicist employed to the Government, along with a number of other persons early last week, the decision was taken to seek private care for the cancer patients.
The sole physicist employed to the Government is Dr Collie Miller. The ROCJ’s website has a photograph of Miller and identifies him as “medical physicist and managing director”.
However, Miller said that the arrangement should not be viewed as a conflict of interest.

Seek private care

Dr Collie Miller, who received a government contract to treat cancer patients although employed to the Government, was reluctant to confirm that he was managing director of the the Radiation Oncology Centre of Jamaica (ROCJ).
“I have an interest in ROCJ. That’s what I’m prepared to say,” said Miller.
However, checks with the Companies Office of Jamaica showed that Miller, a medical practitioner, was an active director and shareholder in ROCJ. The company details also revealed that a Dr Collie Miller, whose occupation was listed as unknown, ceased to be a director. Both Millers shared the same address.

Despite admitting to having an interest in ROCJ, Miller insisted that there was no conflict of interest.
“I find it really unkind and unfair when one will talk about conflict of interest when I don’t have anything to do with the referral of patients,” he said, adding that his role was an advisory one.
However, chairman of the South East Regional Health Authority (SERHA), Tanny Shirley, who also thinks there is no conflict of interest in the engagement of the ROCJ, shed some light on the nature of the advice Miller would have given to the minister of health.

“He (Miller) had a hand in the advice not in the decision. It is the decision of the minister, not his. What he does is give the minister technical advice. Particularly, he advised us that the risk of using that (KPH cobalt) equipment now is endangering possibly the lives (of the patients) because it needs to be repaired,” Shirley revealed.
He also supported using the services of ROCJ on economic grounds.
“The new machines coming out are no longer linear and cost US$10 million. If this company (ROCJ) is not supported, where are they going to get the financial support to get to another level that you and I who can afford in Jamaica?” asked Shirley, adding that this type of technology changes rapidly.
The SERHA chairman argued that companies like ROCJ should not be marginalised by a narrow-minded approach that anything a person does, he is seeking to benefit from it.
“Business is about profiteering and how you grow your business and the support you get to grow it. If you don’t have patients who
are being treated on the machines, how you going to return on your investment?” he asked.

“To view it as a conflict of interest at this time might be unwise,” he warned.
Shirley, who said he did not know that Miller was listed as managing director on ROCJ’s website, also noted that the physicist had declared interest in ROCJ to the regional authority, which he described as the only local entity with the technology and expertise to deal with the patients.

“I’m not sure he is the managing director … but I know he had declared his interest in the company and, therefore, it is no secret that he is in that company as a consultant,” the SERHA chairman said.

Costly options

Overseas options would have proven too costly, Shirley continued in his defence of the engagement of ROCJ.

“Overseas companies would have been three to 10 times higher. In the past, particularly with children, where we try to send them abroad, we could be looking at bills of US$300,000 sometimes, plus accommodation … .”

At $28 million for 55 patients, the Government would pay little over $509,000 per patient. Shirley later told our news team that the Government might be able to negotiate the cost down to $9 million.
In the meantime, Miller told The Sunday Gleaner that he did not participate in negotiations with the Government to send patients to ROCJ. “I have never been engaged in any discussion relating to the engagement of the ROCJ.
However, Shirley gave what appeared to be a contradiction. “The oncology centre in Jamaica is the cheapest cost to treat cancer right now than anywhere in the world.”
Shirley also explained that the cobalt equipment used by the Government in its two treatment facilities are not best suited to treat certain types of cancers and that is why patients are from time to time referred to the ROCJ.

“The cobalt is an old system designed primarily to deal with soft-tissue cancer. Not really a system that is the modern way of treating cancer. It is better for surface cancer but when it goes deeper and legions are deeper, you need a linear accelerator system,” he said.
The ROCJ uses a linear accelerator system. Shirley lamented that the Government doesn’t have the approximately US$4 million to purchase one of those systems.
Efforts to make contact with Minister of Health Fenton Ferguson failed. And, he did not return our calls.

tyrone.reid@gleanerjm.com

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