Health Minister On BHB/Dr Donald Thomas

October 2, 2012

Neither the BHB nor the Ministry of Health can detail individual matters, however our discussion about our only hospital should be less about salaries and more about quality of care, Health Minister Zane DeSilva said today [Oct 2].

Minister DeSilva was speaking in reference to the questions surrounding the resignation of Dr Donald Thomas, who was employed as Chief of Staff in June 2008, placed on fully paid “administrative leave” during this past summer before resigning in October 2012. The reasons for his leave and resignation have not been revealed, something OBA MP Louise Jackson has questioned.

Minister DeSilva’s full statement follows below:

Good Afternoon,

Some of the chatter on the talk shows and news at the moment revolves around Mrs. Jackson’s questions regarding the resignation of the Bermuda Hospitals Board’s Chief of Staff Dr. Donald Thomas.

To be clear – neither the BHB nor the Ministry of Health can detail individual matters.

Mrs. Jackson asks whether Dr. Thomas was on fully paid administrative leave since being suspended in July?

BHB has already confirmed that Dr. Thomas was on paid administrative leave. The Board has consistently acted in line with its own policies and within contractual and national legal requirements.

Ms. Jackson also asks what role Dr. Thomas had to play in the “increase in salaries and specialist fees at the BHB”?

I should have to remind anyone that specialist fees are approved every year by the House as part of the budget setting process for Standard Hospital Benefit.

The increase in salaries in the 2010-11 financial accounts had more to do with increasing the number of employed physicians and other staff, which increased the services offered by the hospital, rather than a simple increase in salaries.

BHB is already reviewing its service profile and physician specialty offering.

Work is already underway, and physician contracts and subspecialties are included in the Clinical & Corporate Governance Review that is planned.

I would like to remind everyone that our discussion about our ONLY Hospital should be less about salaries, and more about quality of care.

In this regard there have been many achievements this year by BHB. These include:

A New Leadership Focus – Better Quality, More Accountability at Lower Cost.

  • A restructuring of the Chief of Staff office was agreed by the Board back in March 2012.
  • That restructure is already underway with physician contracts and credentialing moving to the Human Resources section.
  • It was also agreed that the recruitment process for the Chief of Staff position should be updated to include a panel with representatives from the physician community as part of the appointment of a permanent replacement.

A Clinical & Corporate Governance Review was approved by the Board to look at strengths and areas to improve governance, decision making, accountability and ensure the focus is always on quality and the patient.

The Ombudsman of Bermuda has agreed to be involved on behalf of the Bermuda community and will make public comments on the process as well as the final report.

The Bermuda Hospitals Board has published the Request for Proposal (RFP) for the Clinical and Corporate Governance Review, and the short-listing process will take place this month.

The Clinical and Corporate Governance Review has been planned for the following reasons:

  • To ensure robust corporate governance standards are in place;
  • To identify obligations and liabilities relating to the growth in the number of BHB-employed physicians;
  • To address concerns expressed in the community regarding quality of care;
  • To review preparations for the operational readiness of the new hospital facility;
  • To address BHB responsibilities under the National Health Plan;
  • To ensure financial preparations enable BHB to meet obligations of the KEMH Redevelopment Project, despite the economic challenges; and
  • To review the transition to a new corporate management structure under the new Chief Executive Officer.

Quality. Accreditation Canada – BHB has the highest level of accreditation and is tested under the same standards as Canadian hospitals. Patient Satisfaction shows increases across the board.

Palliative Care. The Liverpool Care Pathway has been introduced at Agape House to improve the quality of end-of-life care under the clinical direction of Dr Sharon Alikani.

Chronic Disease Management. New Pressure Point Classes have been started to help people with high blood pressure manage their condition. A new Diabetic Foot Clinic, run by Dr Annabel Fountain, has been implemented to help reduce incidence of amputation due to diabetes

New leading edge pap smear equipment, called “thin prep” has been introduced to catch more cervical cancers earlier.
Automated Lab equipment is helping making the lab service more efficient.

Diagnostic Imaging
A new CT Scanner has led to the introduction of virtual colonoscopy for people who are not candidates for the surgical option
MRI now offering breast imaging.

Mental Health
Mental Health First Aid Course is now being offered to help community members recognize and support people with mental health issues.

Finally, there seems to be a perception that Government provides a great deal of money to the hospital.

In truth, the Government provides a grant for the operations of MWI but, for KEMH, the only funding which the Government provides is for the payment of claims for patients who are eligible for the Patient Subsidy.

Of the revenue that KEMH receives, two thirds comes from private insurers, while only one third comes from “government insurance” in the form of Patient Subsidy.

Patient Subsidy is essentially Government paying the claims for people who are treated at the hospital who are eligible for subsidy – those being our vulnerable populations – children, seniors and the indigent.


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Comments (18)

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  1. Robb says:

    So the Minister admits that one of the major reasons for Bermuda’s rise in healthcare costs is “increasing the number of employed physicians and other staff” at our ONLY Hospital. Now I know why my healthcare premiums have risen so dramatically in the past few years,10-20% above inflation!

    • Amazed says:

      Bermudians have been demanding more services for example a choice of oncologist. So if you add services you have to add people to provide those services don’t you?

  2. Kathy Gee says:

    Louise need to stop her scaremongering. her daughter Susan Blakenley is to run in her seat when are they going to announce this?

    • Vulpes says:

      As I see it Cathy, there are five possibilities:

      You are clueless.

      You are in serious denial.

      You are a releative of Zane’s

      You are seriously brainwashed in PLP claptrap

      Any combination or permutation of the above.

      • blackboy says:

        Vulpes, it is people like you that will keep the OBA out. You are frightening with your baseless attacks

      • Polly's Family says:

        @VULPES – I totally agree with Kathy G – she’s made the most sense on this blog.

        My parents have future care and now are receiving good care. We won’t be voting for the OBA because we are afraid of Louise’s statements that we will have less benefits.

        • observer says:

          If the OBA did a quarter of the mistakes the PLP has done this island would have had a riot by now. It is a shame you die hearts just don’t want what is best for all, just the chosen few in their ranks. Sadly we will all feel and your mom’s health care will not be sustainable and where will we go from there?

  3. Alicia says:

    If the BHB and ministry of health indicate that they don’t need to release dr Thomas’s salary while he was chief of staff then someone needs to remind them of the bermuda hospitals board act of 1970, whereby it indicates that the BHB has to submit the salaries of the board to the minister 6 months after the financial year ended and this same act defines the board as comprising, in part, of the chief of staff, ergo, dr Thomas’s salary is supposd to be a matter of public record.

    Interesting though how he indicates that this conversation shouldn’t bef about salaries but on quality of care… Is that his way of saying that they plan on charging all Bermuda a lot of money for a national health plan that still won’t cover all that a major medical plan does, but they sure will charge you more…

    • Amazed says:

      I agree that the salaries should be released but the reasons that an individual leaves is none of my business and I dont’t care. I am sure that he is not the olny person to have left the hospital this year.

  4. Mad Dawg says:

    Typical excuses for lack of transparency. He’s trying to keep their mistakes quiet.

  5. Keepin' it Real...4Real! says:

    bunch o hogwash….you people jus don’t get it do you..? Zane’s jus readin wat he’s told to read…he should be the works n engineering minister not health minister…this island is sooooo confused it aink funny anymore…the end.

  6. Erasmus says:

    I am not interested in salaries: I assume that there was a healthy base salary, housing and commissions.

    I smell dam,age control on a rat. I am interested to know what was in the minds of our Bermudian leaders? Was there improper political influence in the business model for the new hospital? Why did it suddenly change? Was there any circumventing of established hiring protocols? Has it increase the bricks & mortar expense of the new hospital? Will it impact health care there?

    Was there any illegal activity by Dr Thomas?

    You must admit that trust is scant after Govt wanted to put this new hospital on the Botanical Gardens?

  7. blackboy says:

    Zane get a grip…
    We are talking about MONEY! We have a healthcare system that is too expensive. You are paying cardiologist over 300 thousand a year. Nephrologist and Endocrinologist and Anesthesiologist get the same and the hospitalists are getting greater than 24000 dollars a year. These salaries are out of step with any other country on the planet…How do you justify these expenses. Just because government publishes the costs of proceedures does not justify them. Stop playing with people. Dr.Thomas was flying out every friday and coming back evey monday. He had a car and housing allowances. HE was certainly making more money than the underling doctors. So how much more are we being raped for…The time has come that we want to know. You are a servant of the people we are not your slaves. We want to know how much we are paying of tax payers dollars.
    Royal Gazette has published that A Surgeon is suing the hospital. Some suggest that it is because of Dr. Thomas unprofessional behaviour. It is alleged that there are other areas of professional misconduct aswell. Those are minor points what is major is the hiring practices of the hospital and the compensation packages and the justification of these costs. WE are not stupid. WE need to get the PLP out if they dont want to be held accountable.

  8. Petra says:

    Sorry Minister but you are absolutely 100% wrong! We the public need to know that we are receiving good quality healthcare at a reasonable cost, therefore the salaries, which are the largest spend area by BHB, ARE the publics business. hiring more and more staff without performance levels increasing, means you just have more staff to do the same, or less work.

    To illustrate my point. If you had a bakery and every day your baker made 500 loaves of top quality bread, people would come and eat it, eventually you would sell out of bread every day. If you hired an extra baker, therefore doubling your salaries, but he could only make 200 loaves of inferior quality bread compared to the first baker, you have to increase the cost of each loaf to a level which covers your costs – problem is, your reputation is shot, so people don’t buy anyway, leaving you with massive problems where the “surplus didn’t meet the level of investment”

    Business 101!

    • Petra says:

      And I should add – if by some hope the Minister actually reads these comments. Your Interim Performance Management Director is the rudest, most obnoxious man I have ever had the displeasure of having to interact with. There is a reason why the UK Civil Service didn’t want him any more – working for 19 UK health organisations may sound like he knows what he’s doing, but did you ask why he didn’t spend long on each one? hmmmmmm.