‘My $1m investments don’t fit in Bahamas’

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.”

Comments

GrassRoot says...

So it seems that PET technology has been around for a while. Found a weblink on FDA Approval in 2012 for an agent (not the technology itself), so technology must have been approved before. Well what can we expect, this is 21st century technology reviewed with a 20th century state of mind our Government has. So looking at that technical norms office the Bahamas wants to set up (and has rented the premises for already..), who in the world should that ever work?

http://www.fda.gov/NewsEvents/Newsroom/…

Posted 22 June 2015, 3:43 p.m. Suggest removal

Economist says...

Laws requiring applications, be they medical, immigration, investment or otherwise need to have time frames for responses by the relevant authority and for appeals.

"it is under consideration" is too often heard. How can something be under consideration for years?

This is why we have so little investment and so much unemployment.

Posted 22 June 2015, 3:46 p.m. Suggest removal

Well_mudda_take_sic says...

From what I've heard about this matter, this may be one of the few times that the delay and intransigence of our regulators in the medical area have achieved the right thing in terms of public safety, i.e. save Bahamians from experiencing the very costly and horrible effects of medical mistreatment.

Posted 22 June 2015, 3:46 p.m. Suggest removal

banker says...

Just looked at the Mayo Clinic site. Here is what they say about the dangers:

For your PET scan, a radioactive drug (tracer) will be put into your body. The amount of radiation you're exposed to is small, and the risk of negative effects from it is low. But the tracer might:

-Cause a major allergic reaction, in rare instances
-Expose your unborn baby to radiation if you are pregnant
-Expose your child to radiation if you are breast-feeding

And the advantages:

-PET/CT is a powerful source of data to help make the right decisions.
-PET/CT is safe.
-PET/CT reduces number of invasive procedures.
-PET/CT can avoid unnecessary surgery.
-PET/CT can tell whether a tumor is benign or cancerous.
-PET/CT can show all the organ systems of the body in a single exam, showing, for example, whether cancer has spread.
-PET/CT detects disease often before it shows up on other tests.
-PET/CT is an early predictor of patients’ response to their therapy.
-PET/CT assists in planning for radiation therapy.

So I think this is a travesty, especially since Bahamian women are 40% more prone to breast cancer than the North American population.

Posted 22 June 2015, 3:57 p.m. Suggest removal

Well_mudda_take_sic says...

Unless calibrated by appropriately highly trained and skilled technicians very familiar with this type of equipment (who come with a high price tag), these machines can easily cause great harm with invisible intensely focused (almost lethal) overdoses of radiation. Just ask Dr. Lunn about the problems he experienced at his oncology clinic on Collins Ave a decade or so ago.

Posted 22 June 2015, 4:20 p.m. Suggest removal

GrassRoot says...

Maybe, but the reality is this could have been any business. That is the issue. Losing files, disorganized, petty corruption, leader ship issues, lack of training and knowledge will drag this country down. Ease of doing business? Not in the Bahamas and once you have your shop up the unions walk in....

Posted 22 June 2015, 9:22 p.m. Suggest removal

ohdrap4 says...

and rememebrs. many years ago there were lawsuits about some kind of cancer radiation equipment being improperly kept.

Posted 23 June 2015, 10:28 a.m. Suggest removal

Sickened says...

This is sad. But on the bright side... now that the PLP have successfully closed this guy down, Brave Davis will most likely be opening this same business in a few weeks with all of the necessary approvals (or without, 'cause it doesn't really matter to him) and it will be part of the NHI program.

Posted 22 June 2015, 4:41 p.m. Suggest removal

GrassRoot says...

yay baby. this is truly a source of inspiration.

Posted 22 June 2015, 9:23 p.m. Suggest removal

TalRussell says...

Comrade Anthony if only quarter what you're claiming is factual, it goes to disprove all the PLP Cabinet's repeated claims about how they are out for the financial advancement Bahamalanders. On da other side I can only imagine some involved with Baha Mar, can only wish twas but a million dollars and not 3.5 billions in their investment DNA.Try selling to a "preferred PLP investor" and hopes get backs 20 cents on each ya million dollars invested.

Posted 22 June 2015, 4:46 p.m. Suggest removal

Alltoomuch says...

Why are we so scared by technology in the Bahamas but we will happily pay to go to Florida?
PET scans do not come cheap plus all the attendant expenses & trauma of having to go overseas. I would have thought that we would be proud to be able to support an idea like this by a Bahamian. Dr.Lunn's situation was almost 20 year ago I think and he was just way ahead with his ideas and no support. How can we truly say we want a NH system when we don't seem to trust our own people. Bring in foreigners to run it??

Posted 22 June 2015, 4:52 p.m. Suggest removal

watcher says...

It seems pretty obvious that the government wants no independent health care providers once NHI is up and running (More money for kickbacks and bribes to the usual cronies) Even though the lives of average Bahamians are being played with, I guess the politicians don't give a damn about new technology because (a) they don't understand it and (b) the right bribes and kickbacks haven't been paid

Posted 22 June 2015, 5:28 p.m. Suggest removal

Stapedius says...

The proper provisions must be in place to handle and radioactive tracer material. There's always 3 sides to these stories. For now we've only heard 1. It is laudable that he wants to bring health technology to the islands but things must be done in a safe way. Any medical device or procedure can cause more harm than good if not used correctly. So please before going crazy blaming people let's have a more critical look at this one.

Posted 22 June 2015, 6:05 p.m. Suggest removal

Reality_Check says...

300,000 health insurance policy holders is a drop in the bucket for several of North America's largest health insurance providers. Common sense says our government would be way ahead of the game in terms of cost and quality of healthcare for Bahamians if our nation's healthcare needs were lock stock and barrel turned over to health insurers and healthcare providers operating in Florida. The additional airfare and any hotel accommodation costs for Bahamians to receive medical treatment in Florida, whether it be of the preventative care kind or urgent hospitalization kind, are insignificant in relation to the outrageously high healthcare costs being charged by providers of medical services here in the Bahamas. A colonoscopy at a reputable hospital or clinic in Florida costs less than half of what the exact same procedure costs here in Nassau, and the same applies to many other basic preventative care or emergency (intensive) care procedures. Why should our government try to invent a costly universal healthcare system in the Bahamas when all it has to do is tap into (or piggyback on) the U.S. healthcare insurance system and healthcare provider system that already exists in the State of Florida at costs much more reasonable than could ever be obtained here in the Bahamas? Bahamian medical doctors, healthcare specialists, medical technicians and skilled nurses could be given the opportunity of running emergency care mini clinics in the Bahamas to stabilize critical care patients before their transport to Florida, or could emigrate to Florida to be a part of the preferred healthcare provider systems catering to the universal healthcare needs of all Bahamians. It's all about economies of scale when it comes to keeping healthcare costs to the minimum for quality healthcare. This cannot be achieved in the Bahamas with a relatively small population of individuals requiring preventative and urgent or critical emergency care on an annual basis. Whatever Sanigest is proposing as a National Healthcare Scheme is poppy cock to say the least! The biggest driver of excessive costs for our current healthcare model, that only caters to those of us who can afford the outrageously high monthly insurance premiums, deductibles and co-pays, are the local health insurers. The very burdensome combined administration costs and profits of all local healthcare insurers presently licensed to operate in the Bahamas is a most heavy albatross around the neck of every Bahamian in need of quality healthcare at a reasonable cost.

Posted 22 June 2015, 6:05 p.m. Suggest removal

TheMadHatter says...

:-)

Posted 22 June 2015, 6:39 p.m. Suggest removal

ThisIsOurs says...

Radiation, gamma rays and nuclear bombs...too technical for me!! But seems to have suffered the fate of the bumbling BAMSI "*A. D. Hannerization*" of governing boards. Assigning friends, campaign workers and in general persons not qualified to make decisions to spearhead the decision making process. The result, millions spent on consultants to do a job that someone is already being paid handsomely not to do. If the thinking was that the treatment was too dangerous then give him a quick rejection. Not sure why he invested 1million without approval...but...

Posted 22 June 2015, 7:09 p.m. Suggest removal

Stapedius says...

The point is this thing doesn't have to be politicized. He may not have gotten approval just based on what his proposal lacked. And yes, it is quite stupid to invest that kind of money without being certain that all the requirements are filled. By the way, when since have we ever seen any government body move at an efficient pace. It takes forever and a century for simple things like police records, birth certificate and passport renewal. So I would believe that the file is sitting on some PS desk buried in dust.

Posted 23 June 2015, 1:58 a.m. Suggest removal

Alltoomuch says...

42years after Independence and we still can't claim to be a 1st world country - so many missed opportunities - just too sad.

Posted 23 June 2015, 9:53 a.m. Suggest removal

TalRussell says...

Comrade Alltoomuch, and of course we have that thing called "local government" in family islands and its still controlled from cabinet office in Nassau Town. You cannot change the system until you do away with both the PLP and FNM, and to never promote the junior DNA/FNM up to governing power cuz they have nothing new offer voters.
Good Lord almighty we have a PLP party in power that hasn't held a convention since something like back in 2009. But also the FNM only held their party's convention to try to settle personal infighting matters between Comrades Minnis and Loretta, not for its membership.
Look at the DNA they have NEVER had what could legally be classified as a party convention, acting like a properly constituted political party but has NO elected party leader of executives.
You go figures for ya self, why we is a broken islands nation?

Posted 23 June 2015, 10:09 a.m. Suggest removal

duppyVAT says...

Local government can only work effectively if the District Council has the authority to withhold at least 50% of the government taxes raised OR raise revenue themselves through designated means ..... and local government has to be placed in the Constitution as the third level of executive power .... Cabinet ... Ministry .... L.Govt .......... until that is done, the system is only used as a political pawn

Posted 23 June 2015, 12:01 p.m. Suggest removal

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