This is a post I drafted on November 6th, 2013, on hearing about the decision to close the Lamb Foggo Urgent Care Centre. I never finished it as I wanted to review some relevant documents, and then I got caught up with things and didn’t get back to it.
With the sudden ‘u-turn’ on this decision earlier this evening, I thought it made sense to release it now, before I commented on the current situation. It is, however, a pretty much fully completed post.
On Closing the Lamb Foggo UCC
Back in 2009 I welcomed the opening of the Lamb Foggo Urgent Care Centre – while today, just four years later, I am saddened to hear about its apparent closure under the OBA.
I supported (and continue to support) the idea of a decentralised healthcare infrastructure in Bermuda.
That support stems, in large part, from my experiences over Fabian in 2003.
As part of the first body of troops that fanned out across the island after the hurricane, I was amongst the first of the troops that reached the devastation of the Causeway, and later secured the western site to help facilitate the ongoing emergency operations there.
I was struck by the devastation, and it was quickly apparent that, apart from being largely cut off from the airport, residents on St Davids and St Georges were cut off from the rest of Bermuda (in practical terms; we still had marine access of course), with particular concerns about dealing with medical emergencies over there.
While we were able to assist those emergency personnel across the Causeway through boat access, and even ferry emergency cases to the mainland for hospital access, it was far from ideal.
That alone, in my mind, was reason enough to look at some decentralisation of medical infrastructure to the east. With ongoing restrictions regarding the Causeway in subsequent storms, this has been underlined as far as I’m concerned.
Also of relevance was strategic concerns about the event of a major catastrophe in the east, specifically a plane crash (something we ‘war-gamed’ for while in the Regiment also).
And with the importance of the east as regards incoming marine traffic, and also as a key site for scuba diving, it seemed sensible to me to provide some medical infrastructure in the east as a priority.
Similarly, the designation of Dockyard as our main cruise-ship hub, as well as distance from the central hospital location, made the idea of also providing some infrastructure in the west-end a worthy idea, although not as high a priority as the east which was more vulnerable to disruption.
Another argument, although one I questioned at the time, was the idea of using the Lamb Foggo UCC as part of a medical tourism strategy.
It’s proximity to the airport, and the ability to free-up beds at the main hospital for more serious cases (as opposed to the more cosmetic or less pressing needs of medical tourism) being touted as supporting arguments if I recall correctly. The idea also was that it would free up hospital beds at KEMH for more genuine medical concerns.
While I questioned the idea, I was, and am, able to see the utility of such an approach, provided the bulk of the profit from medical tourism was used to support and improve medical care for Bermudian residents overall and to support the running of the UCC.
Indeed, according to OBMI, who I believe were involved in developing the infrastructure, the Lamb Foggo UCC was developed specifically with consideration for medical tourism – ‘Understanding the vision of medical tourism, the design incorporated efficient corridor spaces which will serve to provide quick primary care and triage medical response‘.
The decentralisation plan also seemed to work to reduce the pressure on the Emergency Room and other services provided by the main hospital.
Indeed, the 2011 BHB Annual Report noted that they had made an $18.3 million profit (in 2010), and that visits to the Emergency Room decreased from 34,439 visits in 2009-2010 to 33,314 in 2010-2011, while visits to the Lamb Foggo UCC increased from 4,343 in 2009-2010 to 5,667 in 2010-2011.
The BHB’s ‘business case’ seems to have rather restricted thinking and failed, in my opinion, to consider fully possible alternatives in the running of the UCC, be it cutting reasonable expenses, developing the medical tourism options and further proper advertising of the facilities existence and capacities.