Air ambulance issue causes stir

Health Minister Anthony Eden defended the decision to seek a single vendor for air ambulance service patients of the Cayman Islands National Insurance Company.

‘At the end of the day, as Minister of Health, I want to be assured that our people have access to an efficient (Accident and Emergency Unit) system,’ he said.

The announcement that the Health Ministry was seeking a single-source air ambulance provider for CINICO was first made by Mr. Eden at the Cabinet press briefing held 11 August.

It created a stir on the radio talk shows last week when an owner of a current air ambulance service broker telephoned Radio Cayman and said she was told by Health Services Authority CEO Craig Brown that her company would not be in consideration for the single-source vendor because it was a broker and not a provider.

Marjorie ‘Margie’ Bodden of Executive Air Services Ltd. said she and her husband Edward were ‘shown the door’ by Mr. Brown after they had gone to his office to discuss the tender for a new air ambulance contract.

‘He told us straight and plain he wasn’t going to give me any business,’ said Mrs. Bodden.

Mrs. Bodden said that when her husband told Mr. Brown that he would take the matter to a higher level, Mr. Brown asked them to leave his office under the threat of calling security.

Executive Air Services used to provide air ambulance brokering services to the government hospital until the air ambulance contract was given to Trinity Air Ambulance International in 2003, Mrs. Bodden said. Executive Air still provides the service to several local insurance companies, including British Caymanian, Generali and Aetna.

Mr. Eden said CINICO entered into a contractual agreement with CMN (Canadian Medical Network) Inc. on 1 August 2005 to manage the air ambulance and medical treatment process overseas.

‘However, the ministry and CINICO are committed to continue seeking ways to improve its services to CINICO clients,’ he said. ‘Therefore, the air ambulance contract is now in the tender process.’

Mr. Eden said Chief Medical Officer Gerald Smith, who is responsible for referring CINICO clients overseas, will chair the tender committee.

The tender committee will also include all key stakeholders, including the HSA.

‘Our collective aim is to provide the best air ambulance service to CINICO clients,’ he said.

‘I will ensure that the selection process of an air ambulance service will be fair and transparent, and the air ambulance service will be timely and cost-effective.’

Mr. Eden said all applicants who meet the tender criteria will be considered by the government’s Central Tenders Committee. When asked, Mr. Eden said he did not know what those criteria were.

The week earlier, Mr. Eden had said a single-source air ambulance provider operating from Grand Cayman would dramatically reduce the time it takes to transfer patients off-island. He added that even if it is not cost effective for the provider to operate from Cayman, ‘a single-source supplier from off island will still improve response times and do so at lower costs than now incurred.

‘Currently, patients sometimes have to wait up to 24-hours before being transferred….’

Mrs. Bodden said the patients her carriers take off-island never have to wait that long.

‘In an emergency, once the insurance is approved, it takes two hours (to get an aircraft here)… maximum three hours,’ she said.

Mrs. Bodden said there was a case last year where CMN Inc. called her to arrange an air ambulance, but none could leave from Ft. Lauderdale or Miami (from where air most ambulances coming here originate) because a hurricane was hitting the area. Mrs. Bodden said she had to arrange for an air ambulance from Atlanta instead, which is only about 45 minutes to an hour farther away.

Mrs. Bodden said Executive Air had a long and successful track record in Cayman.

‘A patient has never had to wait (for an air ambulance) 24 hours with us in the 28 years we’ve been doing this,’ she said.

Mrs. Bodden also questioned the feasibility of an air ambulance service based in Cayman.

‘I can’t see it working,’ she said. ‘You’ve got to keep an aircraft in the air if you’re going to pay for it.

‘Some weeks you’re busy and some weeks you don’t have one (air ambulance trip).’

Mrs. Bodden warned against giving the air ambulance contract to a single-source.

‘You really can’t do that, especially if we have a disaster,’ she said.

Former Health Minister Gilbert McLean, under whose administration CINICO came into being, also thinks having a single-source air ambulance provider is a bad idea.

‘It can’t be cost efficient,’ he said. ‘And it does not suit any insurance company to have an exclusive air ambulance provider.

‘What happens if one (air ambulance) is in the air and another person needs one?’ he asked.

Mr. McLean said he thought having a carrier of first call was a better way to go.

‘I think what this is all about is that the (government) hospital wants to have an exclusive air ambulance carrier,’ he said.

Mrs. Bodden said that because of the confrontation with Mr. Brown, Executive Air would not bother submitting a bid for the contract.

‘If they don’t want to use me, I’ll still be alright,’ she said.

Still, she said she felt the matter could have been handled differently.

‘Even if (Mr. Brown) didn’t like me, he didn’t have to run me out of his office’ she said.

Mr. Brown was off the island and could not be contacted for comment.