Concerns about Ewart Brown’s relationship with the Lahey Clinic were raised with the United Bermuda Party Government almost 20 years ago, according to newspaper reports from the time.

The Royal Gazette reported in November 1998 on a letter which had been sent to UBP health minister Wayne Furbert in July that year, questioning whether Dr Brown, then an Opposition MP, was receiving a financial incentive for promoting the Massachusetts-based teaching hospital on the island.

The letter, from the Health Insurance Association of Bermuda (HIAB), also queried whether it was necessary to bring specialist doctors to Bermuda to see patients and suggested it would drive up healthcare costs.

Many of the same issues are raised in the lawsuit filed last week against Lahey by Attorney-General Trevor Moniz, on behalf of the Government.

The civil complaint, for unspecified damages, alleges that Lahey paid bribes to Dr Brown in order to receive preferential treatment when bidding on public healthcare contracts and to gain privileged access to Bermudian patients that it could service at its facilities in Massachusetts and in Bermuda.

The complaint alleges that “for nearly two decades, Lahey and Brown conspired to promote and ensure Lahey’s increased prominence as both a local and an overseas healthcare provider for Bermudians” and that the scheme, in part, drove up the cost of health insurance premiums for all insured patients.

Dr Brown’s relationship with the Lahey Clinic dates back to 1997, the year before the Progressive Labour Party took power and he became a Cabinet minister.

At the time, he was an Opposition MP and shadow Cabinet minister, as well as a practising physician. Dr Brown signed an agreement with Lahey to bring specialist doctors to the island to see patients at his Paget clinic, Bermuda Healthcare Services (BHCS).

The Royal Gazette reported in October 1997 that BHCS was to offer free mammograms to women who could not afford to pay for them, with the X-ray films being read by the Lahey Clinic — “an associate clinic of Dr Brown’s” — at a cut rate. Mr Moniz’s lawsuit claims that Dr Brown kept his financial relationship with Lahey a secret, failing to declare it on every parliamentary register of interests form that he submitted: in 2000, 2005, 2007 and 2010.

But, the HIAB letter from July 1998 reveals the concerns the local health insurance industry had about the linkup between Dr Brown and Lahey; serious enough to warrant writing to a Cabinet minister.

The letter was penned by HIAB president Judy Panchaud-White, who stated: “The concept of visiting specialists is a worthy one.

“However, without controls, it has led and will lead to further escalation in healthcare costs for the island.”

Her letter referred to an advert promoting visiting specialists at the BHCS clinic.

“This type of advertising will encourage residents to book appointments without their own general practitioner concurring that such a consultation is medically necessary,” claimed Mrs Panchaud-White. “Further, it may result in additional referrals overseas to the Lahey Clinic for follow-up care and further testing.”

Her letter asked if the then-UBP Government was aware of any “financial incentive” to BHCS for the promotion of foreign specialists.

Mr Furbert, according to the article, responded by saying he had “no problem” with any business arrangement Dr Brown might have with Lahey Clinic. He acknowledged that rising healthcare costs were a concern and said “specialists must be used appropriately”.

The article, which was published after the PLP’s general election win and once Dr Brown was in Cabinet, quoted him as saying: “Bermudians have the right to seek the best medical care available and we don’t think anyone has a right to question our integrity.”

He claimed many local doctors had boycotted the programme — called “Quality through Linkage” — because they’d allowed politics to interfere with patient care. And he said Mrs Panchaud-White’s question about financial incentives for BHCS was “entirely none of her business”.

Mrs Panchaud-White said at the time she planned to express her concerns to Dr Brown’s PLP and Cabinet colleague, health minister Nelson Bascome.

Regardless, Dr Brown’s relationship with Lahey continued over the next two decades. According to the unproven claims in the lawsuit, he and Lahey profited “wildly” from their collaboration, with the hospital being paid more than $40 million by Bermudian public healthcare insurers for services performed in the United States between 2006 and 2016.

The complaint says those were “services Lahey would not have received but for its relationship with Brown”.

Lahey has said it will defend the lawsuit, citing “business practices and commitment to patients in Bermuda [which] are beyond reproach” and claiming the action is politically motivated.

Dr Brown, who was Premier between 2006 and 2010, said in a statement the lawsuit against Lahey was an attempt to “settle a political score” against him and contained “countless lies and ridiculous allegations”.

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