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Taxpayer-financed with both employers and employees paying for significant monthly healthcare insurance
What the new King Edward VII Memorial Hospital (KEMH), presently under construction, will look like, possibly under a new name.
By Keith Archibald Forbes (see About Us) at e-mail exclusively for Bermuda Online
To refer by e-mail to this file use "bermuda-online.org/kemh" as your Subject
See also Bermuda's Health Support Groups by the same author.
Newcomers, including those from the United Kingdom, should note there is no equivalent in Bermuda to a treasured national UK institution, the National Health Service (NHS) - see http://en.wikipedia.org/wiki/National_Health_Service - that started in 1948. There, State-funded NHS provides free hospitals and health treatment to all Britons including free prescriptions and free dentistry and eyesight matters for low-paid Britons, and is embraced by all political parties. While grumbling about its perceived slow service is widespread - and planned government reforms are controversial - its egalitarian ethos is a matter of national pride.
Thus, Bermuda's King Edward VII Memorial Hospital, above and below, is not in any way part of the UK's NHS and its hospitals system. Bermuda is the only country in the world where the residents and visitors pay not once but three times for hospital and medical services. In the USA, where hospitals are privately financed built and operated, patients pay for all services they use. In Canada, Australia, New Zealand, the UK, Europe, etc. the great majority of hospitals are financed by taxpayers with hospital and medical services included in the taxes paid. But in Bermuda, taxpayers pay first for the building and operating costs as part of their taxes; again in hospital fees and services they use on an as-needed basis; and also in the health or major medical insurances they all must pay by law to either the government or to private and local insurance companies.
Staff at the two hospitals number over 1500. Bermuda has audiologists, chiropodists, chiropractors, dentists, dental technicians, dieticians, medical doctors. There are also emergency medial technicians, medical laboratory technologists, midwives, nurses with SRN status or equivalent or enrolled, occupational therapists, optometrists and opticians, dispensing opticians, pharmacies, pharmacists, physiotherapists, radiographers and speech-language therapists. Under the Nurses Act 1969, all nurses, whether registered (SRN or equivalent) or enrolled, are required to renew their licenses on an annual basis. The Medical Program at KEMH has an Annual Review and Awards Ceremony, sponsored by the Bermuda-based prominent international corporation Merck Sharpe and Dohme. It provides thousands of dollars a year in awards as part of a commitment to Continuing Medical Education at KEMH.
See http://www.bhec.bm/wp-content/uploads/2013/03/Bermuda-Hospitals-Board-Hospital-Fees-Regulations-2013.pdf. And 2013. January. Bermuda Health Disparities Report published by Bermuda Health Council. See http://www.bhec.bm/wp-content/uploads/2013/01/Health-Disparities-Report-2013-Final1.pdf.
New KEMH hospital wing under construction, August 2013
EMT staff at KEMH
Point Finger Road, Paget Parish DV 04, Bermuda. Postal address P. O. Box HM 444, Hamilton HM BX. Phone (441) 236-2345. Fax (441) 236-2213. The main hospital, KEMH is Bermuda Government owned and operated. When first established and purpose-built in 1920 by the Bermuda Government it replaced the old Cottage Hospital (once visited by Mark Twain) in Happy Valley Road, Devonshire Parish. It was so-named to honour Queen Victoria's eldest son Albert (nick-named Bertie), who married Princess Alexandra of Denmark in 1863 and took the name of King Edward VII when he finally ascended the British Throne in 1901 at the age of 60. He reigned for only nine years, dying in 1910. Since first constructed as a single unit it has gobbled up once-nearby buildings in constant expansions and renovations along both Point Finger and Berry Hill Road. One such then-prominent residence was Abbotsford, once owned by prominent physician, amateur architect and botanist Dr. Henry Hinson. In the 1940s, during World War 2, the British (not Bermuda) Government made some war-time improvements. KEMH is today operated by the Bermuda Ministry of Health and Family Services, via the Bermuda Government-appointed Bermuda Hospitals Board (BHB), a publicly-funded quango (quasi autonomous non-governmental organization) established under the Bermuda Hospitals Board Act, 1970. The BHB is not a private business. It is a quango, owned by the Government on behalf of the people of Bermuda and administered by a board appointed by the Government on behalf of the people of Bermuda. It also has a wholly-owned subsidiary Healthcare Partners Ltd (HPL). BHB is funded entirely by the people of Bermuda by way of direct payments, insurance, donations and Government subsidies. Its employees are paid by the people of Bermuda. However, salaries and bonuses of senior managers of the hospital are kept secret from taxpayers. It has a Bermuda Government-approved Board and a Chief Executive Officer, responsible for King Edward VII Memorial Hospital and Mid-Atlantic Wellness Institute. At the heart of both organizations is high quality care to all patients. With approximately 1,700 employees, the Bermuda Hospitals Board is Bermuda’s second largest employer. King Edward VII Memorial Hospital and Mid-Atlantic Wellness Institute are the only healthcare organizations in Bermuda accredited by Accreditation Canada, an independent organization whose role is to help hospitals examine and improve the quality of care and service they provide to their clients. In addition to providing an extensive list of services for the community, the Bermuda Hospitals Board is part of a referral network that includes some of the world’s leading specialist hospitals. For more information, please log on to www.bermudahospitals.com
It is an Associate of the American Hospital Association. It has been accredited since 1972 by Accreditation Canada, formerly the Canadian Council on Health Services Accreditation, but does not appear on the latter's website.
2013. November 22. A further $10 million in fundraising is needed to cover a $40 million payment for Bermuda's new hospital wing before next year's impending deadline. However, Health Minister Patricia Gordon-Pamplin said she was completely optimistic and confident that the campaign by the Bermuda Hospitals Charitable Trust (BHCT) would reach its goal. BHCT launched its Why it Matters campaign in April 2011 to raise the capital due from Bermuda Hospitals Board (BHB) to project investors Paget Health Services. The money must be paid upon the completion of the new medical facility originally slated for April 1, 2014. BHB is liable for covering any shortfall in that one-off payment. Asked about backups in place for cash-strapped BHB which Chairman Jonathan Brewin has said might slip into debt by the end of the current fiscal year the Minister said: "While there is a contingency plan in effect, we are focusing on the positive, and will roll out that alternative plan should the need arise." Ms Gordon-Pamplin recently announced a slight delay in the April 1 deadline, which she said would allow the BHCT extra time to solicit donations for the cause. A spokeswoman for the Trust said the group had so far raised almost $30 million, and was confident of meeting its objectives. "At this time, we are solely focused on fundraising and will continue to rally support from companies, organisations and individuals. This is our Island and our hospital, and we all have a stake in the game." And a spokeswoman for BHB pointed out that the construction project for the $247 million hospital wing is backed by a Government guarantee. BHB Chairman, Mr Brewin said: "BHB has been very conservative in its planning to ensure both best case and worst case scenarios are prepared for. In terms of the one-off payment, we still have every confidence there will be a successful fundraising campaign where the generosity of individuals, families and companies of Bermuda are able to donate $40m. But we have potential plans should this not materialize and through careful planning and discussion with the BHCT and Government, we have a number of options to help us meet our obligations. We will continue to work closely with our partners and remain extremely grateful for all donations received. Every dollar raised helps healthcare and Bermuda." The $40 million one-off payment signals the start of an expensive year for BHB, as outlined for Wednesdays Senate by Junior Health Minister Lynne Woolridge. She said that Paget Health Services (PHS) was committed to maintaining the new hospital wing over the next three decades but added BHB will face significant payments. In the first year, the monthly payments to PHS are about $2.5 million, Senator Woolridge said. On top of this, BHB must cover general running costs such as staffing and cleaning costs which Sen Woolridge described as substantial. After the first year, 70 percent of the payments to PHS will remain fixed with the other 30 percent subject to variables such as inflation and insurance. This means there is significant pressure on BHB to manage the contract well, to ensure it is adhered to, and BHB is putting the necessary management arrangements in place, Sen Woolridge said.
2013. November 20. The Bermuda Hospitals Board will consider bringing Mid-Atlantic Wellness Institute (MAWI) services to King Edward VII Memorial Hospital. The suggestion was one of several made recently by the SAGE Commission, who said the MAWI site could be sold off rather than spending $40 million to renovate the Devonshire facility. A spokeswoman for the BHB said: "The board is looking at every way it can to run more efficiently while maintaining safe, quality services. MAWI is an ageing facility and a recent review of the MAWI estate estimates that a $40 million investment would be needed over time to maintain and upgrade its infrastructure and ensure it can continue operating as a psychiatric facility. We are currently reviewing the delivery of BHB services, and our Senior Management Team and Board will certainly consider the opportunities in consolidating the two sites in more detail as part of this process." The SAGE Commission Report, released on Friday said: Duplicated services are provided at the King Edward VII Memorial Hospital and at MAWI because the two facilities are operated on two separate sites. Substantial savings would be generated from operating both facilities on one site. It also suggested the BHB examine the possibility of erecting a new building adjacent to the acute care centre already under construction to house both psychiatric services and continuing care facilities for the elderly.
2013. July 16. A “fee-for-service” billing system at King Edward VII Memorial Hospital is being reviewed by health chiefs who claim that it “incentivised” physicians to carry out tests and invasive examinations on patients in order to increase the hospital’s revenue. And even terminally ill hospital patients may have undergone unnecessary medical tests and procedures because of the arrangement, health advocates claim. The billing system — also known as case-based reimbursement — was introduced by the former Bermuda Hospitals Board (BHB) in 2009. According to the Board’s website, it is “a fairer, more transparent way to charge people for services used. It means someone who is admitted to hospital will be charged based on the type of treatment and services associated with their diagnosis. Previously, the hospital charged one daily rate, no matter how many services were needed,” the website added. But Government MPs have criticized the method, saying that it needs to be re-examined to ensure that vulnerable patients are not being taken advantage of. And according to one health watchdog, the process has been “abused to the extent that medical tests were recommended and used purely as a means to increase revenue.” Backbencher Jeanne Atherden, who is also chairman of the Bermuda Health Council and a member of the new BHB, said: “We’re looking at the whole system of charges to see that they are not being abused. Nobody wants to see duplication or over testing because that can have a negative affect on the patient. One never wants to have a system that encourages revenue generation — the emphasis needs to be on patient care and patient outcomes. If you have incentives for people to generate income, what we really should have is a system that encourages quality. I have real concerns when I see salaries that were related to things not related to quality of care.” She added that the hospital appeared "to place great emphasis on revenue growth which was very much encouraged. The health council is now looking at utilization management, standards of care and regulation.” Those concerns were echoed by Economic Development Minister Grant Gibbons, who said: “You don’t want somebody paid or incentivised on the basis of the more tests or more time. What you want them to be compensated on is the quality of the outcome — how successful has the treatment been and how efficient have you been in administering that. Pay was connected to utilization which is not good at all. There was a complete lack of attention to cost control at the hospital.” Last month the BHB said it was aware “that there is a perception that BHB charges too much, makes too big a surplus and yet squanders its resources.” We believe there was not enough focus on cost control at BHB, as its strategy over the last seven years had been to grow its revenue and increase the number of services available on Island,” Chairman Jonathan Brewin said in an open letter to the community. “This contributed to the increasing use of services — utilization — further driving healthcare costs up.” Last night hospital watchdog the Bermuda Health Advocacy Group welcomed news of the review, claiming that the billing system had put dollars ahead of care in the hospital’s list of priorities. “The premise for change was purely economical and in an endeavor to increase profit margins,” a BHAG spokesman said. “To date the BHAG has had numerous complaints from a wide spectrum of the community complaining about costs and unnecessary procedures.”
2013. July 16. Hospital watchdog Bermuda Health Advocacy Group (BHAG) has applauded moves by Government to shut down an ageing hospital wing which provides long-term care to elderly patients. Health Minister Patricia Gordon Pamplin announced the move last week, claiming that the Continuing Care Unit at King Edward VII Memorial Hospital was "no longer fit for purpose". Government is now looking at alternative facilities to care for some 150 mainly elderly patients, many of who are suffering from deteriorating mental capabilities. In a statement, BHAG said news of the closure should come "as no surprise" and that "it was only just a matter of time before a hard decision had to be made concerning how to move forward with CCU's mode of operations." Healthcare in Bermuda is transitioning at an alarming rate and unfortunately the focus objectives are far removed from concerns in relations to the elderly," the statement said. "The continuous accusations surrounding the questionable and sometimes inappropriate level of care for our elderly on that unit was much to be desired furthermore, the staffing issues was always a point of contention and controversy. The Bermuda Hospitals Board, for whatever reason, always seemed to avoid real dialogue when it comes to the concerns and issues plaguing the infrastructure and level of care associated with their seniors. It is no secret that families for many years have complained about the substandard care given to their love ones to the point some of the seniors’ children become part-time caregivers to their parents as a result of visiting the unit everyday. The truth be told there is plenty of blame to go around as a result of the disrepair and neglect of the CCU. BHB along with the previous government should have taken measures and planned initiatives to task with a strategy that was proactive and comprehensive over a reasonable duration considering the direction it was heading. The remised foresight and lack of attention given to the seniors at CCU is overwhelming evidence to suggest ill-equipped and inexperienced administration who lacked knowledge and ability capable of such an undertaking. Bermuda should be embarrassed and ashamed of what has been allowed to transpire with our seniors. The dignity and legacies of those who helped to pave a better and bright Bermuda, who no longer have the mental capacity or strength to fend for themselves, have become a wasted commodity to its people. The Bermuda Healthcare Advocacy Group could only hope that any endeavor to move forward with our greatest prize and possession would be done with as much dignity and compassion available.”
2013. May 18. Bermuda’s healthcare system is “well above average” for the size of the community it serves, according to an independent team of inspectors. But the consultants also listed a number of areas that needed to be improved at King Edward VII Memorial, including poor facilities, staffing, and a failure by officials to deal with staff and patient complaints. And the Corporate and Clinical Governance Review by Canadian company Howard Associates came under fire from Ombudsman Arlene Brock, who said the company’s report “breezes over the key concerns that led to the report in the first place”. (See separate story.) The company spent five months carrying out an assessment of healthcare services on the Island before submitting its findings to the Bermuda Hospitals Board last month. “We do not know of any other jurisdiction that provides this high level of quality, quantity and spectrum of healthcare services for a comparable small population,” the report concluded. “For those who were expecting a very ‘damning’ report against the BHB, they will be disappointed. Hospitals, as we stated earlier in the report, are difficult to manage. There is much to be grateful for BHB including the new hospital wing currently being built. Having said that, the huge if not enormous challenges voiced by some leading figures in Bermuda of how to pay for this going forward, are also valid.” The report added that the range of services provided at KEMH was “strong and impressive” and added: “In our benchmark comparative, the BHB stands up well under most metrics to other small hospitals that we know well.” But the inspectors went on to list a slew of concerns over standards of care — and also took a swipe at the former board, which was replaced earlier this year by the new Government, for its management of the hospital. Criticizing the facilities at KEMH, the report said the hospital “is out of date.” It went on: “There are too many ward rooms. Modern hospitals have mainly private rooms. The rooms are far too small to handle modern equipment. Every room should have a ceiling hoist. We saw very few. Corridors are too small. There is a total lack of storage space for practically everything. Bathrooms are too small. Door openings were made for a different era. There is a lack of space for infection control.” Staff moral at KEMH was “lower than it ought to be”, and the hospital was not “providing adequate staff recognition and staff rewards. The stress on staff ... is very high”, according to the review. The report noted the “lack of clinical, medical and healthcare expertise of the previous Board members”, adding: “Most stakeholders told us the Board has had problems in the past with transparency.” And it highlighted concerns over front line healthcare, with problems in medical and surgical units. It said there was an over-reliance on junior house officers for patient care and “a striking lack of peer review for physicians. Over the past five years, BHB did not devote enough time, resources or effort to measuring quality or to patient safety. Over the past year there has been a significant improvement in this important function. Despite the above successes, we believe that more work needs to be done and some revised modalities should be implemented. We believe all hospitals must continually strive to improve quality and patient safety and the BHB is no exception.” The report said that “patient and staff complaints are not properly addressed by the current BHB system” adding: “To say that patient complaints fall on deaf ears would be an understatement.” And it concluded by putting forward ten recommendations for improving services, including the need to become more transparent, the introduction of a coordinated clinical service plan, more efficient and effective methods of funding and the better use of middle managers and front line staff.
2013. May 4. Hospital chiefs insist they are working to improve the care and conditions of patients suffering from Alzheimer’s and dementia after visiting experts criticized standards at King Edward VII Memorial. Yesterday The Royal Gazette revealed that a team from the UK’s Dementia Training Company inspected the hospital’s facilities last December. Faults found at the Alzheimer’s and Related Disorders Unit (ARDU) included the use of restraints to strap patients to chairs, an “unwelcome” and “clinical” environment, and a lack of “meaningful engagement” between patients and staff. But, according to the unit’s director, staff are now implementing recommendations put forward by the inspectors in an effort to raise standards. And Granville Russell also claims the hospital is working with the charity Action On Alzheimer’s to ensure that progress on the ward continues. The charity was responsible for bringing the inspectors to Bermuda. “We are working on all the recommendations and many improvements have already been made,” Mr Russell said. “Many improvements have been made since the review, and we have just this year started a satisfaction survey. Residents who are able are surveyed, and family members of patients with dementia and Alzheimer’s are surveyed. We will be measuring the impact of the changes as they are implemented and listening to the feedback to ensure we deal with any issues families, and residents, experience that were not raised by the review. Restraints were only used as a last resort. Our focus has been on ensuring all staff know the policy and follow it. It should be noted that ARDU does not have or use ankle restraints. When needed for resident safety, and only as a last resort, we use posey vests and soft belt restraints. Staff treating Alzheimer’s and dementia sufferers attended training sessions last autumn and a full-time activities aide was now employed at the unit. Activities includes bus rides, spiritual sessions, baking sessions and Friday movies. We also have plans to better utilize the garden, as recommended in the report. In the coming months, garden beds on the perimeters of the walkways will be filled in, new furniture will be provided and a herb garden formed. Trees overlooking the harbour will be cut back to allow a beautiful view of the harbour. Additionally, a staff team room has been adapted to become a ‘quiet room’ for residents who might have become agitated and need time to relax and feel comfortable within their environment.” Mr Russell also pointed out that patients did not spend all day in their pajamas, as one of the inspectors claimed, and that there was now enough chairs in the unit’s dining room to accommodate all patients. Inspectors had witnessed some patients sitting in wheelchairs. “We believe this report was incredibly helpful and we are grateful to the reviewers and Action on Alzheimer’s and Dementia charity who brought the reviewers to Bermuda. There were some minor inaccuracies — ankle restraints were not used — but we certainly believe it was a fair reflection of what the reviewers saw during their visit. While the issues raised concerned us, we have been pleased about the growing relationship with Action on Alzheimer’s and Dementia. It is one thing to provide a review, but the charity has stayed the course with us and become partners in improving the service and environment for our residents. I would also recognize our staff, who have worked on and implemented many of the actions. As the providers of the service, their input, support and commitment to improve has been vitally important.”
2013. January 9. The final cost of Bermuda’s new hospital will prove higher than many expect, the new Health Minister has warned. But she promised to be keep the public informed as to where the money is being spent. This week, Health Minister Patricia Gordon-Pamplin vowed to press ahead with releasing BHB officers’ wages as part of the Board’s accounts reporting. Responded BHB Chief Operating Officer Venetta Symonds: “BHB remains committed to meeting the obligations mandated by the Hospitals Act. We are currently also in the final weeks of our Corporate and Clinical Governance Review, which will include recommendations regarding transparency and accountability.” Ms Symonds said she would work closely with the Board and the Minister to ensure that “an appropriate level of disclosure is provided. Our financial statements for the fiscal year 2011/12 are currently in the final stages of being audited. As soon as this process is complete, the Annual Report will be compiled and produced. It will go through its usual process through Cabinet and then the Houses of Parliament, at which point it will be made widely available to the public. At a time when cost containment is a top health concern, Ms Gordon-Pamplin also vowed to make good on One Bermuda Alliance calls for the salaries of Bermuda Hospitals Board officers to be made public. While in Opposition, the OBA chastised Government for its tardiness in releasing BHB financial statements. Ms Gordon-Pamplin this week affirmed the OBA’s bullish stance as Opposition on the release of wage figures. “Absolutely,” said the Health and Seniors Minister, when asked if she would follow through. “The BHB legislation requires disclosure.” Previous administrations have published wages as a lump sum, which the OBA maintained wasn’t sufficient. Ms Gordon-Pamplin conceded: “Obviously, there are some things that may need to be relatively confidential. However, with that said, I think that when we are spending public money, we have an obligation to let the public know where that money is going. If you’re spending my money, I want to know where it’s going. That’s just the way it is. We have made that commitment to transparency.” Although the new hospital facility’s original design and construction costs are given as $247 million, the project’s complex financing as a Public-Private Partnership (PPP) carry significant long-term costs. “From an accounting perspective, historically, PPPs end up costing more,” Ms Gordon-Pamplin said. “That’s just the nature of it. The people who have put their money up front want a return on their investment, which is perhaps not an unreasonable expectation. The fact is that given the budgetary constraints that we have operated under, given the economy as it is, there is no way that we could have afforded to build the hospital. What’s interesting is that within the debt number that we have heard, the hospital in not included — because it’s deemed to be, within the accounting jargon, an off-balance-sheet transaction with the PPP. So it’s going to perhaps end up costing us more, in the long run.” The hospital remains on-budget, and scheduled to finish next year, she said. “But the budget number that exists for the construction of the building, you can be assured that is not the final amount that will have to be paid at the back end for the cost of the construction. I still have to get a handle on the exact amounts that we’re dealing with — but I expect it to be high.” In the wake of an acrimonious election campaign which saw a war of words over the FutureCare seniors’ insurance programme, the Minister reiterated that the new administration has no intention of scrapping the programme. “Election campaigns bring out the worst in people as they jockey for position,” she said. “There was a big advertising campaign by the PLP that we were going to take away FutureCare. That has never been the intention of the OBA, and it’s certainly not the intention of the OBA Government.” Government’s aim now is to “make it fair, so that people who are getting specific benefits are paying the same amount. While one cannot fault people for making the most of an opportunity that’s presented, I think there are people who are harder done by who have a greater need than others. We want to look at the entire concept. Sustainability is important.” Another legacy of the previous administration is the legislation banning upfront payments for medical treatment, which Ms Gordon-Pamplin said made eminent sense. “The one thing that you will not get us doing is throwing out the baby with the bathwater. If there is a policy that exists that makes sense, we obviously will allow it to continue.” However, she said, the system would need tweaking: “I do believe that we have to try to broker something where there is a little bit more latitude on behalf of service providers, such that people do not feel as if they have to do without healthcare simply because they do not have to $20 or $30 or $40 for the co-pay. It’s something we have to work with. If we have to tie it in with Financial Assistance, then we just have to make it robust. I don’t want people being ill just because they don’t have a dollar.” Ms Gordon-Pamplin could offer no advance details on healthcare expenditure in next month’s Budget. “We have to recognize the fact that I can’t spend any more money than is made available to me,” she said. “And we can’t have any more available to me than exists from a budgetary perspective.” Promising a healthcare system based on “sustainability and equity”, she added: “What we want to make sure is that the people of Bermuda get the best bang for their buck, if I can be so crude as to put it that way. It’s important to look at everything, from the cost of pencils to the cost of imaging.”
2013. March 13. It was announced that construction of the new hospital had so far injected $35 million into Bermuda’s economy, with $125 million spent so far on construction orders. More than 60 percent of the hospital construction workforce consists of Bermudians, or spouses of Bermudians. The workforce averages 90 daily; at the height of construction, that will rise to 250. With construction of the new hospital on the doorstep of the existing hospital having been a challenge, the impact of noise and dust was being kept to a minimum, with measures such as air filtration inside the hospital, and washing of the wheels of vehicles before they leave the site. Faults in the limestone at the site had required 4,300 cubic yards of backfill. Mock-ups of facilities such as a trauma area, ambulance bays and patient bedrooms, have permitted modifications of designs. Equipment purchases are expected to run up $40 million, with stringent reviews of requests already in place. Construction at King Edward VII Memorial remains on target for completion in 2014. At that point, the Bermuda Hospitals Board (BHB) must pay project managers Paget Health Services $66.7 million. The BHB has been increasing hospital fees by one percent annually, over five years under an agreement formalized in Cabinet back in 2009, in preparation. The Bermuda Government's 2012-2013 Budget has a spending cap of $104 million for KEMH but it does not mean people will be denied services. It’s a paradigm shift. There will no longer be a free-for-all. Hospital use for 2011/12 had exceeded estimates. As well as the new cap on the KEMH subsidy, the BHB had piloted a Memorandum of Understanding with a local insurer. With some of the risk transferred onto the healthcare provider, it gave more inventive to the BHB to ensure careful use of funds. BHB results of a three-year survey showed patient satisfaction continually rising. Nurses have historically been in short supply. Bermuda has 530 registered nurses, and BHB is aggressively courting Bermudian medical professionals from overseas, as well as promoting further training at home. Meanwhile, “fast tracking” incoming emergency room patients resulted in 88 percent of patients getting a hospital bed with in six hours. A new food delivery system had addressed a key problems with patient satisfaction, with a new kitchen system in 2012. Once the hospital redevelopment has progressed further there are plans to move the maternity ward next to the Operating Room. This means that mothers in labour will no longer have to be wheeled through the public corridors and taken in an elevator to the Operating Room. There is a prospect of a new birthing centre, possibly with a birthing pool, after requests by mothers in the community. For the Agape House hospice, BHB is adopting the Liverpool Care Pathway, the latest model of best practice to comfort dying patients and their families. The Island’s low rate of blood donation has caused concern. Bermuda’s total blood donor population of 1,107 is less than half that of comparable western countries. A total assessment of BHB’s information technology has been completed, and electronic health records are to be implemented at both hospitals. BHB will hire an expert to oversee the procedure. The Queen Elizabeth Nursing Residence is increasingly unsafe and demolition is the preferred option, but due to the recession, BHB believes this can be put on hold. At the Mid Atlantic Wellness Institute (MAWI) the Mental Health Plan is based on the recovery model. Assertive outreach teams are now able to visit patients in their homes. Part of this can be seen in the Budget with the allocation of $120,000 for vehicles to outreach teams. The team also attends both Government senior schools to assess students, and a residential team is in place to serve group homes. All 74 of MWI’s resident learning disabled clients, who formerly lived on site at MWI, have transferred to a group home in the past year.
2011. February. The BHB cut short its multi-million dollar five-year contract with Kurron Shares by 18 months to save money. It cost Bermuda $13.5 million over five years.
2011. February 26. The new hospital will cost $13 million less than anticipated. According to the Bermuda Hospitals Board [BHB], the final bill for the design and construction costs will be $247 million. Any cost overruns will be the responsibility of Paget Health Services, which is building the new facility. The original estimate of $260 million was based on a Johns Hopkins Medicine International Report. In a statement, a hospital board spokeswoman said: "BHB has chosen to deliver the new facility through a public private partnership [PPP] that transfers many of the project's risks, such as cost overruns and on time completion, to the private partner. The PPP model also allows for cost certainty, and frees funds to be used by BHB now to improve patient care and facilities, because the first payment on the new building will not be made until 2014. A fair and competitive bidding process between the three bid teams short listed by BHB helped keep the project costs down." BHB chairman Herman Tucker, said: "It gives me great satisfaction to see us come in under estimate. We have entered into a project we know we can afford, and our private partner has financial incentives to build, on time, a high quality hospital building. Paget Health Services will also maintain the building for the length of the contract, giving Bermuda an assurance that we will have a high quality, modern healthcare facility for the next 30 years. As this is Bermuda's biggest construction project, any delays and cost over-runs could be very damaging to us, especially as we face one of the most challenging economic times in living memory. A key benefit of the way we are delivering this new facility is that Paget Health Services take on the risks of delays and cost over-runs. This is very good news for us and Bermuda as we seek to control healthcare costs for the community." Deputy Chief Executive Officer, Venetta Symonds, said: "We would like to thank the many people involved in this project, from staff to government employees, community groups, neighbours and advisors. It should give all of us great pride that we have managed to come in under budget and that work has already started. We are really looking forward to treating our first patients in the new building in 2014." BHB is responsible for paying Paget Healthcare Services $40 million once the hospital has been built in accordance with the agreement. The rest of the costs will then be paid over the course of 30 years, through annual payments. According to the BHB statement: "The first year's total annual payment obligation is $26.7 million. Like the capital costs of the construction phase, this annual payment amount is less than BHB had budgeted for in its capital financial planning process. All annual service payments will be disclosed via BHB's regular financial reports."
2010. Late. the Bermuda Hospitals Board (BHB) signed a project agreement for the new hospital site, now being built (see photo at top of page). The agreement with Paget Health Services (PHS), a consortium of experienced local and international firms, allows them to design, build, finance and maintain the new King Edward VII Memorial Hospital building at the existing site. The new hospital is expected to begin caring for patients in 2014. It is expected to cost over $260 million. It was announced in December 2011 that the first year cost alone to taxpayers will be $66.7 million. There will be a 30-year payment schedule.
The partnership between BHB and PHS includes a three-year construction phase and 30-year maintenance phase. The new building will include 90 single-occupancy en suite patient rooms, Bermuda’s first dedicated day surgery unit and ambulatory care services like oncology, dialysis, asthma and diabetes management. It will also include diagnostic imaging services and a new emergency room and utility plant.
BHB will make its first payment for the hospital redevelopment in 2014. Health Minister Zane DeSilva told the House of Assembly under the agreement between Paget Health Services (PHS), the company that will be building and maintaining the property, and the Bermuda Hospitals Board (BHB), no money will exchange hands until the construction is completed. PHS pays for construction of the new hospital building, and the BHB pays nothing until it is complete in three years’ time to BHB’s specifications. BHB will retain ownership of the land and building.
medical consultants Kurron Shares of America Inc won a five-year $13.5 million
contract to help BHB develop a long-term health care strategy for the Island,
beating a bid by world-renowned Johns Hopkins Medicine International. The
decision prompted criticism from doctors, who claimed Kurron Shares was “minor
league.” Also terminated was physician support contract with Greeley, which
was not renewed in 2011. A number of other smaller contracts have either been
terminated, not renewed or reduced. In total, net savings per annum are expected
to be in the order of $4 million.
The goal is to improve efficiency and find appropriate operational cost savings, while continuing to improve health care services.
The continuous review is part of BHB’s commitment to consistently provide value to the community in the face of rising health care costs and the current economic challenges in Bermuda. It also reflects BHB’s responsibility to be prepared to meet the financial obligations of the KEMH Redevelopment Project, which includes making repayments for the new hospital facility from 2014 and funding the revitalization of the existing KEMH facility. BHB’s succession planning programme has identified Bermudians for senior leadership positions that were once held by consultants. With plans for the new hospital facility approved and a contract signed, the timing was right for a full review so that we only maintain those contracts whose role remains vital for us to meet the long-term health care needs of Bermuda. The Ministry of Health spent approximately $19.4 million on consultants between April 1, 2008 and January 31, 2010.
Bermuda-based Air Ambulance services have been discontinued and will not be able to fly again unless Government provides some money to help. The Bermuda Air Medivac plane has not flown since November 2011. The service was dealt a double blow by a declining number of patients and competition from cheaper US services. The air ambulance, which was set up in 2004, made 500 trips to take sick people for specialist medical help overseas before it folded. Patients ranged from head injury and stroke victims to cardiac cases. Meanwhile, the plane which ran the service, which was purchased with a charitable donation, remains in New York and may eventually be sold. Earlier, in the event of an emergency air evacuation from Bermuda to the USA or Canada, for medical services that cannot be performed in Bermuda, Bermuda Air Medivac Ltd was the operator of Bermuda's only emergency aircraft. A well-known philanthropist, David Barber, donated $2 million in 2005, in memory of his wife Mary, to buy an 11-seater jet for the company. Before the initiative, those critically injured or seriously ill had to wait for air ambulances based in the United States and Canada to fly to Bermuda and transport them off the Island.
Medical tourism with HIFU, above
Hospital waste. All hospital waste is piped from the hospital across the South Road into the from City of Hamilton underground piped sewage system at the sea end of Seabright Avenue, Paget and then dumped untreated into the sea.
KEMH's Hyperbaric unit
Scanner. In 2009 The Hospitals Auxiliary of Bermuda allocated $500,000 toward Bermuda Hospitals Board's purchase of a new 64-slice CT scanner.The scanner, which has four times as many detectors as a typical single slice CT scanner, combines unequalled image quality with remarkable speed. It can produce detailed pictures of any organ in a few seconds and provides sharp, clear, three-dimensional images, including views of blood vessels, in an instant. Introduction of the 64-slice CT scanner at the hospital will extend over the 2009/10 fiscal year, as it will require renovations in the CT area, along with the addition of a digital image archiving system, needed to manage the vast number of images produced by the new equipment.
Special Care Baby Unit. For premature and other needy new babies. Located in the maternity ward, unlike in large hospitals abroad where it can be some distance away from a maternity ward.
X-ray equipment, new in January 2013 was purchased thanks to the donations of the Hospitals Auxiliary of Bermuda (HAB). The new equipment is intended to replace a 16-year-old system at KEMH, which was becoming increasingly difficult and expensive to maintain. It includes a replacement fluoroscope which enables an imaging technique that uses X-rays to obtain real-time moving images of the internal structures of a patient, called fluoroscopy. Fluoroscopies are frequently used to investigate the gastrointestinal tract or urinary tract, or provide an arthogram of joints. While the Hospital Board paid $57,855 to install the system, the cost of the donated equipment itself cost $419,864, all raised by the HAB through membership dues, The Pink Cafe, The Gift Shop and The Barn. HAB donates around half a million dollars to the Hospital Board annually to purchase new equipment, along with supplying the hospital with numerous volunteers. This donation helped us replace equipment that was increasingly challenging and costly to maintain. The impact to patient care resulted in delays due to high levels of maintenance, and extended downtimes. The HAB’s donation enabled KEMH to improve quality with new technology and relieved the escalating financial burden of keeping aged equipment running. The equipment will improve the quality of care provided by the hospital, and will be moved to the new hospital building when opened in 2014. The new equipment updates the technology and enables KEMH to improve the quality of the images and reduce the amount of contrast and radiation patients are exposed to in each test.
44 Devon Spring Road, Devonshire FL01. P. O. Box DV 501, Devonshire DV BX. Phone (441) 236-3770, fax (441) 235-9383. Also Bermuda Government owned and operated. It includes a detoxification unit, 8-bed. At the Turning Point Center.
To better regulate health professionals, there are now powers to suspend or bar people for misconduct. The Professions Supplementary to Medicine Amendment Act 2006 , enacted by the Bermuda legislature, ensures practitioners are competent and stay up to date with the latest techniques and that there are more teeth for dealing with complaints. The primary purpose is to ensure they meet established standards of education, training and professional conduct and are educated about new procedures that come along. Covering such professional categories such as physiotherapist, occupational therapist and diagnostic imaging the Act establishes a Council for Allied Health Professionals to promote patient interests and exercise discipline over practitioners. A Preliminary Proceedings Committee has been set up to investigate complaints – serious complaints will then be referred to a Professional Conduct Committee which can hand out fines of up to $2,000, suspend a person’s registration for a year or even bar them from practicing.
Only persons on their respective registers are recognized to practice in Bermuda. All involved who need or want further details about registration should contact the Administrative Assistant to the Council, Ministry of Health and Family Services, P. O. Box HM 1195, Hamilton or telephone (441) 236-0224 extension 3441.
|Age Concern Bermuda||Bermuda-registered charity # 137. 25 Point Finger Road, Paget DV 04, Bermuda. P. O. Box HM 2397, Hamilton HM JX, Bermuda. Telephone (441) 238-7525. Fax (441) 238-7177. Open to the public 9 am-4 pm Monday-Friday. Not part of Age Concern in UK and not offering the services they do. Most of the income from this entity is from the corporate private sector, Bermuda Government and some individuals. Income goes to operating expenses. It will not campaign for free hospitalization and free prescriptions for seniors. There is an annual membership fee to individuals.|
|Bermuda Cancer and Health Centre||46 Point Finger Road, Paget. P. O. Box HM 1652, Hamilton HM FX. Phone 236-0949. RC 070. Formerly Bermuda Tuberculosis, Cancer & Health Association. Since 1945, established by Act of Parliament. founded to assist patients fighting TB. It educates the community about prevention and early detection of cancer. It conducts 75% of all mammograms. It educates and supports diabetic and ostomy patients. 25 percent of all deaths in Bermuda are attributed to cancer. Most common types in Bermuda include (in descending order) prostate, breast, colon and rectum, lung and bronchus, and skin. The Centre highlights the importance of early detection as the best form of prevention. Other services include ultrasound and bone densitometry.|
|Bermuda Council on Ageing||Since late 2006. Charged with coercing Government to implement strategies necessary to protect one the island’s fastest growing demographics. The Department of Statistics estimates the over-65 population will reach 22 percent by 2030 – double the amount of the 2000 Census. So one of the most crucial roles for the Council is preparing the country for an onslaught of elderly care giving – at home and in assisted living facilities.|
|Bermuda Dental Association|
|Bermuda Dental Board||See Bermuda Government Boards. P. O. Box HM 2748, Hamilton HM LX. Phone 295-8233.|
|Bermuda Health Alliance||Suite 200, 40 Par La Ville Road, Hamilton HM 11. Telephone (441) 296-2875. A cooperative venture of the Bermuda Diabetes Association, Bermuda Hospitals Board, Bermuda Heart Foundation, Friends of Hospice, Resident's Family Council and Hospitals Auxiliary. Registered charity.|
|Bermuda Health Care Consortium||Founded September 20, 2002. Chairman Mark Selley. Founded to help bring much-needed long-term insurance and other pressing needs to Bermudians and residents presently without the type of coverage or financial and other support services common in other developed countries. Call Chairman at "Ship's Bow," 4 Keith Hall Road, Warwick WK 06, phone 236-0037|
|Bermuda Health Council||A Bermuda Government appointed entity. Established as an official health watchdog. Responsible for regulating, coordinating and enhancing the delivery of health services in Bermuda. Made up of doctors, insurers, hospital officials and patients. Also responsible for regulating the price of drugs sold to the public and conducting research on the subject of public health.|
|Bermuda Health Foundation||Owned and operated by Murray Brown, Philip Butterfield, Dr. Vincent Bridgewater and Dr. Ewart Brown|
|Bermuda Heart Foundation||For coronary incidence, treatment and prevention. P. O. Box HM 1993, Hamilton, HM HX. Telephone (441) 295 3346. Fax: (441) 295-5371. A registered charity, 1996. Unlike most support groups, it is a major player in arranging the funding for critically important life saving heart related equipment for the hospital and is supported by health professionals of the highest reputation in every relevant field. It has no paid employees. Board meetings are on the 3rd Thursday each month. Board of Directors include Dr. Shane Marshall, MD, FRCPC. Goals are equipment, building, direct services, education.|
|Bermuda Hospitals Board||See Bermuda Government Boards.|
|Bermuda Hospitals Charitable Trust (BHCT)||P. O. Box HM 2273, Hamilton HM JX. T. 441-298-0151. F. 441-296-1072. An independent organization founded as the formal charitable arm for accepting donations and fundraising on behalf of the Bermuda Hospitals Board (BHB). A separate entity from the BHB and Ministry of Health, governed by its own Board of Trustees who determine policy and are responsible for its own sound fiscal management.|
|Bermuda Integrated Health Service Cooperative (BIHC)||
Lotus, Victoria Street, Hamilton. Since 2012. BIHC, proponents of out-of-hospital childbirth have won Immigration approval to bring their own midwives to the Island. BIHC received permission after the Bermuda Medical Council confirmed it didn’t need a full medical licence to do so. The victory follows eight years of struggle, said director Sophie Cannonier. “Midwives here in Bermuda function as obstetric nurses. They are not available to the public for birthing outside the hospital. So when I started to investigate through Immigration how I could bring in midwives, that’s where the impasse came in. They said we were not able to do it. I was told we couldn’t bring people in because I wasn’t the holder of a medical licence. So we went back and forth trying to get the door open.” Residents now have access to Bermuda-registered US midwives Susan Cassel, Makeda Kamara and Lisa Dalporto. The trio will work under the auspices of the BIHC, allowing residents to give birth “anywhere they want.” The move could prove a breakthrough in changing Bermuda’s medical culture, with costs far lower than typical hospital births. BIHC is trying to negotiate reasonable fees for insurance to cover BIHC services. Ms Cannonier serves as Cooperative director alongside her husband Michael Watson and Eugene Dean. With out-of-hospital midwifing “disappearing” across the US its emergence in Bermuda is a special victory. BIHC hopes to expand its services as more residents choose to explore their options.
|Bermuda Medical Association (BMA)||75 Victoria Street, Hamilton. An association of all medical doctors in practice in Bermuda.|
|Bermuda Medical Council||See Bermuda Government Boards.|
|Bermuda Medical Society||King Edward VII Memorial Hospital, Point Finger Road, Paget. An association of all medical doctors in practice in Bermuda. All doctors in the heath care profession in Bermuda must be members.|
|Bermuda Nurses Association||Patrice Dill at (441) 236-3770 extension 3254. A registered charity and active organization that celebrates the annual Nurses Week theme with community wide activities, free blood pressure, blood sugar and blood cholesterol screening. Under the Nurses Act 1997, all nurses whether registered or enrolled must renew their licenses on an annual basis and pay dues each year.|
|Bermuda Nursing Council||See Bermuda Government Boards.|
|Bermuda Occupational Therapists Association||See web site.|
|Bermuda Organ and Tissue Donor Association||For more information, call KEMH at 236-2345. Welcomes those willing to become donors. In association with the New England Organ Bank.|
|Bermuda Pharmaceutical Association (BPA)||All Bermuda pharmacies must be licensed members.|
|Bermuda Psychologists Registration Council||See Bermuda Government Boards.|
|Bermuda Stroke & Family Support Association||The
Association meets on the third Wednesday night each month at 7 pm at
King Edward VII Memorial Hospital. Telephone D. Mark Selley, Chairman,
at 293-3121. Or write to him at "Seven Seas" #6 Rock Garden
Lane, Harrington Hundreds Road, Smiths FL04, Bermuda. Phone 293-3121 or
cell 334-8487. Or Ann Selley
295-3764; Hazel Lowe 236-0407; Moira Lindo 294-7613. RC 361.
Support, help, advice, encouragement, to assist Bermudian and Bermuda-based stroke survivors of all ages and backgrounds and families affected by stroke. Has no membership dues, takes no minutes, has no structured agenda or board of management. Strokes, more than any other medical problems, cause permanent chronic disabilities. Stroke identification - how to identify signs of a stroke - may be crucial. Getting a stroke recognized, diagnosed, and then having the patient medically cared for within 3 hours, which is tough, can make the difference between life and death. The stroke victim may suffer severe brain damage when people nearby fail to recognize the symptoms of a stroke. Now doctors say a bystander can recognize a stroke by asking simple questions, or looking carefully. Can the person smile? Is the face crooked or normal? Can he/she talk and speak a simple sentence coherently? ( For example, it is sunny out, today). Speech is important. Can he/she raise both arms? Can he/she stick out their tongue? If the tongue is crooked or goes to one side or another, it's another cause for concern. If he/she has trouble with any one of these four questions, call the doctor or hospital or emergency service immediately and describe the symptoms.
Older adults often do not realize or may even forget they have had a stroke and may not be a reliable source of medical information, US researchers said in May 2009. Brain scans showed that while just 12 percent of seniors asked about strokes remembered having had one, nearly a third had brain damage showing they had. (Permanent brain damage results from a stroke). The stroke itself could damage memory, and many people may also have so-called silent strokes that are never diagnosed at the time. Stroke is associated with motor impairment but can also be accompanied by impairments in memory, sensation and speech or language, diminishing the ability of an individual to accurately report a history of stroke. Researchers who want to study strokes in adults young and old need to rely on MRI scans, and not patients, to get accurate information about stroke history.
50% of all strokes occur in people who have no prior symptoms. Strokes are a leading cause of severe permanent disability and death. People never recover fully from strokes, their limbs or brain or heart are often permanently affected. Some hospitals (unfortunately not in Bermuda) or private health systems (such as LifeLineScreening.co.uk) offer ultrasound screenings that can identify risk of strokes. Screenings are fast, painless, accurate and often affordable, involving four tests. Test 1 is stroke carotid artery screening. Test 2 is atrial fibrillation screening. Test 3 is abdominal aortic aneurysm (AAA) screening. Test 4 is peripheral arterial disease (PAD) screening.
|Board of Chiropodists||See Bermuda Government Boards.|
|Board of Dietitians||See Bermuda Government Boards.|
|Board of Medical Laboratory Technologists||See Bermuda Government Boards.|
|Board of Occupational Therapists||See Bermuda Government Boards.|
|Board of Physiotherapists||See Bermuda Government Boards.|
|Board of Radiographers||See Bermuda Government Boards.|
|Board of Speech Therapists||See Bermuda Government Boards.|
|Council for Allied Health Professionals||Established in 2006, it promote patient interests and exercise discipline over practitioners. It has a Preliminary Proceedings Committee, set up to investigate complaints – with serious complaints referred to a Professional Conduct Committee which can hand out fines of up to $2,000, suspend a person’s registration for a year or even bar them from practising.|
|Diabetes Resource Centre||Beacon House, Beacon Street, Hamilton. People can get their blood sugar tested and pick up supplies of insulin and syringes here, while patients without adequate insurance coverage can get financial assistance from Bermuda Diabetes Association. Visitors can also read publications related to diabetes, while bi-monthly foot screenings are available by a podiatrist. Support for the project has come from Allied World Assurance, Butterworth Associates, XL, the Bermuda Society for the Blind and the Corporation of Hamilton. The Long Riders Motorcycle Club's 48-hour ride for diabetes last year raised $18,000 towards costs. The dispensary is open from 8.30 a.m. to 12.30 p.m. Monday to Friday. Private consultations may be arranged in weekday afternoons. Telephone 297-8427 or 29-SUGAR for more information.|
|Government Employees (Health Insurance) Appeals Tribunal||See Bermuda Government Boards.|
|Government Employees (Health Insurance) Management Committee||See Bermuda Government Boards.|
|Health & Safety Advisory Council||See Bermuda Government Boards.|
|Hospital Insurance Commission||See Bermuda Government Boards.|
|Medical Practitioners||A register of names of doctors under Section 6 (2) of the Medical Practitioners Act 1950 is maintained by the Bermuda Medical Society and Bermuda Hospitals Board. It is in the order in which they were registered in Bermuda.|
|Medical Reference Committee||A Bermuda Government committee under the Motor Car Act 1951 to determine the fitness or otherwise of licensed Bermuda drivers, especially those over 75 years old. See Bermuda Government Boards.|
|Mental Health Review Tribunal||Bermuda Government appointed under the Mental Health Act 1968. See Bermuda Government Boards.|
|National Drug Commission||See Bermuda Government Boards.|
|Optometrists and Opticians Council||See Bermuda Government Boards.|
|Professions Supplementary to Medicine Council||See Bermuda Government Boards.|
|Register of Audiologists||Bermuda Government maintained under the Professions Supplementary to Medicine Act 1973. A full list is published annually.|
|Register of Chiropodists||Bermuda Government maintained under the Professions Supplementary to Medicine Act 1973, not in alphabetical order but in order of day of registration so that those earliest currently registered are first and the most recent are last. A full list every year.|
|Register of Dental Hygienists||Bermuda Government maintained under the Dental Hygienists Regulations 1950. A full list every year.|
|Register of Dental Technicians||Bermuda Government maintained under Regulations 2(b) of the Dental Technicians Regulations 1950. A full list every year.|
|Register of Dental Practitioners||Bermuda Government maintained under the Dental Practitioners Act 2008, not in alphabetical order but in order of day of registration so that those earliest currently registered are first and the most recent are last. A full list every year. The new act amends the Dental Practitioners1950 act which had no provision for registering dental hygienists and assistants. The act also requires dentists, hygienists and assistants to have continuing education to remain registered, have a professional conduct committee with mandatory reporting of impaired practitioners, a report annually and more. The Board increased from five to seven members with the senior Government dental officer becoming an ex officio member. The Bermuda Dental Association and Bermuda Dental Hygiene Association will be allowed to nominate members for the Minister to appoint, similar to other medical boards.|
|Register of Dieticians||Bermuda Government maintained under the Professions Supplementary to Medicine Act 1973, not in alphabetical order but in order of day of registration so that those earliest currently registered are first and the most recent are last. A full list every year.|
|Register of Emergency Medical Technicians||Bermuda Government maintained, registered with the office of the Chief Medical Officer. Some are Bermuda Hospitals Board, others are Bermuda Fire Service. A full list every year.|
|Register of Medical Laboratory Technologists||Bermuda Government maintained under the Professions Supplementary to Medicine Act 1973, not in alphabetical order but in order of day of registration so that those earliest currently registered are first and the most recent are last. A full list every year.|
|Register of Medical Practitioners||Bermuda Government maintained under Section 6 (2) of the Medical Practitioners Act 1950, not in alphabetical order but in order of day of registration so that those earliest currently registered are first and the most recent are last. A full list every year.|
|Register of Midwives||Bermuda Government maintained under Section 6 (2) of the Midwives Act 1949, not in alphabetical order but in order of day of registration so that those earliest currently registered are first and the most recent are last. A full list every year.|
|Register of Occupational Therapists|
|Register of Optometrists & Opticians||Bermuda Government maintained under Section 4 Part III of the Optometrists and Opticians Act 1973, not in alphabetical order but in order of day of registration so that those earliest currently registered are first and the most recent are last. A full list every year.|
|Register of Pharmacies||Bermuda Government maintained under Part IV Section 17(4) of the Pharmacy & Poisons Act 1979, in alphabetical order. A full list every year.|
|Register of Pharmacists||In accordance with Section 7 (4) of the Pharmacy & Poisons Act 1979. It shows every currently licensed pharmacist - Bermudian and non-Bermudian - by full first, middle and last name and the year, day and month when entered in the register.|
|Register of Physiotherapists|
|Register of Psychologists||Registrar General, Section 8, Psychological Practitioners Act 1998. A full list every year.|
|Register of Radiographers|
|Register of Speech-Language Therapists|
|Standing Medical Board||Pension and Gratuities (War Service) Act 1947. All surviving beneficiaries of such pensions are senior citizens.|
|The Psychological Practitioners Act 1998||For psychologists practicing in Bermuda|
Some accommodation is available for incoming non-Bermudian doctors and nurses. Incomers to Bermuda should know Bermuda is the wealthiest place in the world according to the World Bank. Aspiring medical newcomers should check for themselves and make appropriate comparisons to determine that terms and conditions of service generally are comparable and equivalent in accommodation, length of service, upward mobility, salaries, benefits and airfares to those offered in American, Australian, Canadian, Cayman Islands, European and New Zealand hospitals. At all such places abroad, for academically and professionally qualified staff standard attractions and contracts include all local Board of Nursing or MD-certified or equivalent fees paid, accommodation (one-bedroom or more) for a stipulated period of time, round-trip air fares once every year or two, good local transportation options and financial assistance if merited, good living conditions and possibly a sign-on bonus.
Once, the hospital system was private sector. At that time, it was supported by charity with the efforts of visitors like Mark Twain and British Army then in Bermuda. Today, the costs to all who need the hospitals of Bermuda are not included in national direct and indirect taxes as they are in Canada and the United Kingdom. There is no national health plan in Bermuda.
Prudent visitors will bring spare money in US Dollars, travel insurance and health insurance to cope with possible unexpected problems including accommodation in an emergency medical situation or a death. Visitors from the United Kingdom should note that the National Health Service of the UK does not apply at all in Bermuda. Nor does it have an equivalent. Medical costs here are as high as, often higher than, those in the USA. Affordable accommodation in Bermuda for such emergencies, especially from April to November, is extremely difficult to find. Every week, visitors suffer emergencies. Many say they do not make any contingency or emergency plans. They claim they have no money and no health and travel insurance for unexpected problems. (When locals go the USA and elsewhere, on cruises or by air, they must either have such a plan or be prepared to pay full medical costs themselves).
In Bermuda, There is no insurance coverage for birth control, only for abortions in certain approved circumstances.
|1812. 1st Hospital. Royal Navy. Admiralty House, Long gone.|
|1818. Construction of the RN Hospital near the Dockyard, in the same pre-fabricated manner as the Commissioner's House. In addition to cast iron structural features, such as veranda columns, floor joists, and possibly cast and wrought iron roof trusses, some of the stonework for the building was the hard local limestone. A surgeon, doctors and medical staff were appointed and sent by the Royal Navy. During World War 2, the Royal Naval Hospital, Bermuda, treated and often saved the lives of many brought in from torpedoed ships. The Royal Navy left in 1950s. That hospital building ended its life as an egg farm, then finally was deliberately burnt to the ground by the Fire Department in November 1972. Part of it became the site for Lefroy House, for senior citizens.|
|1841. Planning of first Bermuda civilian hospital. . On 28 April, the Bermuda Legislature passed an "Act for the Safe Custody of Insane Persons charged with Offences. " It was the first local legislation to deal specifically with persons with mental problems. Persons charged, if found to be insane, were kept in custody until they could be sent to an asylum. In 1846, a further Act was passed to establish a hospital for the reception of "insane paupers." It enabled the Governor, Lieutenant Colonel William Reid, to buy land in a central parish for an asylum. Moved to and see under "St. Brendan's Hospital" in Devonshire Parish.|
|1848. Opening of first Bermuda civilian hospital - the Lunatic Hospital (as it was then called, insensitively). Dr. Henry Josephus Hinson, a graduate of Edinburgh Medical School in Scotland, was the first medical superintendent. It remained in its original location for 22 years.|
|1864. A Board of Health hospital was established at Cedar Hill, St. George's, for victims of the Yellow Fever epidemic then raging in Bermuda.|
|1868. Re-location and expansion of former Lunatic Hospital, now St. Brendan's. It moved to its present location, the site of the former Devonshire College. Later, under Governor General Sir John Lefroy, the Devonshire College buildings were expanded after he convinced Parliament to spend £3,650 sterling to pay for additional work. A much larger facility was required from the beginning of the 20th century, especially during and after the two world wars. St. Brendan's became its official name, after the Irish saint born about 484 AD.|
|1850s. 3rd Hospital. British Army, Prospect. Building still there, British Army left in 1950s, continued as Bermuda Government-owned Old Prospect Hospital until 1971/72. No longer a hospital.|
|1894. March 11, Hospital Sunday. 4th Hospital. Second civilian hospital. Patients of all classes who required hospital treatment were admitted to the little rectangular structure known as the Cottage Hospital which had only a handful of beds. It was the first civilian (but not military, as there were two) hospital in Bermuda. It was on elevated ground near the east end of Pembroke Parish on the Military Road from Fort Hamilton to Prospect. It subsequently became King Edward VII Memorial Hospital. See below.|
|1901. Port's Island Hospital for Boer War prisoners-of-war. Also used to house 3 German nationals interned and 58 German merchant seamen in the 1914-18 Great War.|
|1920. The first official Royal Visit to Bermuda was when Albert Edward, Prince of Wales (later, briefly, King Edward VIII) concluded his tour of the British Empire. It was the first of three visits to Bermuda by him. On this first occasion, one of his official duties was the opening of the King Edward VII Memorial Hospital on its present Paget location, formerly the much smaller Cottage Hospital in Paget Parish.|
|1941. First American hospital facility in Bermuda. American troops at the Castle Harbour Hotel brought with them a medical contingent of eight officers and men and established on a temporary basis on the first floor of the hotel an infirmary, not a hospital.|
|1941. August. First American Hospital in Bermuda. It was at what was was - is now, again - the Bermuda Biological Station for Research at Ferry Reach. The American Government obtained a lease of the buildings and grounds (with the biologists re-housed at the Government Aquarium, Flatts). A temporary American military hospital was established there. It was staffed by four physicians, a dentist and nurses, all US Army personnel. It was responsible for all members of the US Army Engineers and the thousands of workers involved in the building of the Fort Bell/Kindley Field Base.|
|1941. September. US Navy began construction of an Annex Clinic at the first US Armed Forces Base in Bermuda, in Southampton Parish. In 1993, it was closed and amalgamated with the Base Clinic at USNAS, St. David's.|
|1941. October. Work was begun by US Army Engineers on the building of an elaborate 150-bed permanent hospital at Fort Bell. It is no longer there but on the same site on which the present, much-newer, former US military hospital - but now abandoned, vandalized and vacant - now stands.|
|1942. When the Riddell's Bay Golf Club was a US Navy recreation centre during the war, a mobile hospital for the war-wounded was established nearby. It too saved the lives of many brought in from torpedoed ships. Others were brought in to the Royal Navy Hospital just outside Dockyard (now Lefroy House).|
|1943. May. The first US Military base hospital at Fort Bell was finally completed, but only with the bare essentials, notwithstanding its price-tag to US taxpayers of more than $1 million. But there were sufficient facilities at the new site to justify giving plenty of notice in advance of the closure of the infirmary at the Castle Harbour Hotel and the temporary hospital located at the Bermuda Biological Station.|
|1943. December 30. With completion of the first purpose-built hospital at Kindley Air Force Base (KAFB), Bermuda, the infirmary that had been established at the Castle Harbour Hotel was finally closed out and the hospital facility that had been in operation at the Bermuda Biological Station was also shut down.|
|1954. It was resolved by the US Military in Bermuda that the base hospital had to be demolished and re-built from scratch at US taxpayers expense again as it had become too much of a liability. Over time, it had been established its beams, concrete and other structures were riddled with rust and related problems, apparently with sea water instead of fresh water used for building, using shoddy construction techniques.|
|1956. June 21, 1956. Kindley Air Force Base (KAFB), Bermuda celebrated a major event, with Bermudian help. The occasion was the official dedication of the brand-new base hospital up to latest US hospital standards, on the site of the old building which had been demolished because it had incurred some major building errors and its foundations and walls were doomed. Its use was confined to civilian and military employees and personnel of the US Military Forces in Bermuda and their military colleagues at the British and Canadian bases in Bermuda. It was designated as the 1604th Hospital (and stayed that way until 1967 when it was downgraded to a dispensary). Vanguard Construction of the USA built the new building, at a cost to US taxpayers of more than US$1,500,000. It had taken almost two years to build, mostly with Bermudian labor, with the complete interior decoration work undertaken by the Front Street, Hamilton firm of A. S. Cooper & Sons Ltd. The grand opening, held under sunny skies outside the hospital's main entrance, was attended by His Excellency, Governor Sir John Woodall; a delegation from the USA including Dr. Frank B. Berry, then Assistant Secretary of Defense (Health and Medical); Major General W. H. Powell, Jr., Deputy Surgeon General, United States Air Force; and the Honorable J. B. Pine, the United States Attorney General. Also in attendance were the Hon. Sir John Cox, then the Speaker of the Bermuda House of Assembly, the Venerable Archdeacon Stowe, who performed the Invocation and the Right Reverend Robert S. Dehler, Roman Catholic Bishop of Bermuda, who performed the Benediction.|
|1965. June. King Edward VII Memorial Hospital (KEMH) present building was completed (added to greatly since).|
|1970. Bermuda Hospitals Board (BHB) established. It brought King Edward VII Memorial Hospital and slightly re-named St. Brendan's Psychiatric Hospital under one governing body. Today, both are owned and staffed by this specialist agency of the Bermuda Government. See Bermuda Government Boards. There is also a Bermuda Hospitals Charitable Trust (BHCT), shown in Associations in Bermuda, B Listing. More than 1,500 staff are employed by the two hospitals.|
|1971. Patients were transferred from old Prospect Hospital to newly opened Geriatric and Rehabilitation Unit at KEMH.|
|1995. When US Forces quit Bermuda, the former base hospital, by then demoted to a dispensary and Base Clinic, was abandoned.|
|1998. Additions to KEMH. They included new Surgical Wing, new Emergency Ward, Hospice, Intensive Care Unit, Pharmacy, etc. plus increased space for many Departments.|
|2005. 12th May. Mid Atlantic Wellness Institute (MAWI) became the new name of St. Brendan's Hospital in Devonshire.|
|2014. The new King Edward VII Memorial hospital, now being constructed at the same Paget location, is expected to open.|
December 5, 2013.
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