An impending $40 million to be paid for the new wing of King Edward VII Memorial Hospital in the coming fiscal year has many in the community wondering who will be called upon to pay.

However, even though the Bermuda Hospitals Board (BHB) is out of cash, and the Bermuda Government is on an austerity budget, hospital charges are not set to rise.

Jennifer Attride-Stirling, CEO of the Bermuda Health Council, said there had been encouraging signs that the imperative to cut costs had a positive impact in 2014-15.

“For example, the Home Medical Services Benefit, which was implemented with great cooperation from BHB to redirect patients from acute care to the community, resulted in health system savings,” she said.

“Revisions to the standard benefit package for 2015-16 are being targeted to reduce unnecessary hospital stays, which should bring down claims and health spending.”

In the wake of ominous revelations this month by Jeanne Atherden, the Minister of Health, Ms Attride-Stirling said her council was collaborating with the minister, BHB and others to roll out the new benefits later this year.

Giving a grim appraisal of the hospital’s financial straits, Ms Atherden said it would be “unfair” for the public to benefit from new health facilities without expecting any additional charges.

A BHB spokeswoman pointed out that the hospital’s predicament was nothing new.

“The financial shortfall that was commented on in the minister’s budget brief and has been discussed publicly by BHB for two years,” she said.

“BHB’s plans to address this shortfall do not include significant fee rises, but focus on improved efficiency and effectiveness internally and supporting improved public health to reduce the need for all healthcare services. BHB is committed to do all it can to make the necessary changes to meet its obligations.”

BHB does not set its own fees or add new ones without Parliament’s approval, and the spokeswoman affirmed that there had been a consensus that the Island “cannot afford significant fee increases”.

The BHB chairman, Jonathan Brewin, announced in February that the organisation had launched a formal Modernisation Project — not merely to cover its monthly payments for the new acute care wing. BHB will continue to invest in its services, along with maintaining the ageing facilities at the Mid-Atlantic Wellness Institute and the general wing of KEMH, even as the costs of drugs and equipment continue to rise.

“Achieving financial sustainability requires change in how we operate and work, and could reshape our service profile, but our focus will be on protecting the safety and quality of front line services and maximising our effectiveness and efficiency,” the spokeswoman added.

“It is important to note that hospital fee increases alone do not drive premium increases. Cutting BHB costs alone does not resolve the hospital or the country’s challenges around healthcare premiums. Premiums pay for all healthcare costs — and 56 per cent of costs are not hospital related.

“The biggest driver is utilisation across all local and overseas services. For the country to address premium costs, we need to look at public health, better prevention and management of chronic diseases, as well as better coordination and collaboration throughout the healthcare system. Even when there has been no increase in hospital fees, such as in 20013/14, healthcare premiums have still gone up.”