Union boss Ed Ball has praised the new King Edward VII Memorial Hospital plan but wants to know who will foot the $315 million bill.

He added that the current hospital revenues should be protected by a medical lab register that would ensure there were no conflicts of interest when it came to delivering services at KEMH.

On Wednesday the Bermuda Hospitals Board (BHB) unveiled the second phase of the Johns Hopkins Review, which suggested rather than replacing the hospital in one go, that a phased-in approach could save money.

The first five years will include two new wings, a central utility plant and renovations to the tune of approximately $315 million.

Mr. Ball said he was encouraged by this plan, but also concerned about how the community was going to cover the cost.

"It's going to be good for the staff and by extension for Bermuda. Some of the renovations that (BHB) CEO David Hill stated can be done immediately, but the replacement of the two new wings, I guess, we will have to wait," he said.

"I think that the Hospitals Board has done a good job in trying to meet the needs of the Bermudian public within the confines of the site.

"The question is how will they fund these two items and what's the community going to do to assist? We need to ensure it's modern and that the experts and professionals are there."

According to Mr. Hill the plan revealed yesterday is a work in progress and the next phase requires a business plan on how to deliver the project. KPMG will be working with BHB to review how to provide best value for money, and designs will be developed as part of the delivery project.

Initial projections in the Johns Hopkins Phase II Report indicate the construction costs could total $260m while renovations could reach $55m.

Mr. Hill said on Wednesday that these costs could be covered by a three percent fee hike over the five years.

But yesterday Mr. Ball said further costs could be saved by scrutinising the hospital revenue and ensuring those with decision-making powers state their interest.

He added: "We need to be sure there's financing for training and make sure research and patient services are not being compromised.

"I say compromise because there are people running businesses directly against the hospital and we need to look at what that means for revenues and loss of revenue.

"Some of the people practising at the hospital have visitation rights at the hospital are in direct competition with the Board.

"All labs should be registered and meet international standards. Who owns them and who has a conflict of interest? We cannot have someone who is a physician on the board and running a daily lab.

"You cannot have someone who is a politician talking about health care who is in direct competition with the hospital."