House of Assembly today.

MPs will discuss the Health Care Review, which will be introduced by Health and Social Services Minister Clarence Terceira, for most of the day.

But Dr. Terceira said last night he did not expect major controversy over the document, which contains more than 160 recommendations.

He said: "The purpose of the whole exercise is to get input from Parliamentarians -- it's such a wide-ranging, comprehensive report, it should stimulate a lot of debate.

"I am not, however, looking to see anything vastly controversial because basically -- as the report says -- we do have a good health care system.

"But with things like escalating costs, we do have to have a look at changing some things.'' The probe into health care, published in August last year, was carried out by four task forces.

Areas covered were quality of care, the cost of care, future requirements and finance. Each task force made a list of recommendations which are contained in the 250-page report.

In quality of care, major issues included decreasing waiting times, opening a non-urgent out-patient clinic to relieve pressure on the hospital, bringing in regulations covering nursing homes and increasing specialisations available on the Island to cut down on the cost of overseas treatment.

Other suggestions for trimming the health budget included a Bermuda Health Council to oversee health care to ensure cost effectiveness. It is also recommended that the Health Council draw up a Health Plan to replace the existing hospital insurance scheme which will provide universal cover at affordable cost, as well as promoting healthy living and provide alternatives to in-patient care.

A dental care review is also suggested, along with the use of cheaper, generic drugs by doctors rather than brand-name medicines.

Finance recommendations include 100 percent subsidies for the elderly and removing the youth subsidy -- but gradually increasing parental premiums -- and increased assistance for the poor, especially the elderly and the young.

Public health initiatives to educate people out of habits which will lead to health problems are also mooted, along with fee guidelines to be displayed in doctors' surgeries.

Shadow Health and Social Services Minister Renee Webb said she expected to speak for some time on the issues.

She added: "There are a lot of issues in there which are critical of how the system is run, whether it's cost-effective and how the hospital runs financially and whether it is efficient and cost-effective.

"And with respect to the formation of the Medical Council, a large section of the medical profession don't agree with it -- they agree in principle but not with the far-reaching powers the Council would have.'' Ms Webb added there was also a large group of elderly people dependent on expensive hospital care, rather than in the less expensive setting of family or rest homes.

She said: "Indigent care is subsidised to a certain extent by the health insurance companies but that is not enough.'' And she added: "The health system in general is considered to be good, but there is a perception among the public that health care is too expensive and a negative perception of the quality of health care offered to residents.

"That's the whole reason why the health care review was called for in the first place.'' Government Whip Rick Spurling agreed with Dr. Terceira that the health care review was unlikely to start a cross-bench war, although many MPs will wish to speak on it.

He said: "I don't think this issue is as political as some other topics.'' Mr. Spurling added that, if time allows, it was hoped that a variety of regulations affecting marine traffic tariffs would be dealt with before the house rises.

HEALTH HTH