Concerns about the $15 million hospital subsidy overrun were this week raised by Opposition Senator Jeanne Atherden.

She asked Junior Health Minister Thaao Dill to explain how costs could rise to more than $100 million last year and return to $86 million this year.

Mrs. Atherden questioned whether the increase was related to the elderly as seniors hospital stays are frequently longer than those of other patients.

"Because their [seniors] stay ends up being charged 80 percent on the aged subsidy we will see that subsidy increase," she said. "I think it's unrealistic to raise up to $100 million last year and it's going to go back to $86 million next year.

"The change in the insurance scheme [from per diem to per case] was thrown out as if it was the saviour. It has been something considered in the health care for years.

"Per diem to per case will not change the average length of stay. It was 17.3 days in 2008. Could anyone tell me what the average length of stay in the hospital is now?

"Has this had any effect? Because the long-term are the elderly who cannot be discharged."

The average hospital stay for long-term patients is now nine days, Mr. Dill said.

Mrs. Atherden continued her questions: "Does the hospital still get paid on a monthly basis? How far behind is the approval process from the time the claims are approved and the services are rendered?

"That makes a big difference for what's in the pipeline. If you are not projecting it properly you can have a $15 million overrun."

And she added: "So I am going to ask the question that people want to know.

"Is there a breakdown in the providers? And how much was spent on the outpatients and the inpatients? We have lots of talk about FutureCare and what it covers and how many people are in and how many people are out.

"How we diffuse a lot of these issues that come up, is the access of information. Will the $10 million be adequate? You only put the number here and you don't see how it's broken out.

"Numbers that stay the same year after year as an accountant that's always suspect. Numbers that stay too round and consistent are red flags for me."

Health Minister Walter Roban explained during last week's Budget debate in the House of Assembly that the extra $15 million was "directly related to utilisation of services".

Mr. Roban said the subsidy covered services accessed by seniors, youth and indigent patients, as well as outpatients and those needing haemodialysis.

He said the Ministry also had to cover an increase in a Lady Cubitt Compassionate Association (LCCA) grant which wasn't part of the hospital subsidies. The grant increased from $2 million to $3 million because Government was required to cover their patients' care abroad.

Mrs. Atherden asked for more information about the Bermuda Health Council and other output measures for the department which she said were missing from the budget brief.

"Seeing what the Bermuda Health Council has been doing we would have thought that would be in the output measures," she said.

Senator Dill added that he has repeatedly offered information about FutureCare and the work of the Bermuda Health Council.

l More Senate reports – Pages 10 & 11