Questions persist over funding allocation for hospital crisis
Six months after a major budget allocation to the Bermuda Hospitals Board to alleviate overcrowding, health officials have not yet decided how the money will be spent.
It comes as an independent review of the matter continues, in the wake of revelations from a former chief of emergency services, Edward Schultz, who branded delays in care a “crisis” in April.
Dr Schultz criticised design flaws leading to a lack of capacity at King Edward VII Memorial Hospital’s emergency department and its acute care wing.
David Burt, the Premier, acknowledged problems in February, when the 2026-27 Budget came with a $55 million support package from the health ministry for BHB operations and $12 million in capital improvements.
Mr Burt said a 30-bed transitional unit would be funded, and highlighted the need for step-down facilities, able to accommodate patients in need for lower levels of care, to free up space.
Last week, the ministry was asked how much financing had been allocated to the extra patient accommodation — and when it was projected to become operational.
However, a ministry spokeswoman responded: “The specific portion allocated to new step‑down and long‑term care capacity is still being confirmed with BHB as part of the budget implementation process.”
The Royal Gazette also queried whether the announcement of a 30-bed transitional unit at the Mid-Atlantic Wellness Institute represented new capacity.
A joint statement on June 2 by the ministry and the BHB stated: “To support long-term system sustainability, BHB will be adding 30 long-term care beds at MWI.
“This is part of the broader strategy to address the projected need for approximately 365 skilled nursing facility beds by 2035.”
Statistics online from the BHB show MWI long-term care and rehabilitation beds dropped from 38 to 17 between March 2023 and March 2025, and that the Devon Lodge rehabilitation unit was closed.
The ministry was asked if the net gain in system-wide post-acute beds was actually 30, or closer to nine once the Devon Lodge and MWI rehabilitation closures were accounted for.
The response was: “The ministry is verifying system‑wide post‑acute capacity figures, including the impact of past closures and the addition of the transitional unit at MWI.
“Confirmed numbers will be shared once that review is complete.
“Our focus is ensuring sustainable capacity for patients transitioning out of acute care.”
The Gazette has fielded repeated complaints of hours-long delays in the emergency department — although at midday on Tuesday the hospital reported a wait of just under 90 minutes to see a doctor, with 23 people admitted and awaiting a bed.
Median boarding times fell from about 50 hours at the start of this year to roughly 20 hours by May.
In January, the highest median time from an ED admit decision, entailing an inpatient bed request, stood at about 115 hours. The shortest reported was 4.7 hours.
The same figures for last month ranged from 70 hours to eight.
This week, Dr Schultz continued to blame poor planning of the acute care wing and emergency facilities, built under a largely undisclosed public-private partnership. It formally opened in September 2014.
“This all relates to the decisions that were made during the final planning phase for construction of the acute care wing,” he said, adding: “I can certainly state that I constantly advocated for much greater bed space and surge capacity in the ED as well as more inpatient beds.
“There is a long trail of paper and electronic documents to verify this claim.”
Dr Schultz cited the two-phase Johns Hopkins Medicine International Report, completed in 2008, proposing upgrades to Bermuda’s acute care capacity as the island looked to build a new hospital.
He noted it initially suggested the island decentralise care with three urgent care centres — at the East End and West End, as well as one centrally located.
“Only the East End Lamb Foggo Urgent Care Centre was ever constructed, and its size was ultimately reduced by a third from the original architectural plans,” he said.
Dr Schultz called the concept unrealistic, saying: “It was just never going to be cost effective or affordable in the long term.”
He added: “So, we are left with a single central healthcare facility, KEMH, Bermuda’s only medical hospital — which is woefully inadequate to provide services for our population in the 21st century.”
May 2026 marked three decades since the landmarkOughton Report on healthcare in Bermuda was published.
The report identified critical structural weaknesses in how the island delivered healthcare, and came with 104 recommendations.
Asked which of its suggestions for long-term care and care co-ordination remained outstanding, the Ministry of Health responded: “The Oughton Report is 30 years old, and its themes have been overtaken by more recent system assessments and planning work.
“Our focus is on today’s priorities for long‑term care and care co-ordination.”
The Gazette also queried the BHB on its data for the long-term care units at the Cooper, Gordon and Perry wards.
The figures for 2024-25 showed stays averaging 637 days at the units, with only 40 discharges in the year — suggesting that many of the 113 beds essentially functioned as permanent placements.
The BHB was questioned on its strategy for patient output, and how many of these 113 patients could be safely cared for in a community nursing home if beds existed.
A spokeswoman said the BHB “recognises that acute hospital wards are not the ideal long-term environment for patients who no longer require acute medical care”, and that each got assessed on admission to determine “their precise level of clinical need”.
She said clinical teams held “meet-and-greet” talks with families to set “clear expectations that the ultimate goal is a safe transition to community social care or, when appropriate, specialised units like Agape House”.
“Clinical assessments indicate that a significant number of our current long-term care patients could be safely and appropriately managed in the community, either within government nursing facilities [such as Sylvia Richardson or Lefroy House] or private rest homes.”
The BHB highlighted a series of challenges, noting that community facilities are frequently operating at maximum capacity, unaffordable to many families and that “system-wide administrative delays” hampered community placements.
“Complex family dynamics” were also cited.
The Gazettereported this week that as part of an effort to boost care options in the community, the Bermuda Health Council is compiling an internal database of privately owned properties potentially suitable for use as residential care homes and nursing homes.
Dr Schultz accused BHB management of “intransigence” in the face of well-known flaws.
Asked when the BHB formally notified the ministry that its boarding situation had reached crisis levels, the BHB responded: “The management of bed capacity and emergency department boarding is a high-priority, heavily monitored operational metric at BHB.
“There was no delay or intransigence in acknowledging or addressing this issue.
“Long before these concerns were raised publicly, multiple internal escalation protocols and strategic workstreams were already fully active.”
The spokeswoman referenced the hospital’s moving to Alert Level 3 twice last year to trigger systemic support.
She added that “comprehensive, multidisciplinary strategies to improve patient flow were already in motion well before early 2026”.
The hospital adopted a Patient-Flow Steering Committee in late 2024 and has tripled its geriatric specialist team from one to three. The BHB said the specialists now review ED admissions to prevent unnecessary hospital stays.
Additional hospitalist teams were said to conduct reviews in the ED during high-volume periods to safely divert suitable patients to community care.
The BHB has piloted a “fast-track clinic” after 4pm in its orthopaedic clinic area to alleviate ED foot traffic, and had begun its clinical overflow unit “prior to recent public comments”, as well as “the safe utilisation of non-traditional spaces”.
In addition, hospital officials were also said to conduct “superuser” reviews for frequent ED attendees.
• For the Bermuda Hospitals Board’s monthly performance summaries this year, see Related Media
You must be Registered or to post comment or to vote.
