Politics is the most challenging aspect of running the Island’s hospitals, according to Herman Tucker.“It’s trying to understand the political viewpoint while at the same time making sure the vision and the goals of the organisation are not compromised and go according to our plan,” said chairman of the Bermuda Hospitals Board Mr Tucker, when asked to explain the challenges of being appointed by a politician.“That interface is important and politicians as we know, they see things from a different viewpoint sometimes. And the trick is trying to make them see the rationale behind whatever it is you are trying to present.”The late Nelson Bascome was his favourite Health Minister, Mr Tucker said because of his background in health and his decisiveness.“He had a vision, he spoke our language and he understood. And it’s Nelson’s vision why we have this [new hospital project] today,” said Mr Tucker.Government had all but shelved the controversial project to build the new hospital by the time Mr Tucker took over the Chairmanship.Besides the public uproar over plans to site the facility in the Botanical Gardens, the hospital was contending with a host of internal issues all of which conspired to push plans for the new build to the bottom of the priority list.“Nelson came in about three Ministers later during my term, and in my very first meeting with him he asked ‘What about the new hospital?’,” he said.Mr Tucker had asked the same question when he was first appointed in April 2007 with no ready response from the political masters.“He said ‘But don’t we need a new hospital?’. I said ‘yes but no one wants to touch it right now’. He just looked at me with his little smile and that twinkle in his eye and he said ‘well, I want a new hospital’.”The ongoing project to build the $250 million hospital is one of the major hallmarks of Mr Tucker’s tenure. Despite concerns about the PPP model used for building public facilities, he says he is satisfied that the right approach is being taken, as BHB had consulted with experts who had experience in Public Private Partnerships.“We made a very good decision to hire the right advisers from the outset in order to give us good advice on how to avoid the pitfalls and how to set this up.”Mr Tucker ends his tenure as Chairman of the Bermuda Hospitals Board at the end of the year, after almost five years a tenure which makes him one of the longest serving Chairs in recent memory.In that time he’s had five political bosses, starting with Phil Perinchief and ending with the current Health Minister Zane DeSilva. But he was lucky to have the same Permanent Secretary Warren Jones for four of those Ministers.“He was a very good PS. He understood the issues and he could help us manoeuvre what we were trying to do through the Government system.”Mr Tucker is also proud of the fact that all of the BHB’s audits are up to date and unqualified “and we have sufficient surplus in order to fund our improvements”.He leaves the hospital a much more Bermudian-led organisation 80 percent of the top level executives are now Bermudians, as compared to just 50 percent when Mr Tucker came into office five years ago.That’s the result of a concerted effort to institute a recruitment and development programme targeting locals.“I believe it’s created a culture, at least among the Bermudians where they feel that they are valued as much as anyone else,” he said.“And their talents and their skillsets are recognised. And if they have the right talents and the right skillsets they would succeed in this organisation. Whereas prior to, there was this sense that maybe that wasn’t the case, and that they would always go overseas to look for a CEO before looking in-house.”BHB has also been searching the world for Bermudian physicians, hoping to lure them back home to work at the hospitals. Under Mr Tucker’s tenure, the number of Bermudian doctors at the hospital has increased by ten and the BHB is keeping a close eye on the 30 or so Bermudian medical students overseas.Access to quality care at home and overseas has improved as well, says Mr Tucker. Not only did the hospital gain unconditional accreditation from Accreditation Canada but it also has a series of formalised relationships with overseas facilities such as Johns Hopkins and Howard University.Importantly, BHB has seen strong improvements in patient satisfaction. Ratings for the in-patient services, which are collected by a third party for the hospital, had improved from 68 percent in 2009 to 87 percent in 2010, Mr Tucker shared.Policies such as “service excellence training” and “nurse rounding” which requires a patient to be seen by a nurse at least hourly are responsible for such improvements.“It is treated as a political football,” he said of his disappointments. “There’s a lot of political rhetoric from both camps who don’t actually know or understand the realities and the issues.“And that’s fair enough because they are politicians but I wish they would consider the consequences of the things that they say and the impact that it has on the organisation in terms of the people that work here and are working very hard to deliver a good service and the impact and perception it leaves with the public.“Because it’s very easy to stand up and make an accusation or say something that is half truth or an outright lie.”Asked for examples, he noted that politicians had questioned why the hospital was making a surplus and once suggested that key players at the hospital were “lining their pockets”.“The hospital is making a surplus because it needs to make a surplus in order to reinvest. Any hospital that is not making a surplus, you’ll find a facility that’s deteriorating it’s not reinvesting in its equipment, in its people.”But he acknowledged criticism that there were no plans to provide a long term care facility at the new hospital.“That would be another category of ‘work to be done’. We’ve started the process and studies have been done,” he said.“Long term care and Continuing Care do not belong in an acute care facility which is what it is. So there’s still work to be done and the BHB will probably play an integral role.”Another difficulty has been the challenge to find and keep oncologists, due to their high demand and short supply, something that the Opposition has had a field day with.“I know the Chief of Staff’s office has really been trying. But it’s been a challenge just finding the right people, getting them to come and getting them to stay,” said Mr Tucker.“So, it’s easy for the Opposition to jump up and down and criticise. And they’re right to a certain degree. And it’s our job to fix it. We take responsibility for that.”The Ombudsman’s systemic investigation into racism at the hospital was one of the early issues that Mr Tucker had to deal with. “I found it credible,” he said of the report ‘A Tale of Two Hospitals’. “I had some insights before I came, as to what was going on. But there were 15 recommendations in there and we addressed them. And they were difficult ‘legacy’ issues.”Asked what he thought was the most important message for the public to understand about the hospital, Mr Tucker was quick to stress that KEMH offers a high standard of care.“The standard of care, as attested to by the fact that we’ve had an unconditional accreditation which put us in that top 20 percent of hospitals in Canada, the service and level of care here is very good. Does that mean we don’t make mistakes?“No. Because every hospital does. Does that mean we don’t have negative events? No. But a lot of people come into this facility and get very good care. But they don’t say anything about it.”And if he could change just one aspect of the hospital?“I would somehow try to find a way for the hospital to have more autonomy. Accountable to somebody if we go off the rails, but more autonomy to do the things we need to do without the political agenda.”