MWI’s outpatient services to expand
Better services for people with special needs will include treatment in their own homes, MPs heard yesterday.
Kim Wilson, the Minister of Health, explained that an additional grant to the Bermuda Hospitals Board of $1.2 million will pay for the development of a team “to support individuals who live in the community, but are not resident in BHB's group homes”.
She said: “The demand for expert assessment and support from people who live in the community is growing.
“Because there has been insufficient community support to meet the people's needs, currently their only option is admission to a group home or long-term unit.
“Improved community support will help people to stay in their homes with their families.”
She added that the money will pay for resources such as clinical psychology, social work, occupational therapy and physical therapy.
Ms Wilson, speaking as she delivered a presentation on her ministry's Budget, said that an extra $350,000 for the Mid-Atlantic Wellness Institute would help cater for the number of community treatment orders expected under new mental health legislation.
She explained: “Community treatment orders are provided to people after an inpatient psychiatric admission under the Mental Health Act.
“It means that they will have supervised treatment after they leave hospital with certain conditions in place. If the conditions are breached the individual can be brought back to the hospital.
“Each new patient placed on a community treatment order under the Mental Health Act requires reviews of treatment and these will require a second opinion of an approved doctor.
“The funds will pay for the increased supervision, training and for the approved doctor to regularly visit Bermuda to provide the required second opinion.”
Ms Wilson said that figures for 2018-19 showed that the BHB cared for about 6,000 medical and surgical inpatients as well as 97 long-term care residents and 102 hospice patients.
She explained that at MWI there were 231 mental health adult inpatient stays and that the total number of child and adolescent inpatient admissions was 33, nearly double the number of 18 in the previous year.
The minister added that 66 intellectual disability and 29 mental health service users were in the BHB's 27 community group homes.
Ms Wilson said: “MWI remains busy. In mental health outpatient numbers, MWI staff saw over 1,700 individual visits, compared to 1,150 visits the previous year.
“Follow-up appointments rose from 6,291 to 7,199.
“Day-patient visits rose from 12,590 to 17,317 and walk-in appointments rose from 12,388 to 14,937. Home visits also rose from 8,010 up from 7,437.
“These numbers are astonishing and we must address them now and BHB is a willing partner in seeking solutions to address them. Our hospitals are susceptible to the same pressures as the Government, businesses and individuals in Bermuda and cannot afford the spiralling health cost.”
She added that increased demand — mostly due to an ageing population, chronic non-communicable diseases and increases in mental health problems — limited the King Edward VII Memorial Hospital and MWI's abilities to “reduce the influx of people in need coming through their doors”.
Ms Wilson explained that from June 1 last year, the portion of funding earlier paid by insurers to meet claims under the Standard Health Benefit was replaced by a fixed payment from the Mutual Reinsurance Fund.
She said: “The total funding from Government was capped at $322 million.”
Ms Wilson explained that the amount was lower than BHB's expenses in the previous fiscal year and that savings of $14.1 million, or 4 per cent, were needed for the board to break even in 2019-20, which was required by legislation.
She told the House: “Through much hard work and a number of improvement projects, BHB had made $13.1 million of these savings by January 2020 and expects to achieve a break even position at the end of this fiscal year.
“After the third quarter of this year, BHB had a loss of $0.2 million based on current revenue for the year with $256.2 million and total expenses of $256.4 million. This illustrates that BHB is successfully controlling expenditure and increases in revenues to counteract the impact of the restricted revenue.”
Ms Wilson added: “BHB is performing better than its budgeted estimates of a net loss from operations of $5 million at this point in the fiscal year.
“This is due to the hard work by staff and managers who have taken responsibility for their budgets and improvements within their departments resulting in greater operational efficiencies.”