Health strategy to widen focus to push prevention, collaboration
An eight-point plan was unveiled yesterday as part of the Government’s efforts to improve the health system.
Kim Wilson, the Minister of Health, said the Bermuda Health Strategy 2022-2027 put people at its heart.
She explained: “One of the highlights of the strategy is its focus on the need for greater collaboration among healthcare industry stakeholders.
“We are building stronger partnerships so that together we can find solutions to the health challenges the island is facing, while also ensuring more efficient use of healthcare system resources.
“The strategy also outlines a shift to a more people-centred approach to healthcare with the aim of delivering essential care that meets the needs of individuals and families today and for many years to come.
“It aims to bring about health systems’ reforms that enable people to feel more included in the decision-making process around their health and wellness as well as improving the patient and family experiences as a whole.”
Ms Wilson said healthy living and preventive care were prioritised in the blueprint, which was put together with the help of global health experts at professional services firm KPMG.
She added: “We in the ministry understand that more must be done to empower and support people to lead healthy lifestyles and we are identifying ways to provide greater tools and resources to the public.
“Through public policy and other measures our aim is to make it easier for people to shift their mindsets and behaviours towards making healthy choices.”
The minister said that the eight “core areas” of priority included promoting healthy living and preventive care; focusing on people-centred care; understanding the island’s health needs; and providing universal access to healthcare coverage.
Strengthening the healthcare workforce; harnessing healthcare technology; partnership and collaborative working; and preventing wasteful care as well as promoting efficiencies were also listed.
According to pre-pandemic figures:
• 50 per cent of residents have at least one chronic condition such as diabetes, heart or kidney disease.
• 75 per cent of the population is either overweight or obese.
• One third of residents have either high blood pressure or high cholesterol.
• $29 million is spent annually on dialysis and demand for the service grows by 10 per cent every year.
• Bermuda has the third highest incidence rate of diabetes among Organisation for Economic Cooperation and Development countries, at over 13 per cent diagnosed.
• There are 3.9 people in the workforce for every dependent aged 65 or over. By 2039, this will drop to 1.7.
• Healthcare funding – including premiums, taxes, co-pays or out-of-pocket spending and charities – totalled about $736 million in 2019.
• Average life expectancy by 2030 is expected to be 83.5 years.
Ms Wilson added: “In its current state, Bermuda’s healthcare system is unsustainable.
“In addition to the high costs, which continue to grow year on year, the health of our people is also struggling in many respects.”
She said that 11.55 per cent of Bermuda’s GDP was spent on health — the third largest among Organisation for Economic Co-operation and Development countries.
Ms Wilson added that the island’s health expenditure grew 92 per cent between 2006 and 2017.
She said: “If nothing is done now, it is forecast to grow a further 43 per cent in the next two decades.”
The minister highlighted that it would take years for incremental health reforms to take place.
She said: “This is not a big bang version of transformational change.”
Ms Wilson added: “Included in the strategy is one of the Government’s ambitions to ensure that all people have equitable access to essential, affordable health services through universal health coverage.
“As it stands, up to 35 per cent of the population remains unable to access quality healthcare without financial hardship and this includes those that are uninsured, which is about 12 per cent of Bermuda’s population, as well as those that have defined unaffordable health insurance or are under insured, which accounts for approximately 23 per cent of the population.”
Ms Wilson said that it must be determined what essential care health services will be covered, based on people’s needs and available resources.
She added: “We look forward to working with all healthcare stakeholders including our local doctors, nurses, insurers and our businesses, our union and our community partners to make the necessary changes to better Bermuda’s healthcare system.”
Ms Wilson said that it was too early to say what would be included in an essential services package.
Aideen Ratteray Pryse, the ministry’s chief strategy officer, added: “An important part of starting this work is actually a health needs assessment of the population.
“That’s when you’re able to identify what those high priority needs are and that can then translate into what an essential benefits package ends up being.”
She said: “One of the things that an essential benefits package would likely take into consideration is your primary care situation.
“If someone does not have insurance now then they may be using the hospital’s emergency department as their primary care provider and that’s the most expensive way to receive a health service.”
Ms Ratteray Pryse added that universal healthcare would mean everyone could access essential benefits.
She added that a “mechanism” would need to be in place to cover people who were unable to afford the core package but that it would take time to plan that.
Ms Wilson said that a reduction in health system costs would “trickle down” to residents.
She highlighted that money raised from the sugar tax, introduced in 2018, was used in the Consolidated Fund “and part of that fund obviously goes to health”.
Ms Wilson said: “We are able to utilise that for such things as our health promotion office, which you may see them every now and again, they’re dancing up and down the streets or doing things at City Hall as well as Victoria Park to have workshops and public engagements that are fun as well as promoting healthy lifestyles and healthy living.”
She added: “The last omnibus survey that was done — I don’t have the year but it would have been just prior to the pandemic — showed a reduction in the consumption of sugary drinks by adults, so obviously that’s something that’s certainly a positive impact.”
• An earlier version of this story incorrectly stated that consultant Edward Fitzgerald from KPMG was at the press conference.
* To read the health strategy and Ms Wilson’s comments in full, click on the PDF under “Related Media”.