A consultation on a proposed framework for reviewing significant changes to the island’s healthcare system has been completed by the Bermuda Health Council.

The council, in support of the Ministry of Health, has carried out the work to help inform the ministry’s continued development of the advance review, which would ultimately be subject to the appropriate government and Cabinet approval processes.

Online responses for the consultation totalled 69, while four detailed written submissions were received.

Overall, 91 per cent of respondents supported or strongly supported the proposed approach, the health council said.

There was also strong support for the Government having the ability to require safeguards, modify or delay a proposal, or prevent it from proceeding where significant harm could not otherwise be addressed.

Respondents were equally clear that the framework should focus on changes that could genuinely affect patients or the health system, and should not create unnecessary approval requirements around routine healthcare decisions.

Stakeholders called for clearer rules, practical timelines, stronger clinical input, proportionate treatment of smaller providers and better use of information that the Government already holds.

At its core, advance review is intended to give Bermuda an opportunity to understand the likely consequences of a major healthcare change before it takes effect, rather than trying to manage the impact afterwards.

For example, if significant health insurance premium increases are proposed, the process could provide an opportunity to examine the evidence supporting those increases before higher costs are passed on to households and employers.

The process could also look at whether CIT credits are producing the public benefit they were intended to achieve.

A health council spokesman said: “In a small health system, resilience has to be built before the disruption, not after it.

“We do not always have a second specialist, another supplier or another service ready to step in when something changes.

“The purpose of advance review is not to stop change. Change is necessary in healthcare.

“It is about making sure significant change happens with our eyes open and with enough time to protect patients, manage transitions and address unintended consequences.

“Good policy should give us the opportunity to ask, ‘what happens next?’ before patients are already living with the answer.”

The full report and a summary brief will be made available online.