Bermuda’s healthcare legislation is outdated, said the head of the Bermuda Health Council.

BHC chief executive Ricky Brathwaite was also concerned about Bermuda’s antiquated healthcare databases and called for better digitisation.

Speaking in a panel at the Bermuda Chamber of Commerce’s annual general meeting, Dr Brathwaite said Bermuda’s healthcare legislation badly needed upgrading.

“We have acts from the 1970s,” he said. “The intent was great but we have learnt so much over time. Because our legislation has not kept up, we cannot keep each other accountable. The legislation does not allow us to do so.”

He told The Royal Gazette about several pieces of legislation that needed attention, including the Health Insurance Act 1970.

“It would need updating if we did have universal healthcare coverage progress,” he said.

He also mentioned the Pharmacy and Poisons Act 1979; Bermuda Hospitals Board Act 1970; and the Bermuda Health Council Act 2004.

“The list actually goes must further,” Dr Brathwaite said. “A large majority of the health-related legislation needs holistic reviews and updates to ensure alignment”.

He said the legislation needed to match the strategies that were put forward to improve the population’s health.

“It needs to ensure a sustainable health system in the face of an ageing population, different economy and different global outlook,” he said.

The panel discussion held at the Hamilton Princess & Beach Club on Tuesday focused on universal health coverage for Bermuda.

Dr Brathwaite said having a healthcare system that was based on income was problematic.

“During the pandemic, one of the things that we saw was the dynamics of unemployment, leading to impacts on healthcare funding,” he said.

“If you cannot guarantee that employment is going to happen, then you also cannot guarantee the contributions to the healthcare system.”

He said universal health coverage would create better cost management.

“It would reduce overall patient risk profiles,” he said.

He also said it would push the insurance industry to find more creative and effective solutions beyond the essential benefits.

“It should push innovation,” Dr Brathwaite said. “It will most likely require a review of the fundamentals of health insurance theory for the local market.

“For example, we go against theory having such small insurance pools, so universal health coverage and the implications that come with consolidating some of the benefits, will cause the industry to look at how their businesses are run for such a small population.“

Dr Brathwaite questioned why Bermuda has five separate major insurance companies for a population of 60,000 to 64,000 people.

“There is also a need for more data around local healthcare so we do not repeat the mistakes that we have made before,” he said.

“We need to have ongoing adaptability. We need to be able to change our actions on a regular basis to refine our universal health coverage tenets and use the data that we have.”

Dr Brathwaite asked the Chamber of Commerce to increase pressure for more digitisation of the island’s healthcare systems.

“We are in 2024,” he said. “Yet, a lot of our inability to get data that we can use to govern with, is because our systems are antiquated.”

He said doing that would help get Bermuda’s healthcare systems up to date and save money on the decisions that were made.