And Bermuda Hospitals Board (BHB) chairman Jonathan Brewin and chief executive officer Joan Dillas Wright said they had also rejected the idea of out-sourcing services, which was recommended in the report.

And Ms Dillas Wright also said the hospital's estate master plan ? which may involve the blueprint for a new hospital ? is close to being finalised.

"We have been short-listing from the eight submissions we received and we shall be selecting very soon," the CEO said.

The operations review, carried out last year by US company Kurron Shares of America and commissioned by the Ministry of Health, was released in a summarised form last month.

The consultants, who have a track record of improving struggling hospitals' bottom lines through cutting jobs and services, highlighted inefficiency in Bermuda's hospitals and claimed that $9.3 million could be saved annually.

In its productivity analysis, the report summary states: "Based on detailed analysis of every department, there is an opportunity to right size staffing levels and achieve savings of approximately $7.8 million."

Mr. Brewin told the that if a reduction of the 1,200-plus workforce took place, it could be achieved without compulsory redundancies. On the question of reducing the workforce, it's too early to say whether we are going to be doing that," said Mr. Brewin.

"But we have a considerable turnover of staff ? too high in fact ? so any changes made will be made through natural attrition rather than in an enforced way."

Mr. Brewin and Ms Dillas Wright said they were working on implementing all but ten or 15 of the Kurron report's 250 or so recommendations.

Out-sourcing services like laundry and food was one of the recommendations considered inappropriate for Bermuda, as was Kurron's proposal to appoint an external chief restructuring officer to oversee necessary changes.

"The Board felt that it would be better for us to deal with changes internally," Mr. Brewin said. "We have already proved ourselves capable of affecting change and we would like to continue that process."

Since the report summary was tabled in the House of Assemby on May 7, management and staff of King Edward VII Memorial Hospital and St. Brendan's Hospital have met to discuss the findings and the way forward. The process has been smooth, according to Ms Dillas Wright.

"The fact that we have had a few open meetings so the staff know what the recommendations are has led to a greater confidence among the staff as well as the management," she said. "Being transparent and being involved with the staff has led to a greater element of trust."

Hospital workers have also got a direct conduit to air their views to senior management through the Staff Relations Committee.

To deal with the report's recommendations, the BHB in January set up a task force, headed by Finance Committee chairman and former Accountant General Anthony Richardson.

They have been working on a spreadsheet itemising each necessary change, detailing who will be responsible for making it happen and a deadline for when it must be done. The target is for all changes to be implemented by the end of next year.

"One of the main themes is accountability," Mr. Brewin said. "Our managers will be held accountable for seeing through these improvements.

"We will be forming committees to ensure that these changes are made in different areas and it's important that these are not just talking shops ? they will ensure that things get done."

Overseas consultants with expertise in health care will be brought in to help with implementing specific recommendations.

The Kurron report was scathing about the hospital administration saying there was a lack of leadership under former CEO Stephanie Reid, a lack of communication between managers and staff, and a lack of relevant knowledge among managers.

"I did feel some parts of the report were a bit personal," Mr. Brewin said.

Ms Dillas Wright said the hospital said operation reviews were standard procedure and she welcomed the opportunity for the hospital to aspire to a higher benchmark.