Bermuda?s healthcare industry is on the cusp of a new era of excellence, collaboration and advancement, according to Bermuda Hospitals Board Chairman Jonathan Brewin and CEO Joan Dillas-Wright.

In an extensive interview with yesterday, the duo insisted the recent Health Summit and the soon-to-be-formed Health Council will signal the demise of the days when health practitioners and stakeholders worked independently of each other ? something which they argue will encourage greater professionalism, better treatment and lower costs.

?The Health Summit was a very important turning point in the evolution of healthcare provision in Bermuda,? Mr. Brewin said.

?It was a terrific initiative because it was the first time, that we?re aware of, that all the different stakeholders and healthcare providers have ever been in one room together, talking about the issues and the challenges that face us. It is the first step towards what will hopefully become a more collaborative approach across the industry while the Health Council will also be a very important piece of the jigsaw.?

And while the hospital itself is often the victim of doom-mongering and derogatory comments about the quality of its infrastructure, the reality is, they argued, that the system is now moving very firmly in the right direction.

A damning report by health consultants Kurron released last May called for wide-ranging improvements, including more stringent financial management and the removal of environmental hazards.

But what was once an organisation haemorrhaging money and propped up by enormous Government subsidies, has registered capital surpluses for the past two to three years ? allowing for significant investment in infrastructure and staffing.

?I think it?s fair to say that the CEO and the management team have done a fantastic job over the last three years in being more fiscally aware,? Mr Brewin said.

?We are now generating surpluses which are absolutely essential because that is the working capital that we can invest back into the organisation to either replace existing equipment or proceed with projects that have been on the waiting list for a long time. If you take the ICU project, it was only through careful management by Mrs. Dillas-Wright and her team which enabled us to generate the finances to fund its construction ? it having been on the agenda for three or four years. But just because we are generating a surplus I don?t want people to think premiums are too high or we?re being paid too much. It?s just part of being a business and we are trying to run the hospital system as such.?

In tandem with what they believe is a growing culture of financial stability, the BHB is hoping to attract greater investment from the corporate sector to further bolster its coffers.

A feasibility study conducted three years ago by potential corporate donors called for greater stability and accountability in the hospitals system ? demands which both Mr. Brewin and Mrs. Dillas-Wright are confident have now been met.

A new cost-analysis computer system, the Charge Description Master, has allowed the hospital management team to pin down the exact costs of every area of medical care and will go even further, they say, towards ensuring unimpeachable transparency.

?The hospitals charge a flat, per-diem rate for all medical provision at the moment,? Mrs. Dillas-Wright explained.

?Whether somebody is treated in the ICU or in the cardiology unit, we get remunerated the same amount for each treatment both from Government and from insurers ? which is not the situation in most other jurisdictions. We have been collecting data over the past six months which will hopefully provide a comprehensive break down of exactly what the cost of medical provision is.?

Both Mr. Brewin and Mrs. Dillas-Wright acknowledge the current hospital building off Point Finger Road in Paget is old and in need of constant attention.

But they expressed some concern at what they see as damaging and unnecessary exaggeration, including Shadow Health Minister Michael Dunkley?s decision to label the hospital?s infrastructure as ?crumbling? during the Budget debate ? language described diplomatically by Mr. Brewin as ?unfortunate?.

The CEO was equally unimpressed with this assessment.

?It?s important to point out that parts of our building were built in the 1940s and so we have little control over that,? she said.

?But what is sometimes forgotten is that we also have some state-of the-art, high-tech areas such as the ICU and the cardiology clinic. So in many parts of our building we have first-class facilities which could rival any other like department in the world. So I would take issue with the word ?crumbling?. If it was crumbling we would not be able to provide services. All you need to do is go down to our ICU, go to our cardiology unit and to the wards and see what excellent facilities are on offer. People have come in and we?ve been able to deliver first-class services.?

Whether or not these facilities can be improved and sustained in the long-term, however, is open to question and will depend on the recommendations of the soon-to-be-published Estate Master Plan ? a long term strategic plan for the hospital being developed by overseas consultants ? which is expected to advise the construction of a new hospital within the next 15 years.

Pressure on bed space is another issue currently facing the BHB, with Mr. Brewin conceding that far too many patients who could legitimately be treated at home or day clinics are unnecessarily occupying beds in the acute treatment wards.

?We do face challenges because 30 percent of our acute beds are being used up by patients who really should be out in the community,? he said.

But soon-to-be- announced initiatives recommended by consultants, as well as a number of schemes currently on line such as the home care programme ? which will see hospital staff treating the elderly and infirm in the comfort of their own homes rather than at the hospital ? will ensure significant strides are made to relieve pressure on beds.

The emergency ward, meanwhile, last year treated 31,000 patients ? a number they both believe has to be reduced by encouraging the community against using the facility as a day clinic for the treatment of only minor ailments and persuading a greater number of GPs to offer their services out of hours.

The recruitment process at the hospital is also an ongoing concern, they said, with the BHB required to balance the desire to recruit from the local workforce with the stark reality that overseas specialists are vital in ensuring the hospital provides a broad cross section of top-class expertise.

?There is a huge commitment by the board and other organisations that are putting in place scholarships and training and development programmes,? Mr. Brewin said.

?We work closely with the Bermuda College and there is a fundamental need for us to increase awareness of the number of career opportunities that exist within the hospital. We have to be cognisant of the fact that we will never generate the quality of expertise here that we will need and therefore an allied focus must be put not only on making sure we recruit staff but also dilute the level of turnover which is currently far too high at 20 percent. We are challenged by cost of living in Bermuda ? people will not come here to work now simply because we have nice beaches. They?re being enticed by all sorts of other benefits around the world and it is up to us to remain competitive.?

Together with ?exciting? technological innovations such as telemedicine, an online resource which connects local hospitals with specialists around the world and allows for easier sharing of ideas and expertise, they are adamant the healthcare industry in Bermuda is about to turn the corner.