King Edward VII Memorial Hospital may start to charge for the treatment of road traffic victims and non-residents seeking medical help may pay higher fees under proposed regulations.

The initiatives are part of a drive by the Bermuda Hospitals Board to increase revenue and balance its books.

Health minister Kim Wilson announced the plans in the House of Assembly on Monday during the debate on her ministry’s spending plans for the next 12 months.

The health ministry receives the largest share of government revenues. This year it has been allocated more than $200 million.

Through government grants and other funding, the Bermuda Hospitals Board will receive $334.6 million — an increase of $12.6 million on last year.

Ms Wilson pointed out that the BHB still had to exercise “careful fiscal management” to keep within its budget and was looking to cut costs and increase revenue.

“The BHB has worked diligently to continue to improve the quality of patient care while working within the revenue cap set by Government.” the minister said.

This has not been an easy task in the present economic environment, especially as the BHB no longer has cash reserves and the cost of supplies, medications, equipment and staff continue to rise.

“It has required careful fiscal management and the use of an overdraft facility with a local bank. By the end of January 2024, the BHB had recorded a net loss of $1.2 million — a better position than had been anticipated due to cost savings and government concessions,” Ms Wilson said.

“Net revenue is slightly above budget by $2.8 million and expenses are $13.1 million below budget, highlighting the efforts BHB staff have undertaken to control costs, deferring hiring and maintenance. This will allow the BHB to align spending with funds available.

“The BHB is also looking at different revenue opportunities outside of the government funding and has undertaken an initial review and listed recommendations this year.

“One change will be the move in line with legislation for the BHB to bill people injured in road traffic accidents.

“When the BHB was first moved to the new funding model it stopped billing for all services that are not within a specific section of the fees legislation.

“However, it has since been confirmed by the Bermuda Health Council that traffic accidents should not have been included in the Standard Health Benefit and should be billed separately. This means it will be something the private insurers cover within their premium offerings from this upcoming fiscal year onwards.

“As the BHB is seeking to control revenue costs to the Bermuda population, it is also requesting that the fees paid by tourists seeking healthcare services at the BHB be increased. This requires a legislative update to the fee schedule and is something the ministry will be working on in the upcoming year.”

Ms Wilson said that improved efficiencies could also reduce the length of time some patients stayed in hospital.

The BHB has been gathering data from staff and patients since December under its 100-Day Challenge “to make the journey for patients admitted to hospital more efficient to assure their earliest safe discharge”.

Ms Wilson said: “This journey from admission to discharge is called patient flow and has become a focal area of improvement at the BHB.

“While the initial 100-Day Challenge will end in March its findings and recommendations will help the BHB formulate improvement plans that will run through into the next fiscal year.”

Ms Wilson said that a lack of community services from home care to nurses in placements resulted in patients who were medically fit for discharge having to extend their stay in hospital.

She said: “These people also have complex needs and require external services and sometimes families at home to resolve.

“If the BHB can make minor changes in efficiency and reduce their length of stay by a day or two each this opens much more capacity for patients waiting for beds.

“The 100-Day Challenge is therefore gathering data and listening to staff, patients and their families to identify what the BHB itself can do to be efficient as possible. While this is important for those waiting for a bed, it is also important for the inpatients.”