Construction at the hospital has so far injected $35 million into Bermuda’s economy, with $125 million spent so far on construction orders.And Bermuda’s hospitals have picked up high scores overall, from overseas surveyors and the Island’s own patients, according to Health Minister Zane DeSilva.Updating the House of Assembly on funding and performance in his Ministry, Mr DeSilva said that more than 60 percent of the hospital construction workforce consists of Bermudians, or spouses of Bermudians.The workforce averages 90 daily; at the height of construction, that will rise to 250.Noting that construction on the doorstep of the existing hospital posed a challenge, the Minister said impact of noise and dust was being kept to a minimum, with measures such as air filtration inside the hospital, and washing of the wheels of vehicles before they leave the site.Faults in the limestone at the site had required 4,300 cubic yards of backfill, he said, but Paget Health Services would make up for the time lost and the expected completion date would not be affected.Mock-ups of facilities such as a trauma area, ambulance bays and patient bedrooms, have permitted modifications of designs.Equipment purchases are expected to run up $40 million, with “stringent reviews of requests already in place”, the Minister said.Construction at King Edward VII Memorial remains on target for completion in 2014, he said.At that point, the Bermuda Hospitals Board (BHB) must pay project managers Paget Health Services $66.7 million. The BHB has been increasing hospital fees by one percent annually, over five years under an agreement formalised in Cabinet back in 2009, in preparation.BHB has been “relentless” in cost control, Mr DeSilva said.The new Budget’s spending cap of $104 million for KEMH in the coming year “does not mean people will be denied services,” he said. “It’s a paradigm shift. There will no longer be a free-for-all.”The Minister conceded that hospital use for 2011/12 had exceeded estimates.“It’s not overspending, but simply people in Bermuda using hospital services. We’re usually faced with a supplemental payment to cover,” he said. “Historically this has been the way in Bermuda, which was in place well before this Government took office. However, our current economic climate requires great care about costs.”As well as the new cap on the KEMH subsidy, Mr DeSilva noted that during the last year the BHB had piloted a Memorandum of Understanding with a local insurer. With some of the risk transferred onto the healthcare provider, it gave more inventive to the BHB to ensure careful use of funds.Last month, he said, BHB compiled results of a three-year survey that showed patient satisfaction continually rising.Surgical outpatient services were “the only category that slipped”, he said down one point last year, to 94 percent.A survey of KEMH by consultation Accreditation Canada had put Bermuda’s hospitals in line with the top 20 percent of Canadian hospitals. Many departments have also pursued their own accreditation.Nurses have historically been in short supply, he said. Bermuda has 530 registered nurses, and BHB is aggressively courting Bermudian medical professionals from overseas, as well as promoting further training at home.Meanwhile, “fast tracking” incoming emergency room patients since last year resulted in 88 percent of patients getting a hospital bed with in six hours.A new food delivery system had addressed a key problems with patient satisfaction, Mr DeSilva said, with a new kitchen system to be implemented this year.He revealed that once the hospital redevelopment has progressed further there are plans to move the maternity ward next to the Operating Room. This, he said, means that mothers in labour will no longer have to be wheeled through the public corridors and taken in an elevator to the Operating Room. He mooted the prospect of a new birthing centre too, “possibly with a birthing pool,” since one has been requested by mothers in the community.When it comes to the Agape House hospice, BHB is adopting the Liverpool Care Pathway, the latest model of best practice to comfort dying patients and their families, the Minister said.One of the few areas in which Mr DeSilva reported displeasure was the Island’s low rate of blood donation.“My plea has not worked, but I’m going to keep beating the drum,” he said, noting that Bermuda’s total blood donor population of 1,107 was less than half that of comparable western countries.A total assessment of BHB’s information technology has been completed, and electronic health records are to be implemented at both hospitals, the Minister added. The Board is seeking to hire an expert to oversee the procedure.Mr DeSilva said its Queen Elizabeth Nursing Residence is “increasingly unsafe”, and demolition is the preferred option, but due to the recession, BHB believes this can be put on hold.The importance of Bermudian Chantelle Simmons’ appointment as chief of psychiatry at the Mid Atlantic Wellness Institute “can’t be overstated”, he said, especially as MWI moves to the Mental Health Plan based on the recovery model.Assertive outreach teams are now able to visit patients in their homes. Part of this can be seen in the Budget with the allocation of $120,000 for vehicles to outreach teams, he said. The team also attends both Government senior schools to assess students, and a residential team is in place to serve group homes.All 74 of MWI’s resident learning disabled clients, who formerly lived on site at MWI, have transferred to a group home in the past year.During the Opposition reply to Mr DeSilva’s speech, Grant Gibbons of the One Bermuda Alliance expressed concern over what he said would be close to a billion dollars in payments over the course of the next 30 years that Government will make towards the new hospital. The project is being done through a public-private partnership.He said he understood that would save Government some debt service up front and save Government debt’s level from increasing “but I think we are going to pay dearly over the next 30 years for that extension to the hospital.”www.bermudahospitals.bm.