Bermuda’s healthcare system is “well above average” for the size of the community it serves, according to an independent team of inspectors.But the consultants also listed a number of areas that needed to be improved at King Edward VII Memorial, including poor facilities, staffing, and a failure by officials to deal with staff and patient complaints.And the Corporate and Clinical Governance Review by Canadian company Howard Associates came under fire from Ombudsman Arlene Brock, who said the company’s report “breezes over the key concerns that led to the report in the first place”. (See separate story.)The company spent five months carrying out an assessment of healthcare services on the Island before submitting its findings to the Bermuda Hospitals Board last month.“We do not know of any other jurisdiction that provides this high level of quality, quantity and spectrum of healthcare services for a comparable small population,” the report concluded.“For those who were expecting a very ‘damning’ report against the BHB, they will be disappointed. Hospitals, as we stated earlier in the report, are difficult to manage. There is much to be grateful for BHB including the new hospital wing currently being built. Having said that, the huge if not enormous challenges voiced by some leading figures in Bermuda of how to pay for this going forward, are also valid.”The report added that the range of services provided at KEMH was “strong and impressive” and added: “In our benchmark comparative, the BHB stands up well under most metrics to other small hospitals that we know well.”But the inspectors went on to list a slew of concerns over standards of care — and also took a swipe at the former board, which was replaced earlier this year by the new Government, for its management of the hospital.Criticising the facilities at KEMH, the report said the hospital “is out of date”.It went on: “There are too many ward rooms. Modern hospitals have mainly private rooms. The rooms are far too small to handle modern equipment. Every room should have a ceiling hoist. We saw very few. Corridors are too small. There is a total lack of storage space for practically everything. Bathrooms are too small. Door openings were made for a different era. There is a lack of space for infection control.”Staff moral at KEMH was “lower than it ought to be”, and the hospital was not “providing adequate staff recognition and staff rewards. The stress on staff ... is very high”, according to the review.The report noted the “lack of clinical, medical and healthcare expertise of the previous Board members”, adding: “Most stakeholders told us the Board has had problems in the past with transparency.”And it highlighted concerns over front line healthcare, with problems in medical and surgical units. It said there was an over-reliance on junior house officers for patient care and “a striking lack of peer review for physicians”.Over the past five years, BHB did not devote enough time, resources or effort to measuring quality or to patient safety. Over the past year there has been a significant improvement in this important function. Despite the above successes, we believe that more work needs to be done and some revised modalities should be implemented. We believe all hospitals must continually strive to improve quality and patient safety and the BHB is no exception.”The report said that “patient and staff complaints are not properly addressed by the current BHB system” adding: “To say that patient complaints fall on deaf ears would be an understatement.”And it concluded by putting forward ten recommendations for improving services, including the need to become more transparent, the introduction of a coordinated clinical service plan, more efficient and effective methods of funding and the better use of middle managers and front line staff.