The health minister has said she has “grave concerns” about the financial impact of Covid-19 on the healthcare system.

Kim Wilson warned that there was a risk that the Bermuda Hospitals Board would “not be able to sustain its existing service nor undertake critical investments that are vital for the safe ongoing delivery of care”.

There was no change on the last financial year for the hospitals allocation of $147.25 million in the Ministry of Health budget.

But Ms Wilson, speaking at Wednesday’s sitting of the House of Assembly, highlighted that the BHB had spent $17 million of its cash reserves in the last financial year.

She added that the remaining BHB cash reserve was about $28 million.

Ms Wilson said: “While there are grave concerns about the financial impact of the pandemic on the hospitals, the response to Covid-19 and the needs of our community have shown BHB at its best.

“It however, has had a major emotional toll on its workforce.”

Ms Wilson said that hospitals had “transformed service delivery and operations in order to keep patients and residents who are highly vulnerable safe while continuing to deliver on its mandate of caring for the community”.

She added: “The long-term affordability of services for the community was a key concern in the BHB’s attempts to make savings.

“The pressure of increasing healthcare costs led to the development of a financial recovery plan prior to the pandemic.

“The pressures experienced in this fiscal year have meant deeper savings had to be made – BHB’s reserve is declining.

“This year it had to be used to secure Covid-19 related supplies, especially personal protective equipment.”

But Ms Wilson said the ministry was committed to the transformation of the island’s healthcare system through the Bermuda Health Plan, designed to supply equitable access and control costs.

She added: “Bermuda’s current health system is at a breaking point.”

Ms Wilson said an integrated health service delivered by a single-payer mechanism remained the focus of the plan.

She added: “These services will contribute to improved health outcomes and greater resiliency in times of disaster.

“This patient-centric approach enables Bermudians to get the care they need, when they need it and to have quality of care at a fair value.

“It is intended and anticipated that the integrated service model will reduce duplication, enhance information sharing and realise synergies, efficiencies and economies of scale that cause savings to be realised.”

Michael Dunkley, the shadow for the health and national security ministries, said health was a critical sector and the pandemic had highlighted how important its work was.

He praised the healthcare staff who had been on the front line of the coronavirus battle for the last year and appealed to the public not to give in to “Covid fatigue”.

Mr Dunkley said: “Clearly, as we head forward into the coming months, if we let down our guard, if we take our eye off the ball, we will have some challenges that we could avoid.”

He raised questions about the travel authorisation fee, which raised $3 million last year and is expected to raise $4.2 million in the next financial year.

Mr Dunkley queried how long it would last and how the estimated figure was arrived at.

Mr Dunkley also said he was “alarmed” by the lack of annual reports from the BHB.

He added that the most recent report was from 2015 and also questioned the use of sole-sourced contracts in the ministry.

Ms Wilson said that sole sourced contracts were now going through the tendering process to “regularise” them.

She added the initial sole sourcing approach was adopted as an emergency measure because of the need for rapid action to combat the pandemic.

Ms Wilson said that 2016 and 2017 BHB audits had been completed and approved by the board and 2018’s audited report will go to the board next week for approval.

She added that the travel authorisation fee would remain in force “until Covid-19 ends”.

The Minister said a “stoplight” system for immunised travellers – similar to the scheme for non-vaccinated travellers – would be released today and a vaccine passport programme was expected to be completed by “around May”.