The Ministry of Health is to carry out a population survey to establish public health priorities during this legislative session while also trying to rein in co-pay medical costs.

Rena Lalgie, the Governor, said during the Throne Speech on Friday that the Steps 2024 survey was to be conducted in an attempt to prevent chronic, non-communicable disease.

She said that the legislature would consider a Bill to support data collection to control medical co-pays, which would play a crucial role in achieving universal healthcare.

Ms Lalgie highlighted a 2023 report by Ayoola Oyinloye, the former chief medical officer, which referenced the four major risk factors common to the leading chronic diseases — tobacco use, excessive alcohol use, poor nutrition and physical inactivity.

Ms Lalgie said: “There is evidently a requirement for further evidence-based policies to address these risk factors, particularly for the most deprived, who are likely to be at greatest risk.

“The Ministry of Health will undertake the Steps 2024 population health survey to provide that evidence and establish public-health priorities, tracking the trends and magnitude of these risk factors and leading the fight to prevent chronic non-communicable diseases.”

Mark Selley, chairman of the Bermuda Healthcare Advocacy Group. founded in 2012, said: “I’m not overly impressed with what was said in the Throne Speech but I’m glad it has come to the fore again. It’s good but let’s act on it for once – let’s get the results and the resolve. The follow through is as important as the survey.

“We need to fix why we have these problems. We definitely need the survey but then we need to act on it.”

The Steps survey uses the Pan-American Health Organisation’s approach to chronic diseases risk factor surveillance and was carried out in Bermuda in 2014 and 2019.

It includes a face-to-face interviews, physical measurements and biochemical measurements, where as previous reports had been based on self-reporting.

The 2014 survey gathered data from 1,000 families, including information about the four risk factors.

It found the common non-communicable disease risk factors of poor dietary habits, physical inactivity, and overweight and obesity, were “all too common”, including that three in four people were overweight or obese.

It recommended Bermuda: “Build healthy public policy; create supportive environments; strengthen community actions; develop personal skills; reorient health services; and build alliances” and concluded it was “essential the risk factors are addressed in alignment with the vision of the Department of Health — healthy people in healthy communities”.

Ms Lalgie said the Bill to support data collection to control medical co-pays would come with new healthcare service coverage.

She said: “This critical step on the journey towards universal healthcare will be accompanied by the establishment of the core healthcare services to be included in a universal healthcare benefits package for all residents and a full assessment of the demand and cost to deliver those core services.

“Access to essential, quality health services without suffering financial hardship is key to ensuring improved preventive care.”

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Mr Selley said that administrative bureaucracy and inefficiency was causing wastage, that the cost of healthcare for the patient was unaffordable and “co-pays are out of control and inconsistent at the bottom end”.

He added: “Somewhere in the middle of all that is a solution. The procrastination is not helping the Government at all.

“It is time for a complete harvesting of the whole healthcare system — not just insurance, which is one small conduit. If it is not being double and tripled checked at the point of payment, nothing is going to change and costs will go sky high.

“There are not enough checks and balances in place especially in the area regarding [bill] coding and point of service procedures — there is no consistency.”

Key legislation is pending to allow the Bermuda Health Council to collect details on what health services are being used the most to enable the regulation of “the cost of certain co-pays for the vulnerable”.

Health minister Kim Wilson told The Royal Gazettelast month that core questions remained over the Government’s plan to implement universal healthcare, including how it will be paid for.

A “phased introduction” of core care benefits, starting with the basic benefits package for all is expected to begin in 2025.

Ms Wilson said a national digital health strategy would also create savings from erroneous duplications of service to patients “shopping around” from doctor to doctor.

The Bermuda Hospitals Board declined to comment on the Throne Speech. It said: “Public health is the purview of the Office of the Chief Medical Officer”.