Legislation was passed on Friday in the House of Assembly allowing the health minister to direct which data should be collected from healthcare providers.

However, the move was described as “strong arm” and “almost excessive” by the One Bermuda Alliance.

The Bermuda Health Council Amendment Act 2024 will allow the BHeC, “upon the direction of the minister, to require licensed health service providers, licensed insurers, and approved schemes to provide information necessary to support objective decision making with respect to, among other things, universal health coverage”.

Kim Wilson, the Minister of Health, said that one of the principal objectives of the legislation was to allow for the collection of data “necessary for improving healthcare outcomes and ensuring equitable access to services”.

She explained: “The Government relies on the council in fulfilling its services to regulate, co-ordinate and enhance the delivery of health services in Bermuda and to make evidence-based recommendations.

“However, the council does not have all of the legislative authority required to fulfil its role.”

The House of Assembly heard that one of the main issues was the level of copay.

Ms Wilson added: “For many, there is a lack of clarity with respect to both the provider charge and the level of insurance coverage and the result is an uncertainty that can lead to patients avoiding treatment due to the actual or anticipated out-of-pocket expenses.

“The council currently lacks the required data and information needed to assess the factors determining the payments and thereafter making appropriate recommendations.

“Targeting data collection from health service providers is a necessary first step to reveal the drivers of healthcare costs which contribute to the fees or the prices set by those health service providers.

“Similarly, targeted data collection from health insurers and approved schemes would also assist in understanding the reimbursement decisions for insurers and from there a strategy and action plan for government intervention that is specific and progressive can be sought.”

The minister added that the collection of data regarding diagnostic order rates would also support the BHeC’s efforts in identifying any overuse of health services.

She said: “While anecdotal evidence suggests that there is an oversupply and overuse of some health services on the island, possibly driven by financially-vested referrals and self-referrals which contributes to increased health costs, the actual data to inform policy decisions around this is not currently available and monitoring diagnostic ordering rates through legislation will better enable clinically appropriate testing and imaging without impeding patient access to necessary and appropriate care.”

The BHeC’s data collection will be directed by the ministry to ensure that it is targeted and authorised and “a justification that is grounded in evidence will be required to progress each new data collection”, said Ms Wilson.

She added: “The data collection is integral to advancing universal health coverage by providing the necessary evidence to inform policy decisions. We cannot manage what we cannot measure.”

Ms Wilson told the House: “This targeted approach to decision-making will enable policymakers to design and implement initiatives that promote equitable and affordable access to healthcare services which is a key tenant of universal health coverage.”

The minister assured MPs that the amendment followed international best practice and that “stringent protocols” would be implemented to safeguard information including encryption measures, access controls and regular audits.

She added: “Failure by a healthcare provider, insurer or an approved scheme to provide the information or data requested by the council is an offence and could result in a fine of $20,000 or imprisonment or both.”

Ms Wilson said other sections in the Act had the same provision and that it would serve as a strong deterrent.

One Bermuda Alliance MP, Scott Pearman, said his party accepted that health data collection was necessary and should be encouraged.

He told the House: “When the minister says ‘you cannot manage what you cannot measure’, we would say we agree.”

Mr Pearman added: “The Opposition believes that it is wrong to incarcerate people for a failure to provide health data.

“There has been a dangerous trend by this Government to add imprisonment as a penalty to matters that are not remotely criminal in nature.”

He cited the Invasive Alien Species Act which, the MP said, meant someone could be jailed for having the wrong type of plant in their garden.

Mr Pearman added: “Putting Bermudian workers in jail for non-criminal matters is a very, very dangerous precedent.”

The legislation was “overly broad in its scope”, he said, and claimed that its preamble said it could apply to licensed health service providers, licensed insurers and to approved schemes.

Mr Pearman said there was no definition of what an approved scheme was and that the law risked putting individual workers in those sectors in jail which was “simply wrong”.

“That is not appropriate, it is draconian, it is extreme and it is unfair.”

Susan Jackson, the shadow health minister said she believed the legislation was “strong arm, almost excessive”

“I believe it is because the Government is behind the eight-ball and they need to get this information quickly because things are not as they seem.”

MPs voted 18-5 to pass the Bermuda Health Council Amendment Act 2024 and a proposed amendment from the OBA — to remove a potential prison sentence for failure to comply with the law — was defeated.

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