The Government’s promise of healthcare reform has been on the horizon for several years and, although the public have heard soundbites such as “promises made, promises kept”, this essential reform initiative is yet to materialise.

Since about 2011, the Progressive Labour Party has touted the need for healthcare reform and apart from five years when it was the Opposition, it is fair to ask what tangible solutions can the people of Bermuda expect that would bring about significant healthcare reform.

Putting 2011 aside, in 2021 the Ministry of Health established a Universal Health Coverage Steering Committee to develop the road map for strengthening Bermuda’s healthcare system. Despite there being a general update to stakeholders in March 2023, basic questions remain unclear:

• Which entity has been identified to agree the reform starting point?

• The time frame for agreeing the terms to get started?

• Has a financial model been determined?

It is to be hoped that an update on these and other foundational questions will be forthcoming after the meeting this month since several months have passed after the latest update.

A Joint Strategic Needs Assessment Committee was tasked a while ago with reviewing our population profile and the social determinants of health, health behaviour and risk factors, causes of ill health and death, vulnerable groups — including children, the elderly and people with disabilities — and our healthcare services.

Health minister Kim Wilson said that she expected the committee’s work to be completed by early April 2023, so as we are nearing July, what is the status of this group’s findings?

Despite warnings in 2019 by the One Bermuda Alliance and health insurers that the block-funding model would not work and that it would do nothing to address the high cost of healthcare, Ms Wilson said that the hospital would be held “more accountable” in return for receiving funding. How can the public be assured of this when the accountability standard did not even extend to the Government, as it failed to meet its own self-imposed obligations — leaving the hospital short of funds by current estimates of about $15 million?

So the questions are, when did the Government recognise that it would be unable to honour its commitment, and what is it doing about it now to ensure that it meets its full obligation to the hospital in future? Moreover, what will it do to ensure that the hospital meets its commitments as well, particularly as it relates to delivering timely audited financial statements? Perhaps the Government should consider imposing significant financial disincentives to encourage the Bermuda Hospitals Board C-suite to uphold its reporting requirements.

American author Cassandra Clare said: “Making promises you can’t keep is worse than making no promises at all.”

Bermuda does not need more promises for health reform but actionable steps that do more than shift pieces around for short-term effect, which reinforces the status quo rather than dismantles the pieces of a broken system.

Bermuda needs a healthcare system that ensures quality care for all residents, that is affordable, transparent, and sustainable. The Government should proactively keep the public abreast of steps taken towards achieving healthcare reform not only because it helps manage the public’s expectations, but it also helps to keep the Government that works for the people accountable to the people.

• Robin Tucker, a One Bermuda Alliance senator, is the Shadow Minister for Social Development and Seniors