Continued from Saturday's newspaper In the House of Assembly Budget debate on Friday Health Minister Clarence Terceira went into detail about sections of the Ministry including the Department of Health which looked after issues including prevention, environmental health and nutrition.

There is also a schools programme and Dr. Terceira said it was expected to play a role in addressing sexual behaviour and drug taking.

Shadow Health Minister Renee Webb said the Ministry accounted for 20 percent of Government spending and the amount would increase unless more emphasis was put on prevention.

Greater emphasis could be put on helping parents and therefore keep children out of care, the spread of AIDS and the recidivism rate.

"The Ministry's costs will continue to rise if we do not address the social ills of this society,'' she said.

The department's staff was doing a good job, but Ms Webb asked whether the message about AIDS was getting through to children following a recent survey showing 50 percent of teenagers questioned said they did not use protection during intercourse.

Ms Webb said some far-reaching recommendations resulted from the health care review.

"Even if some of the recommendations are put in place we would be happy to know Government is moving into the 21st Century.'' Government backbencher and former Health Minister Harry Soares said prevention was the way forward.

And it was important to impress on youngsters what was required for good health.

"We in Bermuda are well served by the health care system,'' he added.

Another Government backbencher Grace Bell underlined the need for people in the community to take responsibility for their own health.

"In the future we expect the world's population will be older and in much better health.'' She went on to express concern that obesity would be one of the scourges in the millennium -- unless dealt with now.

Dr. Terceira turned to the Department of Child and Family Services.

He said $7,240,000 had been allocated to this department, representing seven percent of the Health and Social Services Budget.

The department now comprised the Child Development Programme, the Day Care Centre, Family Services, the Residential Services and Probation Services.

"Early intervention and prevention services are being enhanced, and counselling is being reestablished as a top priority.

"The department is working closely with several Government departments and the National Drug Commission to augment and improve delivery of services to children in Bermuda.'' Dr. Terceira said the Attorney General's Chambers was assisting this department to update legislation affecting children to afford them the proper care and protection.

The Child Development Programme identified specific developmental needs of children and offered appropriate services, Dr. Terceira continued.

It was also aiming to become more family focused.

And it had revamped data collection and needs assessment to ensure parents were more involved in the decision making process that identified and prioritised service needs for the child and the family.

"The language screening process has been revised to be a more sensitive tool and to enhance the accuracy of the screening results.

"This is now being piloted. More computers have been made available so that staff can readily input and retrieve data and supervisors can more efficiently and effectively manage programmes under their direction.'' Dr. Terceira said the Child Development Programme provided screening and services to about 66 percent of Bermuda's two-year-olds.

The remaining 34 percent were unable to be located or the parents refused services.

Now ways were being examined to reach even more of Bermuda's children.

Turning to the Day Care Centre, Dr. Terceira said the programme provided care for 42 children between three months and four.

He said the PTA played a strong and active role in getting more parents involved in the programme.

In 1997/98 the Centre would change its name to the Happy Valley Child Care Centre, added Dr. Terceira.

"The Centre will also offer a series of workshops for parents entitled `successful parenting'.'' Dr. Terceira said the Department of Management Services had completed its review of Family Services.

Five new staff positions had been developed to address the major increase in case loads and the need for specialised responses in the area of care and protection of children.

In 1997/98, these additional would allow Family Services to be reorganised to provide three distinct response units -- Intake, Foster Care and Intervention units.

The Intake Unit would have staff trained to assess and respond to various types of allegations of child abuse.

The Foster Unit would supervise the care of children in foster homes and work with parents and foster parents to return children to their home environment at the earliest possible opportunity.

The Intervention Unit would permit a greater level of support to sustain families and prevent family breakdown, said Dr. Terceira.

Dr. Terceira said Probation Services had been reorganised following a review by the Department of Management Services.

"The staffing complement has been increased by two posts -- a Probation Officer and a Senior Probation Officer.

"Services are delivered by two specialist teams -- Assessment and Supervision Teams.

"The Assessment Team provides reports to the Court and Treatment of Offenders Board. This team has redesigned the Social Inquiry Reports to be more comprehensive and has instituted a management process to ensure consistency in the quality and content of reports to the court.'' Dr. Terceira said residential care was provided for older children between the ages of 12 and 17 who were at risk and deemed by the court to be in need of institutional care.

"Through individual and group counselling we provide support and assistance to residents to help them address issues related to their home, school and community life.'' In 1997/98 the Department would continue plans to transform the programme and change its focus from mainly custodial care and protection to therapeutic intervention.

"Adolescents coming into the programme, generally are physically and verbally aggressive, drug users, truants and delinquents.

"They may have been traumatised by verbal, physical and we suspect sexual abuse.'' Switching to the hospitals, Dr. Terceira said the grant for King Edward VII was expected to be about $36.5 million -- up $1.9 million, or about 5.5 percent, over the original estimate of $34.6 million.

"The projected increase will be required to fund the increased cost of providing subsidised care for the elderly who are occupying more beds than was originally projected.'' The 1997/98 estimates, continued Dr. Terceira, also provided for a $17,303,000 grant to St. Brendan's, which was up $1.1 million over the original estimate of $16,205,000 for 1996/97.

Ms Webb said Child and Family Services was one of the most important department heads.

She emphasised the need for it to be adequately resourced, because the department was key to the future of Bermuda.

Ms Webb added: "We should look at the possibility of trying to keep children in foster care within the family units...'' She went on to suggest two ways to ease pressure on King Edward VII Hospital.

Government should certify more private homes for the elderly and subsidise people to be in private care, she said.

This would save the taxpayers a lot of money because a number of beds at King Edward VII were currently being occupied by old folk.

Ms Webb also said the hospital emergency department was being used as a doctor's office.

People should be encouraged to go to their doctors instead.

Government backbencher Maxwell Burgess turned the focus on teen pregnancies.

He wanted to know what the extent of it was.

Shadow Human Affairs Minister Ewart Brown joined Ms Webb in asking what happened to the Bermuda Ocean Surgical Society (BOSS) scheme -- a plan to provide cosmetic surgery services.

He also voiced concern at the number of Bermudians who did not have health care insurance.

And he said something needed to be done about the improper use of acute beds at the hospital.

Dr. Terceira moved on to the prisons and senior training schools, saying $12.04 million had been allocated to this head for 1997/98.

This represented 11.97 percent of the Budget for the Ministry of Health and Social Services.

Dr. Terceira said there was a gradual increase in the number of people incarcerated during most of the year with a daily average of 303.

"This sustained increase has put considerable pressure on our ability to house the additional inmates according to their classification.

"In order to provide Westgate with a little flexibility, last year the beds at the Prison Farm were increased by 50 percent, raising it's capacity to 96.'' During the year 419 people were admitted to prison, said Dr. Terceira.

He added a wide range of programmes continued to be offered inmates.

"Participation in educational and vocational programmes continues to present a challenge, but there is increased participation in the support services and social skills programmes.'' Dr. Terceira said the new senior prisons psychologist took up his post in October.

And since his arrival he had evaluated all psychological and social work services.

Ms Webb complained that she had only been given five minutes of the four hours allotted to debate the Health Ministry's budget which had the effect of cutting the Opposition out of the debate.

Nevertheless, she said the prison budget had not increased although the taxpayer was paying $40,000 per prisoner.

There was also a lack of programmes to help make them productive people.

Moreover, she said that the programmes that do exist should be made mandatory because not enough prisoners participate.